Phacoemulsification and foldable acrylic IOL implantation in children with treated retinoblastoma

Abstract

RESUMO ABSTRACTPurpose: To study the results of cataract surgery in children with radiation-induced cataract after treatment for retinoblastoma. Methods: Retrospective interventional case series. Six consecutive patients diagnosed with secondary cataracts due to radiation therapy for retinoblastoma. Intervention: Phacoemulsification and foldable acrylic intraocular lens implantation. Outcomes mea sured: Visual acuity, binocular indirect ophthalmoscopy and slit-lamp biomicroscopy. Aspirated lens material and aqueous humor samples were collected during surgery. Results: Six uniocular children between 3 to 5 years of age at time of surgery were studied. The mean time interval between radiotherapy and cataract diagnosis was 22.3 months. The mean follow-up after surgery was 17.2 months (range: 12 to 23 months). All eyes achieved a clear visual axis after surgery allowing monitoring of the tumor status. None developed recurrence or retinoblastoma dissemination. His topathological analysis of the aspired material showed no tumoral cells in all sam ples. All patients improved vision after cataract surgery. Conclusions: Phacoemulsification with acrylic intraocular lens implantation seems to be a safe, feasible, and effective method for the removal of radiation-induced cataracts in patients with treated retinoblastoma.

Cataract surgery in treated retinoblastoma eyes: A study of 29 eyes

“…However, literature reveals variation in the exact safety period between tumor regression and cataract surgery, surgical approach, preservation of posterior capsule, and safety of anterior vitrectomy in these cases. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] The recommendations include tumor quiescent period of at least 12 to 18 months, clear corneal approach, and posterior capsule preservation whenever possible with or without PCIOL. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] If posterior capsule is disrupted, cytology of the anterior vitrectomy sample provides evidence for active retinoblastoma.…”

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26] The recommendations include tumor quiescent period of at least 12 to 18 months, clear corneal approach, and posterior capsule preservation whenever possible with or without PCIOL. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] If posterior capsule is disrupted, cytology of the anterior vitrectomy sample provides evidence for active retinoblastoma. 26 In our study, cataract surgery was done in all cases after a period of tumor quiescence for at least 6 months, 24 eyes had a period of tumor quiescence for at least 12 months, and 22 eyes had a period of tumor quiescence for at least 18 months.…”

“…A successful cataract surgery in a case of regressed RB allows vision salvage and globe salvage. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] A large study of 42 treated RB eyes who underwent radiationinduced cataract extraction revealed vision salvage of 20/200 or better in 27 (64%) eyes and globe salvage in 40 (95%) eyes. 27 In our study, vision salvage of 20/200 or better was achieved in 12 (41%) eyes and globe salvage in 26 (90%) eyes.…”