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Adriana Dalea
April 23, 2014
Strontium 90 Eye Surface Applicators
Eye surface applicators in brachytherapy or eye plaques, are used in treatment of different
types of benign or malignant eye tumors. Some of the radiotopes used for these types of
treatments are Strontium 90 (Sr-90), Ruthenium 106 (Ru-106), Iodine 125 (I-125), or Palladium
103 (Pd-103). Sr=90 and Ru-106 emit Beta particle radiation, whereas I-125 and Pd-103 release
Gamma radiation.
I researched and found an interesting article regarding the use of Strontium 90 eye
applicator as an adjuvant treatment for conjunctiva melanoma of the eye.
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This type of treatment
is non invasive and uses a hand held applicator as shown in Figure 1.

Figure 1. Placement of the Sr-90 ophthalmic applicator.
This type of applicator contains the radioactive source and a shielded holder for the source. The
radioactive source has a palladium coating, an encapsulating material made of silver and the

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material encapsulated is Sr-90. Sr-90 has a half life of 28.6 years and the maximum energy is 2.3
MeV. The treatment is administered under local anesthesia and it is fractionated to prevent
radiation complications.
The study took place in the United Kingdom and took in consideration 20 patients treated for
conjunctive melanoma between 1999 and 2011. This type of pathology represents 1-2% of all
ocular melanomas. The purpose of the study was to determine recurrence of the tumor,
considering that is associated with an increased risk of metastasis. All the patients had a surgical
resection of the tumor, followed by double freeze-thaw cryotherapy. In order to obtain a better
tumor control, adjuvant brachytherapy was used with the Sr-90 applicator. The results of the
study demonstrated the safety and effectiveness of this type of treatment, with a rate of success
of 90% of the patients who didnt have any local recurrence of the tumor, didnt have their vision
impaired and didnt suffer any complications.
The use of Sr-90 has decreased over the years, due to the unavailability of the source. The
bulbar shape of the conjunctiva of the eye made it difficult sometimes to use the applicator which
is limited in shape and size. The low demand led to decreased availability of the applicators. As a
consequence, the custom shaped Iodine 125 eye plaques reversed mounted can be used
successfully in treatment of conjunctiva melanoma after primary resection.


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Figure 2. 72 year old patient treated with excisional biopsy, followed by cryotherapy and Sr-90.


Figure 3. The same patient 3 years later, with no evidence of the disease, just the corneal scar
from the surgery.










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Reference
1. Cohen VML, Papasefanou VP, Liu S, et. al. The use of Strontium-90 Beta radiotherapy
as adjuvant treatment for conjunctival melanoma. Journal of Oncology. 2013; 2013.
http://dx.doi.org/10.1155/2013/349162 . Accessed April 23, 2014.