For Hospitals and Administrators

Operational considerations for implementing Y-90 ophthalmic brachytherapy

A streamlined approach to ophthalmic brachytherapy

The LV Y-90 Disc and iWand® applicator system is designed to simplify the ophthalmic brachytherapy workflow. For hospital administrators and department heads evaluating treatment program options, the LV Y-90 system offers several operational characteristics that differ from traditional multi-day plaque brachytherapy.

Procedural workflow comparison

The following comparison describes the procedural steps involved in each approach, based on ABS consensus guidelines and published clinical implementations.

LV Y-90 integrated system

  • Single vendor: source and applicator ordered together from Liberty Vision
  • Disc arrives calibrated, ready for sterilization at the facility
  • Single-use applicator is pre-sterilized and individually packaged
  • Assembly uses a dedicated stand — no manual seed loading
  • Treatment is designed as a single session, typically measured in minutes
  • Hand-held application — no suturing of a plaque to the eye
  • No second surgery required to remove a device
  • 64-hour half-life enables source decay to background within weeks

Traditional I-125 plaque brachytherapy

  • Multiple vendors: seeds, plaque shells, and accessories sourced separately
  • Manual assembly: individual seeds loaded into gold plaque shell
  • Plaque is surgically sutured to the sclera under anesthesia
  • Continuous irradiation over 3–7 days with plaque in place
  • Patient may require hospitalization during treatment
  • Second surgery required to remove the plaque
  • I-125 seeds require long-term waste storage (half-life: 59 days)

Liberty Vision does not claim clinical superiority of one approach over another. The choice of brachytherapy method depends on many clinical factors determined by the treating physician. The comparison above describes procedural and operational differences between the two approaches.

Radiation safety considerations

The LV Y-90 Disc is a beta-emitting source. Beta radiation is effectively attenuated by millimeters of shielding material, which differs from the photon-emitting I-125 and Pd-103 sources used in traditional plaque brachytherapy. This characteristic of beta radiation may simplify facility radiation safety planning.

The iWand A applicator features a transparent polymer tip designed to shield beta radiation side-scatter during anterior applications. Published clinical reports have described radiation dosimeter monitoring of healthcare personnel during Y-90 procedures.

The Y-90 half-life of 64 hours means that sources decay to negligible activity within weeks, which may simplify radioactive waste management compared to longer-lived isotopes.

The LV Y-90 Disc is regulated under 10 CFR 35.1000 (Subpart K). Facilities require appropriate NRC or Agreement State licensing. Contact Liberty Vision for information about licensing requirements.

Institutions using the LV Y-90 system

Several US academic medical centers have implemented ophthalmic brachytherapy programs using the LV Y-90 system. Published implementations include:

  • New York Eye Cancer Center — the first institution to implement Y-90 ophthalmic brachytherapy following FDA clearance, as described in the landmark clinical implementation paper published in Brachytherapy (2023).
  • Duke University Eye Center — published multi-center experience using Y-90 brachytherapy for conjunctival squamous cell carcinoma in the American Journal of Ophthalmology Case Reports (2024).
  • Tulane University — announced the launch of Louisiana's first comprehensive ophthalmic plaque brachytherapy program in 2026.

Full citations for these publications, including disclosures of any author affiliations with Liberty Vision, are available on our Publications page.

Getting started

Implementing a Y-90 ophthalmic brachytherapy program involves several considerations, including NRC/Agreement State licensing, medical physics commissioning, clinical training, and procurement. Liberty Vision can provide information about each of these steps.

Contact Liberty Vision for qualification and licensing requirements, pricing, and terms.

The LV Y-90 Disc is FDA 510(k) cleared for episcleral brachytherapy of ocular tumors and benign growths. The iWand® applicators are FDA Class I devices. CAUTION: Federal (US) law restricts these devices to sale by or on the order of a physician. Individual outcomes may depend on a number of factors including patient condition and disease characteristics. Refer to product labeling for complete information.

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