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视网膜母细胞瘤患者放疗后白内障行超声乳化术后的结局及并发症

Outcomes and complications after phacoemulsification in retinoblastoma patients with cataract after radiation treatment.

作者信息

Velásquez-Aguilar M, Matiz-Moreno H, Amato-Almanza M, Chen-López C Y, Márquez-García G, Ramírez-Ortiz M A

机构信息

Servicio de Oftalmología, Hospital Infantil de México Federico Gómez, Ciudad de México, México.

Instituto Oftalmológico Conde de Valenciana, Ciudad de México, México.

出版信息

Arch Soc Esp Oftalmol. 2017 Apr;92(4):160-165. doi: 10.1016/j.oftal.2016.11.011. Epub 2016 Dec 23.

Abstract

PURPOSE

To describe the visual outcome and complications associated with phacoemulsification in patients with bilateral retinoblastoma (Rb), with lens opacification secondary to external beam radiotherapy.

METHODS

A descriptive study was performed on patients with Rb, treated in Federico Gomez Children's Hospital, Mexico, from January 1997 to August 2015, with external beam radiotherapy eye salvaging. Statistical analysis was performed using Stata 10.

RESULTS

A total of 15 patients were included. The mean age at phacoemulsification was 7.5 years. Mean preoperative visual acuity was 1.0LogMAR (range 0.4-1.6), and the mean postoperative visual acuity was 0.7LogMAR (range 0.1-1.6). Twelve patients had visual improvement (P<.05). The visual acuity decreased in one patient with vitreous haemorrhage and secondary glaucoma, and 2 patients with exudative maculopathy secondary to radiation. Mean follow up was 46 months and not a single patient showed tumour re-activation.

CONCLUSIONS

Cataract surgery produces a statistically significant improvement in visual acuity. These patients have increased risk for eye complications in the mid- and long-term. It is important to conduct a close follow up due to reactivation of tumour.

摘要

目的

描述双侧视网膜母细胞瘤(Rb)患者因外照射放疗继发晶状体混浊而进行超声乳化白内障吸除术的视觉效果及并发症。

方法

对1997年1月至2015年8月在墨西哥费德里科·戈麦斯儿童医院接受外照射放疗保眼治疗的Rb患者进行描述性研究。使用Stata 10进行统计分析。

结果

共纳入15例患者。超声乳化白内障吸除术时的平均年龄为7.5岁。术前平均视力为1.0 LogMAR(范围0.4 - 1.6),术后平均视力为0.7 LogMAR(范围0.1 - 1.6)。12例患者视力改善(P <.05)。1例因玻璃体出血和继发性青光眼视力下降,2例因放疗继发渗出性黄斑病变视力下降。平均随访46个月,无一例患者出现肿瘤复发。

结论

白内障手术在统计学上可显著提高视力。这些患者中长期眼部并发症风险增加。由于肿瘤复发,密切随访很重要。

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