Episcleral plaque brachytherapy using (125)I seed is a viable option for the management of intraocular cancer with minimal invasiveness and surgical complications. This article describes the fabrication of (125)I seeds and initial experience on their use for the management of intraocular choroidal melanomas. The process of (125)I seed fabrication includes immobilization of (125)I into palladium-coated silver wires, its encapsulation in titanium capsules using Nd: YAG laser and quality control to assure safety. Plaque preparation consists of the assignment of seeds to slots on the plaque to achieve a desired dose rate distribution. The clinical study reported here includes the retrospective review of 9 eyes of 9 patients who underwent ophthalmic brachytherapy between May 2008 and June 2011. The average apical diameter before brachytherapy was 7.6 mm and the average largest basal diameter was 12.1 mm, which reduced to 3.3 and 7.2 mm, respectively, after the procedure at an average follow-up of 24 months. Patients in our studies experienced good local tumor control. The results of this study represent a significant step forward in the management of intraocular tumors in India.
Context:To analyze the results of episcleral plaque brachytherapy using indigenous Bhabha Atomic Research Centre (BARC) Iodine-125 Ocu-Prosta seeds for the management of intraocular tumors from a single institute.AIM:To report our initial experience and learning curve on the use of ‘BARC I-125 Ocu-Prosta seeds’ for the management of intraocular tumors such as choroidal melanomas, retinoblastomas and vasoproliferative tumors (VPT).Materials and Methods:We retrospectively reviewed 13 eyes of 13 patients who underwent ophthalmic brachytherapy between May 2008 to March 2012. Nine cases had choroidal melanomas; three had retinoblastomas while one case had VPT.Results:For choroidal melanomas the average apical diameter before brachytherapy was 7.6 mm and average largest basal diameter was 12.1 mm, respectively, which reduced to 4.2 mm and 7.7 mm after the procedure at an average follow-up of 24 months (range 10-43 months). Retinoblastoma and VPT also showed good regression after brachytherapy.Conclusion:Plaque radiotherapy using 125I seeds can be performed under peribulbar anesthesia and provides a viable option for the management of intraocular cancer with minimal invasiveness and surgical complications. Patients in our studies experienced excellent local tumor control. With the availability of indigenous ‘BARC I-125 Ocu-Prosta seeds’ locally, cost effective ophthalmic brachytherapy can be performed in India.
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