Eye Plaque Surgery

As part of our comprehensive Cancer Center, Methodist University Hospital is proud to offer radiation plaque therapy for treatment of uveal melanoma, a cancer of the eye. This rare condition, which affects a very small percentage of people each year, requires highly specialized treatment and collaboration among ophthalmologists, radiation oncologists, physicists and medical oncologists. Methodist University Hospital, in partnership with the Hamilton Eye Institute, is one of only a few select centers nationwide offering radiation plaque therapy.

Uveal melanoma is cancer of the eye, arising from melanocytes (pigmented cells) within the vascular coat, the uvea, of the eye.  The uvea has 3 parts, the iris, ciliary bidy, and choroid.  Thus, melanomas within the eye may arise within the iris, ciliary body, or choroid.  Choroidal melanoma is the most common of the three.  

Uveal melanoma can be detected on a routine dilated eye exam or after further testing on a patient with symptoms.  The symptoms could include flashes of light, floaters, decreased vision, or loss of vision; however some patients never become symptomatic.  If melanoma is suspected, patient will be sent to an ocular oncology specialist (ophthalmologist) immediately.  In order to diagnose the cancer, certain tests are performed.  The ocular oncology specialist will examine the patient, check vision, perform an ultrasound of the eye, take photographs, and any other necessary testing.  If melanoma is then diagnosed, and radiation plaque therapy is recommended, surgery will be schedule immediately. 

Prior to surgery, the patient will meet with the radiation oncology team at Methodist University Hospital for consultation.  During this appointment, usually the day before surgery, the radiation oncologist will review the patient’s history, present illness, and discuss the treatment of plaque therapy.  They will also review radiation safety rules to be followed for the week.       

About the Treatment

Performed by highly skilled ophthalmologists, radiation plaque therapy involves the use of a disc-shaped, gold custom casing that houses radioactive seeds. This custom casing, referred to as the plaque, delivers the high dose radiation to the ocular tumor in a targeted approach, allowing very little radiation exposure to the rest of the eye and body. The plaque is placed in surgery, while the patient is under general anesthesia.  The surgeon will use special lights and instruments to see the tumor, then place the plaque directly over the tumor.  The plaque will be sutured in place and stay typically for 7 days.  After the recommended dose of radiation is delivered, the plaque is removed from the patient’s eye, and the patient is allowed to go home.  The patient will follow-up with the physician as directed.

During the 7 days that the radiation plaque is in place, the patient must remain in Shelby County due to radiation rules.  Both the implant and explant of the plaque are outpatient surgeries; therefore, overnight hospitalization is not required.  Since the patient must remain in county, there are available resources for housing during treatment, some at no cost to the patient. Our team will provide further information regarding reserving these rooms, or you can learn more here.

The goals of this approach are to reduce the need to remove the eye and to retain as much vision as possible.  Even with radiation treatment, there are still risks of vision loss, and metastatic disease. 

Metastasis must be monitored.   Uveal melanoma patients are urged to have routine evaluations every 6 months, or as recommended by an oncologist.  These tests typically include a chest x-ray, liver function tests, and an abdominal CT scan.

About Hamilton Eye Institute Surgery Center

Located in Midtown Memphis, the Hamilton Eye Institute Surgery Center provides advanced clinical and surgical Ophthalmology services. Together with the physician partners, we strive to provide the latest innovation in Ophthalmology surgery. At the Hamilton Eye Institute Surgery Center, our team is dedicated to offering the most advance treatments and surgical equipment. 

Make a Referral

If you have a patient that could benefit from treatment at a comprehensive ocular oncology program, please call 901.516.6000 or use our physician locator.