A biological tissue adhesive and dissolvent system for intraocular tumor plaque radiotherapy: an in vivo animal model experiment.

PURPOSE: To examine a novel biological adhesive and dissolvent system for plaque placement and removal using fibrin glue and urokinase, respectively, in an in vivo animal model. METHODS: The study was performed on 23 rabbit eyes. Of these, eight underwent a technical feasibility study and ultrasonographic plaque displacement measurements, nine were examined clinically and by magnetic resonance imaging and histopathology for tissue reaction to the biological substances used, and in six the impact of fibrin glue as an orbital space occupier on intraocular pressure was assessed. In an additional ex vivo experiment, the glue's radiation attenuating properties were tested using an oncology EDR2 film. RESULTS: Plaque horizontal movement throughout follow-up (7-10 days) was negligible (0.5 ± 0.2 mm), and there was no tilting whatsoever. In the tissue response experiment, no adverse effects were recorded after application of fibrin or urokinase throughout the 21-day follow-up period. Interestingly, a circumscribed local inflammatory response was noted in tissue surrounding the fibrin glue, and persisted at 21 days. In the orbital space-occupying experiment, application of 1 cc fibrin glue did not cause a significant elevation in intraocular pressure (IOP) (P = 0.06), and in the ex vivo experiment, there was no significant difference between radiation readings with and without glue separation of the radioactive sources and film (P = 0.065). CONCLUSIONS: The adhesive and dissolvent system was feasible and safe for plaque placement and removal. It may be superior to conventional surgical plaque placement methods in eliminating the relatively common risk of plaque tilting and complications due to scleral suturing.

Periocular pilomatrixoma: a retrospective analysis of 16 cases.

PURPOSE: Pilomatrixoma is a benign tumor of the hair follicle, occurring more frequently in the head and neck. There are relatively few published large case series in the ophthalmic literature. The purpose of this study was to evaluate additional case series of patients with periocular pilomatrixoma, treated in the institute from 1995 to 2011. METHODS: A retrospective analysis of all cases with periocular pilomatrixoma treated during 16 years was made. Data were collected regarding the age at the time of excision, gender, tumor location, tumor dimensions, suspected clinical diagnosis before biopsy, gross appearance, histopathological features, treatment, recurrence, and other syndromes related and family occurrence. RESULTS: Only 16 cases with pilomatrixoma were treated during 16 years. Most of the cases (69%) presented in the first 2 decades of life with female predilection (62.5%). The most common affected site was the upper eyelid (62.5%). All patients were asymptomatic. Various diagnoses were suspected clinically prior to surgical removal and histopathological confirmation of the tumor, and only in 18.75%, pilomatrixoma was suspected. Simple resection was carried out in all cases. No recurrence or malignant transformation was reported. CONCLUSION: Pilomatrixoma is a relatively infrequent periocular tumor, which isn't usually recognized clinically. The findings of the current case series, which is one of the largest published thus far in the ophthalmic literature, are in concordance with the other series of pilomatrixoma, confirming the epidemiologic, clinical, and histopathological features of this tumor in the periocular region.