Objective: To evaluate the usefulness of plaque-mounted diode-light transillumination (DLT) for the localization of episcleral plaques around intraocular tumors. Methods: A clinical case series was performed to create, evaluate, and modify diode-light plaque construction, application, and imaging. Eight patients with choroidal melanoma were offered DLT as an additional method of ophthalmic plaque localization. Plaques were constructed by affixing non-heat-producing, light-emitting diodes with their apertures flush with the episcleral outer surface of the rim of the plaque. A bioimplantable epoxy was used to encapsulate the electronic components. Radioactive DLT eye plaques were sewn to the episclera to cover the base of the intraocular tumors; then diode lights were illuminated, viewed, and recorded. Thus, DLT was used to photographically document the relative position of the eye plaque covering the tumor base. The use of DLT also permitted a subjective evaluation of the contact (plaque contact) of each light with the sclera. Results: Still and video images of plaque-mounted diode retro-transillumination were obtained, and no evidence of toxic effects of diode light were noted. Conclusions: Small posterior melanomas are difficult to visualize with standard transillumination techniques and are associated with poor local control. To improve and document plaque placement, we developed plaque-mounted diode lights for retrobulbar transillumination. This technique provides unique photographic documentation of episcleral plaque localization beneath intraocular tumors.
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