Ipsilateral Eyelid Disorders Following Ocular Brachytherapy
Author: shiran madgar
Base Hospital / Institution: sheba medical center
ePoster presentation
Abstract ID: 24-366
Purpose
Brachytherapy for intraocular tumors may lead to long-term ocular sequelae, including keratitis, radiation cataract, neovascular glaucoma, retinopathy, and optic neuropathy. Although these ocular complications have been extensively documented, the effects on the adjacent ocular adnexa remain underreported. Our study aimed to explore the development of ipsilateral eyelid disorders (IED) in patients who underwent brachytherapy.
Methods
A retrospective cohort study including all patients who underwent ocular brachytherapy between 2009-2023 at a single tertiary center. Data regarding tumor and brachytherapy characteristics and oculofacial exam was analyzed. The main outcome measures were the associations between brachytherapy and acquired IED.
Results
Included were 226 cases, 117 females (52%), mean age 63±15 years. The left eye was involved in 113 cases (50%). The tumor type was malignant melanoma in all but four cases, and included choroidal melanoma (n=181, 82%), ciliary body (n=31, 14%), iris (n=8, 3.5%), and anterior segment (n=1, 0.5%). Isotopes included Ruthenium (n=178, 81%) and Iodine (n=31, 14%), with a total radiation dose of 80.5 ± 8.4 Gy. Plaque insertion involved muscle disinsertion in 96 cases (43%). IED was diagnosed in 26 cases (11%). Only the upper eyelid was affected, with ptosis in 25 cases (96%) and trichiasis in one (4%). IED rate was similar across genders, age at brachytherapy, plaque diameter, total radiation dose, laterality, isotope type, muscle manipulations, the use of tarsorrhaphy, or tumor location. However, IEDs were more frequent in patients who experienced additional ocular postoperative complications (p=0.03).
Conclusion
Brachytherapy may adversely impact the structure and function of the ipsilateral eyelid, with disorders occurring more frequently in patients who experience additional ocular complications postoperatively. Increased awareness of these potential sequelae and timely referral to Oculoplastic specialists is advised.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Yael | Lustig | sheba medical center |
| Ella | Nissan | sheba medical center |
| Guy J. | Ben Simon | sheba medical center |
| Vicktoria | Vishnevskia-Dai | sheba medical center |
| Ido Didi | Fabian | sheba medical center |
| Daphna | Landau | sheba medical center |
