May 2007
Volume 48, Issue 13
ARVO Annual Meeting Abstract  |   May 2007
Assessment of Surgical Outcomes of Radiation Induced-Cataract Surgery in Retinoblastoma Patients
Author Affiliations & Notes
  • I. M. Osman
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
    Ophthalmology Department, Alexandria University, Egypt
  • A. Balmer
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • H. Abouzeid
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • M.-C. Gaillard
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • P. Othenin-Girard
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • A. Pica
    Radiation Oncology, CHUV, Lausanne, Switzerland
  • R. Moeckli
    Radiation Physics University Institute, Lausanne, Switzerland
  • F. L. Munier
    Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships I.M. Osman, None; A. Balmer, None; H. Abouzeid, None; M. Gaillard, None; P. Othenin-Girard, None; A. Pica, None; R. Moeckli, None; F.L. Munier, None.
  • Footnotes
    Support Fellowship of I Osman at Jules-Gonin Eye Hospital was supported by the ABOU ZEID Foundation
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 5246. doi:
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      I. M. Osman, A. Balmer, H. Abouzeid, M.-C. Gaillard, P. Othenin-Girard, A. Pica, R. Moeckli, F. L. Munier; Assessment of Surgical Outcomes of Radiation Induced-Cataract Surgery in Retinoblastoma Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5246.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose:: The surgery of radiation-induced cataracts in retinoblastoma (RB) children is a main challenge as early intervention for visual improvement and better tumour visualization is weighted against the need to delay surgery until complete tumour control. This study aims at analyzing the safety and functional results of surgery for RB patients suffering from radiation induced cataract.

Methods:: In this retrospective, non-comparative, consecutive case series, we reviewed medical records of RB patients operated for radiation-induced cataract under 13 years of age at the Jules-Gonin Eye Hospital between 1985 to 2006. General data, interval from the last treatment till cataract surgery, surgical technique and postoperative complications were reported. The main outcome measures were best corrected visual acuity, state of tumour control, ocular preservation versus need of enucleation and the presence or absence of systemic metastasis.

Results:: Twenty eyes (7 with macular tumours)of nineteen RB patients were included. The time interval between last treatment and surgery ranged from 3-164 mo with a mean of 35 mo. Posterior capsulorhexis was performed in 11 eyes together with anterior vitrectomy in 6 of them. Centrifugate of the extracted vitreous was negative cytopathologically in 3 cases. Intraocular lens was implanted in 18 eyes using PMMA (n=9), foldable acrylic (n=9) of which blue blockers (n=5). The postoperative follow up period ranged from 4 to 213 mo with a mean of 91 mo. The postoperative visual acuity was≥20/200 in 13 eyes {4 eyes with 20/20 vision}. The visual acuity was <20/200 in 3 eyes. Postoperatively one eye developed glaucoma while another case had an intraocular lens subluxation that was repositioned. Radiation-induced maculopathy occurred in 10 eyes as well as actinic keratopathy in 4 eyes. Seven eyes required YAG capsulotomy (n=6) or pars plana capsulotomy (n=1). Tumor recurrence was noted in two eyes 11 and 12 mo following surgery. Two eyes were enucleated due to tumour recurrence and neovascular glaucoma respectively. No orbital or metastatic disease was observed.

Conclusions:: Cataract removal is a safe procedure in patients with radiation induced cataract as long as tumours have been adequately controlled. The visual prognosis is mainly limited by the initial macular involvement by the tumour and ocular complications of radiotherapy.

Keywords: retinoblastoma • radiation therapy • cataract 

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