Guidelines for Eye Physics surgical positioning:
- The accuracy of the calculated suture coordinates depends on the quality of the CT, ultrasound and fundus images provided and the training and experience of the planner.
- Plaque Simulator calculated suture coordinates for the plaque are usually quite accurate but should be considered only as a guide to plaque placement.
- The surgeon should use a toric meridian angle marker and a Castroviejo caliper to mark the suture coordinates on the eye.
- The surgeon MUST ALWAYS visually confirm the placement using a dummy plaque and indirect ophthalmoscopic observation and/or ultrasound bscan or similar imaging technology. If the fit isn't as planned, the surgeon MUST manually adjust the placement coordinates to achieve the plan objectives...
- Most Eye Physics plaques are protyped using 3D printing and are cast from 18K gold alloy similar to the alloys used for jewelery and dental implants. Radionuclide seeds are glued into slots in the plaque face using a heat tolerant, medical instrument approved cyanoacylate adhesive. These slots both position the seeds at known coordinates and orientations with respect to the suture eyelets and collimate the radiation emitted from each seed into an intensity modulatable "fan" beam. This design enables the delivery conformal isodose treatment within the eye.
- Should a preloaded, presterilized Eye Physics plaque (or dummy plaque) lose its sterility due to accidental mishandling prior to or during surgery, it may be possible to resterilize on-site one time using a 4 to 10 minute flash cycle. Warning: repeated heat sterilization of a plaque containing radionuclide seeds should be avoided because it will eventually weaken the adhesion of the seeds to the gold shell due to thermal expansion and subsequent contraction of the gold shell as it heats and cools.
- Return rented plaques to IsoAid as soon as possible following removal from the patient. Return instructions, including sterilzation procedures, are included with the return shipping documents...