When dealing with plaque brachytherapy, a localized radiation technique that attaches a tiny radioactive disc to the eye. Also known as radioactive plaque therapy, it offers precise treatment for eye cancers. This method falls under the broader umbrella of radiation therapy, medical use of high‑energy particles to destroy abnormal cells. It is especially useful for ocular melanoma, the most common primary eye cancer in adults. By delivering dose directly to the tumor while sparing surrounding tissue, plaque brachytherapy balances effectiveness with safety.
One of the biggest advantages of this approach is its localized nature. Unlike external beam radiation, which sends beams through the body, the radioactive seeds—usually I‑125 or Pd‑103—are embedded in a silicone or gold plaque that sits on the sclera. This radioactive seed, a small pellet that emits low‑energy gamma rays. stays in place for a few days to a week, delivering a high dose exactly where it’s needed. The duration is calculated through dosimetry, the science of measuring and planning radiation dose. Proper dosimetry ensures tumor control rates above 90 % while keeping complications such as vision loss low.
Before the plaque is placed, an ophthalmic oncologist maps the tumor using ultrasound, MRI, or fundus photography. This imaging step links the tumor’s size and shape to the treatment plan. A multidisciplinary team—often including a radiation oncologist, a medical physicist, and a surgeon—collaborates to design the custom plaque. The custom nature of the device is why plaque brachytherapy is considered a personalized therapy, a treatment tailored to an individual’s anatomy and disease. After surgery, the plaque is sutured to the eye, the patient stays in the clinic for monitoring, and the plaque is removed once the prescribed dose is delivered.
Side effects are generally mild compared to other eye cancer treatments. The most common issues are temporary eye irritation, mild swelling, or cataract formation, which can often be managed with eye drops or later surgery. Because the radiation source never leaves the eye, systemic side effects—like those seen with chemotherapy—are virtually absent. This makes plaque brachytherapy a preferred option for patients who want to avoid the broader impacts of systemic therapy.
Cost and accessibility are also worth noting. While the procedure requires specialized equipment and expertise, many major eye centers now offer plaque brachytherapy as a standard service. Insurance coverage is typically available for medically indicated cases, and the overall expense is often lower than that of enucleation (removal of the eye) or long‑term systemic treatments. Patients should discuss financial options with their care team early on to avoid surprise bills.
Research continues to expand the uses of plaque brachytherapy beyond ocular melanoma. Studies show promising results for treating choroidal metastases, retinoblastoma in selected adult cases, and even some benign vascular lesions. Ongoing trials are testing newer isotopes that could shorten treatment time while maintaining tumor control. Staying updated on the latest evidence helps both clinicians and patients make informed decisions.
For anyone considering plaque brachytherapy, the key questions to ask include: How will the plaque be customized for my tumor? What is the expected visual outcome? How will side effects be monitored and managed? And finally, what follow‑up schedule will ensure the tumor remains controlled? Answering these empowers patients to weigh the benefits against any risks.
Below you’ll find a curated list of articles that dive deeper into each aspect we’ve touched on— from choosing the right isotope to managing post‑procedure care, from cost considerations to the latest clinical trial data. Whether you’re a patient, a caregiver, or a health professional, the resources will give you practical insights and actionable tips to navigate plaque brachytherapy with confidence.
Explore how radiation therapy treats eye cancers like uveal melanoma and retinoblastoma, covering plaque brachytherapy, proton and external beam options, benefits, risks, and aftercare.
