Multifocal iris melanoma treated with total anterior segment palladium-103 plaque radiation therapy

Graefes Arch Clin Exp Ophthalmol. 2011 Jun;249(6):937-40. doi: 10.1007/s00417-010-1590-8. Epub 2010 Dec 14.


Background: A 73-year-old patient presented in our clinic with multiple pigmented iris nodules in the left eye. Though asymptomatic, there was a reported increase in size and number of the nodules during the past year.

Methods: Interventional case report describing a biopsy-proven multifocal iris melanoma treated with a palladium-103 plaque to include the entire anterior chamber within the targeted zone. Biopsy was performed utilizing a 25-gauge aspiration-cutter under viscoelastic. The cornea was protected during radiation therapy with the amniotic membrane buffer technique. Evaluation parameters included visual acuity and clinical assessments aided by slit-lamp photography as well as high-frequency ultrasound imaging.

Results: Plaque radiation therapy was well tolerated. Her visual acuity has remained within five letters at 20/25 at 1-year follow-up. Clinical evaluation revealed no evidence of corneal epitheliopathy, iris neovascularization, or visually significant cataract. High-frequency ultrasound imaging revealed a 15% reduction of the tumor's height. Serial abdominal imaging revealed no metastatic uveal melanoma.

Conclusions: We present a biopsy-proven iris diffuse melanoma treated with palladium-103 plaque radiation therapy. Though the entire anterior segment was irradiated, there were no significant side-effects. Local tumor control was excellent during the first postoperative year.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biopsy
  • Brachytherapy*
  • Female
  • Humans
  • Iris Neoplasms / diagnostic imaging
  • Iris Neoplasms / pathology
  • Iris Neoplasms / radiotherapy*
  • Melanoma / diagnostic imaging
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Neoplasms, Multiple Primary*
  • Palladium / therapeutic use*
  • Radioisotopes / therapeutic use*
  • Treatment Outcome
  • Ultrasonography
  • Visual Acuity / physiology


  • Radioisotopes
  • Palladium