Finger’s Slotted Eye Plaque for Treatment of Tumors Touching or Surrounding (Circumpapillary) the Optic Nerve

Finger's Slotted Plaque: Example 1
Finger’s Slotted Plaque: Example 1

Dr. Finger invented “Slotted Eye Plaques” for treatment of juxtapapillary and circumpapillary intraocular tumors. Standard COMS-type gold eye-plaques were altered such that an 8-mm-wide (variable length) slot was created to accommodate the orbital portion of the optic nerve. As the nerve entered the slot, the plaque’s posterior margin extended beyond the optic disk as to cover tumor (on the opposite side). Radioactive seeds around the slot, surround the tumor and its posterior tumor margins.

Dr. Finger says, “due to the physical limitations of notched plaques, there was no plaque device that could extend to cover and treat the posterior portion of a tumor that came within 1.5 mm, touched or surrounded the optic nerve.” This is why Dr. Finger invented slotted eye plaques. Intraoperative ultrasound imaging is used to confirm proper plaque placement. Preoperative radiation dosimetry showed that all tumour-tissue received a minimum of 85Gy (despite the gap created by the slot). To date, there has been only one tumor regrowth which is much better than previous plaque treatments for these tumors. No new complications that might prevent the use of slotted plaque radiation therapy have been noted.

Graphic Animation of a Slotted Plaque in Position over a Circumpapillary Tumor

Dr. Finger says, “slotted plaques represent an innovation that improves radiation coverage for tumors that touch or surround the optic nerve. For the first time, this technique allows plaque radiation therapy to include the entire juxtapapillary and circumpapillary tumor within the treated zone. It “normalizes” plaque treatment of these tumors. He adds, this technique addresses the problems some centers were having with local control of tumors in this location. Certainly, it will allow more patients to keep their eyes and their vision.”

For more complete information read these manuscripts published in the British Journal of Ophthalmology and Ophthalmology in 2012 or contact Dr. Finger.

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