This implant, known as a radioactive iodine plaque, is sewn onto the surface of the eye. It stays there for four days, delivering precise doses of radiation to the cancer.

For patients with eye cancer, University of Florida Health ophthalmology specialist Gibran S. Khurshid, MD, is sowing seeds of hope. In Khurshid’s case, those seeds are tiny particles of radioactive iodine. Attached to a gold implant about the size of a contact lens, the “seeds” deliver tightly focused radiation to eye cancer, oruveal melanoma, according to an announcement issued by the University. Khurshid, an associate professor in the UF College of Medicine’s department of ophthalmology, began doing the procedures earlier this year. The implant, known as a radioactive iodine plaque, is sewn onto the surface of the eye. It stays there for four days, delivering precise doses of radiation to the cancer.

For patients, a plaque can be the difference between sight and blindness. “If you go back just 25 years, patients were having their eyes removed because they had cancer. Now, we can actually treat the cancer and preserve the eye,” Khurshid told UF’s Doug Bennett.

Due to size and location, melanoma in the eye presents special challenges. For Khurshid and his team, that means using high-resolution ultrasound to gather the precise tumor measurements. Then, a plaque implanted with radioactive seeds delivers radiation to the melanoma. These seeds are typically half the size of a grain of rice. Gold is used for the custom-made plaques because it keeps radiation highly focused and prevents scattering.

Scott and Darla Dickerson.
The entire procedure is as precisely focused as the radiation itself. After locating the tumor and determining that plaque therapy is appropriate, Khurshid works with radiation oncologist Paul Okunieff, MD, and medical physicist Jian Wu, PhD, to have the customized plaque made by a supplier. Radiation oncology works on the size of the eye plaque, creating a 3D treatment plan, calculating the activity of the radioactive iodine needed to deliver the proper dose and other essential tasks.

Two spots are booked 96 hours apart in an operating room. A bright light is then shined in the eye, revealing the tumor’s exact shape and borders. A “dummy” plaque is placed on the eye to establish a precise location and contact with the melanoma. It is then replaced by the radioactive plaque, which Khurshid stitches into place.

For patient Darla “Tiki” Dickerson, a freak accident led to the discovery of a 4-millimeter melanoma tumor. Late last year, she got some eye cream in her right eye. It swelled shut, so she sought help. During treatment, a doctor near her home spotted a “unique bubble” in her left eye that had been missed by another physician during an earlier appointment. A Pinellas County eye center confirmed the tumor and referred her to a South Florida hospital for treatment.

Then, there was more bad news: Her insurance wasn’t accepted at the South Florida hospital.

While searching for other options, she contacted Khurshid after recalling he had successfully treated a family member. Not only was UF Health closer to home, it also took her insurance. In late December, Khurshid surgically removed the eye tumor. On Feb. 22, he implanted the plaque to kill the deep penetrations of the tumor.

Killing off the melanoma wasn’t without side effects: Darla said her eye was red and painful after the procedure, and the stitches to attach the plaque were particularly excruciating.

“I have been through an unbelievable amount of pain—the worst kind you can imagine. That was the price of saving my eye and my sight,” she told Bennett.

Still, Darla believes the worst of her eye problems are in the past. “The cancer is gone, and my faith is in my doctor. I can look through a pinhole and see, and that’s an incredible thing,” she said.