title: A biological tissue adhesive and dissolvent system for intraocular tumor plaque radiotherapy: an in vivo animal model experiment.
abstract: OBJECTIVE
  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.
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ofira
authors.initials: O
authors.lastname: Zloto
authors.affiliation: Department of Radiation Oncology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Alezra
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Sagiv
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Belkin
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Vicktoria Vishnevskia
authors.initials: VV
authors.lastname: Dai
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Moroz
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gahl
authors.initials: G
authors.lastname: Greenberg
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Ben-Artsi
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. didifabian@gmail.com.|Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2012, Tel Hashomer, Israel. didifabian@gmail.com.
authors.forename: Ido Didi
authors.initials: ID
authors.lastname: Fabian
mesh_terms: D000818:Animals; D001918:Brachytherapy / Q000379:methods*; D020878:Device Removal / Q000379:methods; D004195:Disease Models, Animal; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D007429:Intraocular Pressure; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008545:Melanoma / Q000532:radiotherapy*; D011817:Rabbits; D011879:Radiotherapy Dosage; D012590:Sclera / Q000187:drug effects*; D013536:Suture Techniques; D013537:Sutures; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014568:Urokinase-Type Plasminogen Activator / Q000494:pharmacology*; D014604:Uveal Neoplasms / Q000532:radiotherapy*; D000098943:Uveal Melanoma
chemical_list: D015718:Fibrin Tissue Adhesive; D007457:Iodine Radioisotopes; D014014:Tissue Adhesives; D014568:Urokinase-Type Plasminogen Activator
keywords: Fibrin glue; Plaque radiotherapy; Urokinase; Uveal melanoma