Abstract
Abstract: :
Purpose:To report the rate of complications after enucleation in children with retinoblastoma. Methods:The charts of 52 patients (56 orbits) who underwent enucleation for retinoblastoma at St Jude’s Children’s Research Hospital from January 1995 to August 2003 were retrospectively reviewed. The following data was extracted from the patients’ records: gender, age at diagnosis, age at enucleation, previous treatment with chemotherapy and/or radiation, implant material, complications following enucleation including infection, exposure, and extrusion, time from enucleation to complications, and surgical management of complications. Results:52 patients (35 bilateral/17 unilateral) with retinoblastoma were diagnosed at a median age of 22 months (range, 4–60 months). Thirty–three (59%) of 56 eyes underwent primary enucleation, and the median age at time of enucleation was 27 months (range, 4–156 months). Forty–four (83%) of the implants were hydroxyapatite (HAI) and 12 (9%) were porous polyethylene (PPE). The median follow–up available was 39 months (range, 4–216 months). Fourteen orbits (25%) developed complications requiring surgical intervention; of those, 10 had PPE implants and 4 had HAI implants. Of the 25 patients who received treatment prior to enucleation, 23 had received chemotherapy and 19 had received radiation therapy (17 received both chemotherapy and radiation therapy); of those 25, 8 (33%) developed complications following enucleation (all 8 of these patients had received both chemotherapy and radiation therapy). The median time to the development of complication was 2 months (range, 1–42 months), and it took a median of 5 surgeries (range, 1–17) to achieve a successful repair. Conclusions:Our results suggest that previous treatment with chemotherapy and/or radiation has an effect on the rate of complications after enucleation in patients with retinoblastoma. Patients with PPE implants had a higher rate of complications than patients with HAI. Complications occurred early after enucleation and required multiple surgical procedures to correct.
Keywords: retinoblastoma • orbit • clinical (human) or epidemiologic studies: outcomes/complications