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Annapurna Singh, Arun D Singh, Jose Echegaray, Jacquelyn Davanzo; Radiation induced cataract: Surgical Outcomes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4779.
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© ARVO (1962-2015); The Authors (2016-present)
To report surgical outcomes in patients with adequately treated ocular and adnexal tumors that developed cataract following radiation therapy.
Methods: Retrospective case series, single institutional, single surgeon from 2/2014-8/20/17
Results: A series of 28 patients (20 males, 8 females; age range 26-83 years) with conjunctival and adnexal tumors (5) and intraocular tumors (23) treated with radiation therapy. The intraocular tumors were ciliary / choroidal melanoma (15), iris melanoma (3), uveal lymphoma (3) and choroidal hemangioma (1). Visually significant radiation cataract developed following exposure to episcleral plaque (22) and IMRT (6) at the median interval of 32.5 months (range 7.6-144 months). All cases (28) were successfully managed by phacoemulsification and posterior chamber IOL. Ancillary intraoperative maneuvers such as use of trypan blue (14%; 4/28), synechiolysis (18%; 5/28), and use of Malyugin ring (21%; 6/28) were necessary to avoid posterior capsular rupture (100%, 0/28). Despite absence of intraoperative complications in all cases, postoperative CME developed in 18% (5/28 cases) requiring intravitreal steroid injection (7%, 2/28). Overall, visual acuity improvement was observed in 75% of cases (21/28). Visual prognosis was poor if pre operative vision was CF or HM vision. Local tumor recurrence, tumor extension to the surgical wound, and metastasis did not develop in any of the cases during the study period (median 10, range 0.1-36.1 months).
Conclusions: Visually significant radiation induced cataract in presence of adequately treated ocular or adnexal tumor can be successfully managed by phacoemulsification surgery. Ancillary intraoperative maneuvers are required to avoid intraoperative complications. However, postoperative CME is a frequent occurrence. In selected cases, visual acuity improvement may be observed in the majority of cases.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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