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November 1991

Palladium 103 Ophthalmic Plaque Radiotherapy

Author Affiliations

From the Division of Ocular Tumor and Orbital Disease, Department of Ophthalmology (Dr Finger and Mr Ho), and the Division of Radiation Oncology, Department of Radiology (Dr Finger and Mr Ho), North Shore University Hospital-Cornell University Medical College, Manhasset, NY; the Departments of Ophthalmology (Dr Finger) and Radiology (Dr Finger), Cornell University Medical College, New York, NY; the Department of Ophthalmology, Ocular Tumor Service, The New York Eye and Ear Infirmary, New York (Dr Finger); and the Department of Biomedical Engineering, Tulane University, New Orleans, La (Mr Moshfeghi).

Arch Ophthalmol. 1991;109(11):1610-1613. doi:10.1001/archopht.1991.01080110148053

• We compared the ocular radiation distribution of palladium 103 (103Pd) vs iodine 125 (125I) ophthalmic plaques sewn to 12 human donor eyes. We then performed preoperative comparative simulations on the first seven patients to be treated with palladium 103 plaque therapy for choroidal melanoma. The in vitro experiment involved palladium 103 seeds placed into a Silastic seed holder, which was affixed into standard 14-mm gold eye plaques. Then the plaques were sewn onto 12 human donor eyes so as to approximate either the nasal (six eyes) or temporal (six eyes) equator. Three sets of two thermoluminescent dosimeters were used to quantify the amount of radiation delivered by the episcleral plaques. Thermoluminescent dosimeters were sewn to the sclera in three locations: on the center of the cornea, on the sclera beneath the macula, and at the equator in a position opposite the plaque. This experiment was then repeated with iodine 125 seeds and thermoluminescent dosimeters. After the plaques were adjusted to equalize their activity (plaque strength), the palladium 103 plaques were found to deliver less radiation to the three target points. Comparative clinical dosimetry also reflected this difference. Preoperative simulations comparing equal doses to the tumors' apex revealed that the palladium 103 ophthalmic plaques delivered more radiation to the tumor and less radiation to most normal ocular structures.

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