ABSTRACT
Brachytherapy plays a modest role in the treatment of retinoblastoma, in contrast to its major role in the management of choroidal melanomas. The features of the tumor and the eye to be irradiated are the determining factors in the decision between teletherapy and brachytherapy. In general, brachytherapy is used most effectively in anterior or equatorial focal disease with a relatively smaller tumor volume. In 1930, a radon seed implanted into the vitreous by Moore et al became the first radioactive source used for ophthalmic brachytherapy in the management of retinoblastoma. The surgical approach to implantation of a radioactive plaque in a child with retinoblastoma is little different from the approach used to center the plaque on the sclera directly over choroidal melanomas in adults. The surgeon determines the general location of the tumor and, with the use of scleral depression and indirect ophthalmoscopy, outlines the edge of the tumor on the scleral surface with a surgical marking pen.
