Yousef Yacoub A, Manna Mamdouh, Khalil Mohammed B, Nawaiseh Ibrahim
a Department of Surgery , King Hussein Cancer Center , Amman , Jordan.
Ophthalmic Genet. 2016 Sep;37(3):314-7. doi: 10.3109/13816810.2015.1046556. Epub 2016 Feb 5.
Intraocular surgeries are classically contraindicated for patients with active Retinoblastoma (RB) due to the risk of tumor dissemination. Unfortunately, RB treatment may be complicated by rhegmatogenous retinal detachment (RD) that necessitates surgical repair especially in a child who is monocular from enucleation of the contralateral eye.
To assess the outcome of surgical repair of rhegmatogenous RD in children with RB using non-drainage scleral buckling.
Rhegmatogenous RD was diagnosed in three eyes of three children during treatment of RB; one of which had associated tractional RD. All patients received systemic chemotherapy, cryotherapy, and thermal therapy. RD was present at the site of the most recent cryotherapy in all of the three eyes. RD was repaired externally with a scleral buckling procedure without subretinal fluid drainage in each of the three eyes. The retina reattached completely after surgery in two eyes and only partially in one eye. In one eye, which had the tractional component, complete retinal attachment was not achieved and thus enucleation was performed. Orbital or metastatic retinoblastoma was detected in none of the cases on follow-up at 6-36 months.
Scleral buckling without subretinal fluid drainage is a useful technique for repairing rhegmatogenous RD in eyes with RB mainly in the absence of a tractional component.
由于存在肿瘤播散的风险，眼内手术传统上对患有活动性视网膜母细胞瘤（RB）的患者是禁忌的。不幸的是，RB治疗可能会并发孔源性视网膜脱离（RD），这需要进行手术修复，尤其是对于因对侧眼摘除而单眼的儿童。
评估使用非引流性巩膜扣带术修复RB患儿孔源性RD的手术效果。
在RB治疗期间，三名儿童的三只眼中诊断出孔源性RD；其中一只眼伴有牵拉性RD。所有患者均接受了全身化疗、冷冻疗法和热疗。三只眼中的所有眼睛在最近一次冷冻治疗的部位均出现了RD。三只眼均通过巩膜扣带术进行了外部修复，未进行视网膜下液引流。术后两只眼的视网膜完全复位，一只眼仅部分复位。在一只伴有牵拉成分的眼中，未实现视网膜完全附着，因此进行了眼球摘除术。在6至36个月的随访中，所有病例均未检测到眼眶或转移性视网膜母细胞瘤。
不进行视网膜下液引流的巩膜扣带术是修复RB患眼中孔源性RD的一种有用技术，主要适用于不存在牵拉成分的情况。
