Modern cataract surgery for radiation-induced cataracts in retinoblastoma.

Details

Serval ID
serval:BIB_43170E2B6D72
Type
Article: article from journal or magazin.
Collection
Publications
Title
Modern cataract surgery for radiation-induced cataracts in retinoblastoma.
Journal
British Journal of Ophthalmology
Author(s)
Osman I.M., Abouzeid H., Balmer A., Gaillard M.C., Othenin-Girard P., Pica A., Moeckli R., Schorderet D.F., Munier F.L.
ISSN
1468-2079 (Electronic)
ISSN-L
0007-1161
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
95
Number
2
Pages
227-230
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Background Surgery of radiation-induced cataracts in children with retinoblastoma (RB) is a challenge as early intervention is weighted against the need to delay surgery until complete tumour control is obtained. This study analyses the safety and functional results of such surgery. Methods In a retrospective, non-comparative, consecutive case series, we reviewed medical records of RB patients </=14 y of age who underwent either external beam radiotherapy or plaque treatment and were operated for radiation-induced cataract between 1985 and 2008. Results In total, 21 eyes of 20 RB patients were included and 18 out of the 21 eyes had Reese-Ellsworth stage V or ABC classification group D/E RB. Median interval between last treatment for RB and cataract surgery was 21.5 months, range 3-164 months. Phacoaspiration was performed in 13 eyes (61%), extra-capsular cataract extraction in 8 (39%) and intraocular lens implantation in 19 eyes (90%). The majority of cases, 11/21 (52%), underwent posterior capsulorhexis or capsulotomy and 6/21 (28%) an anterior vitrectomy. Postoperative visual acuity was >/=20/200 in 13 eyes and <20/200 in 5 eyes. Intraocular tumour recurrence was noted in three eyes. Mean postoperative follow up was 90 months+/-69 months. Conclusions Modern cataract surgery, including clear cornea approach, lens aspiration with posterior capsulotomy, anterior vitrectomy and IOL implantation is a safe procedure for radiation-induced cataract as long as RB is controlled. The visual prognosis is limited by initial tumour involvement of the macula and by corneal complications of radiotherapy. We recommend a minimal interval of 9 months between completion of treatment of retinoblastoma and cataract surgery.
Keywords
Adolescent, Cataract/etiology, Cataract Extraction/methods, Child, Child, Preschool, Cornea/radiation effects, Female, Humans, Lens, Crystalline/radiation effects, Male, Postoperative Period, Radiation Injuries/complications, Radiation Injuries/surgery, Retinal Neoplasms/radiotherapy, Retinoblastoma/radiotherapy, Retrospective Studies, Treatment Outcome, Visual Acuity/physiology, Vitrectomy
Pubmed
Web of science
Create date
13/10/2010 15:49
Last modification date
19/03/2018 11:57
Usage data