Korean J Ophthalmol.  2017 Feb;31(1):52-57. 10.3341/kjo.2017.31.1.52.

Outcomes of Cataract Surgery Following Treatment for Retinoblastoma

• Kim HM
• Lee BJ
• Kim JH
• Yu YS

• KMID: 2368679
• DOI: http://doi.org/10.3341/kjo.2017.31.1.52

Abstract

PURPOSE
To evaluate the long-term visual outcomes and complications of cataract surgery in eyes previously treated for retinoblastoma.
METHODS
We reviewed the medical records of patients who underwent cataract extraction and intraocular lens implantation at Seoul National University Children's Hospital for a secondary cataract that developed after retinoblastoma treatment.
RESULTS
During the period between 1990 and 2014, 208 eyes of 147 patients received eye-salvaging treatment (radiotherapy, chemotherapy, and local therapy) for retinoblastoma at Seoul National University Children's Hospital. Among these eyes, a secondary cataract was detected in 17 eyes of 14 patients, and five eyes of five patients underwent cataract surgery. The median age of cataract formation was 97 months (range, 38 to 153 months). The medial interval between the diagnosis of retinoblastoma and cataract formation was 79 months (range, 29 to 140 months). All patients received posterior chamber intraocular lens insertion after irrigation and aspiration of the lens through a scleral tunnel incision. Anterior vitrectomy and posterior capsulotomy were performed in two eyes and a laser capsulotomy was subsequently performed in one eye. No intraoperative and postoperative complications occurred. The median follow-up after surgery was 36 months (range, 14 to 47 months). The final best corrected visual acuities were improved in all five eyes. No intraocular tumor recurrences or metastases occurred.
CONCLUSIONS
After retinoblastoma regression, cataract extraction in our series was not associated with tumor recurrence or metastasis. Visual improvement was noted in every patient.

Keyword

Cataract surgery; Chemotherapy; Eye salvage; Radiotherapy; Retinoblastoma

MeSH Terms

Capsule Opacification
Cataract Extraction
Cataract*
Diagnosis
Drug Therapy
Follow-Up Studies
Humans
Lens Implantation, Intraocular
Lenses, Intraocular
Medical Records
Neoplasm Metastasis
Posterior Capsulotomy
Postoperative Complications
Radiotherapy
Recurrence
Retinoblastoma*
Seoul
Visual Acuity
Vitrectomy

Figure

• 

  Fig. 1 Distribution of best-corrected visual acuity (BCVA) before cataract surgery and after surgery following retinoblastoma treatment. The linear line indicates no change in vision. logMAR = logarithm of the minimum angle of resolution.

• 

  Fig. 2 Representative fundus photographs and anterior segment photographs before and after cataract surgery. (A-C) Eye 2, a representative case of retinoblastoma in the posterior pole with foveal involvement. (A) Fundus examination before cataract extraction. Lens opacity is shown. (B) Fundus examination after cataract extraction. (C) Total opacity of the lens is observed before cataract surgery. (D-F) Eye 4, a representative case of retinoblastoma without foveal involvement. (D) Eight disc diameter-sized huge mass at the superotemporal retina before treatment is shown. (E) Regressed retinoblastoma mass after completion of treatment. A hazy view at the posterior pole means lens opacity. (F) Anterior segment photo shows a posterior subcapsular cataract.

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