Methods and Apparatus for Intraocular Brachytherapy

Abstract

Methods and apparatus for intraocular brachytherapy are disclosed in which a cannula is introduced into the eye for delivery of radiation to a target tissue. Techniques for properly locating the cannula with respect to the target tissue, for protecting non-target tissue, for regulating heat generated by x-ray emitters, and for combining therapies are disclosed.

1 - 42 . (canceled) 
     
     
         43 . A device for local intraocular delivery of x-ray radiation to a target tissue comprising:
 a cannula sized for insertion into an eye and having a proximal end and a distal end;   a cathode within the distal end of the cannula;   an anode on the distal end of the cannula; and   the distal end of the cannula and the anode being generally planar and being orientated generally perpendicular to a longitudinal axis of the distal end of the cannula.   
     
     
         44 . The device of  claim 43  wherein the distal end of the cannula comprises an x-ray permeable material. 
     
     
         45 . The device of  claim 44  wherein the distal end of the cannula comprises an x-ray blocking material for attenuating the x-ray radiation received by the target tissue. 
     
     
         46 . A method for treating a target tissue located on the interior of an eye with radiation and a further therapeutic agent comprising:
 providing an intraocular probe containing an ionizing radiation source;   introducing the intraocular probe into the interior of the eye in proximity to the target tissue;   irradiating the target tissue with a prescribed dose of ionizing radiation; and   selecting the further therapeutic agent from one or more of anti-VEGF pharmaceuticals, small interfering RNA, photodynamic therapy, corticosteroids, angiostatic steroids, implants of encapsulated human ciliary neurotrophic factor, VEGF traps, dietary supplements, anti-inflammatory medicines, interferon, antimetabolite drugs, aminosterols, protein kinase beta inhibitors, fluocinolan implants, monoclonal antibodies and anti-oxidants;   treating the target tissue with a prescribed first dose of the further therapeutic agent; and   wherein the irradiation of the target tissue and the treatment of the target tissue with the further therapeutic agent occur within a period of time of 14 days or less.   
     
     
         47 . The method of  claim 46 , in which the period of time is 4 hours or less. 
     
     
         48 . The method of  claim 46  in which the further therapeutic agent is administered prior to the irradiation of the target tissue. 
     
     
         49 . The method of  claim 46  in which the further therapeutic agent is administered following the irradiation of the target tissue. 
     
     
         50 . The method of  claims 46 , in which the radiation source is a beta emitter. 
     
     
         51 . The method of  claims 46 , in which the radiation source is an x-ray emitter. 
     
     
         52 . The method of  claims 46 , in which the radiation dose is 20 to 35 Gy. 
     
     
         53 . The method of  claim 52 , in which the radiation dose is delivered at a rate is 5 to 30 cGy/sec. 
     
     
         54 . The method of  claim 52 , in which radiation dose is delivered at a rate of 8 to 15 cGy/sec. 
     
     
         55 . The method of  claims 46 , in which a second dose of the further therapeutic agent is given after the first dose. 
     
     
         56 . The method of  claim 55 , in which the second dose of the further therapeutic agent is given 2 to 8 weeks after the first dose. 
     
     
         57 . The method of  claim 55 , in which the second dose of the further therapeutic agent is given 25 to 35 days after the first dose.