Kim Hyeong Min, Lee Byung Joo, Kim Jeong Hun, Yu Young Suk
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.; Fight against Angiogenesis-Related Blindness (FARB) Laboratory, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Korean J Ophthalmol. 2017 Feb;31(1):52-57. doi: 10.3341/kjo.2017.31.1.52. Epub 2017 Feb 2.
To evaluate the long-term visual outcomes and complications of cataract surgery in eyes previously treated for retinoblastoma.
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.
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.
After retinoblastoma regression, cataract extraction in our series was not associated with tumor recurrence or metastasis. Visual improvement was noted in every patient.
评估曾接受视网膜母细胞瘤治疗的眼睛白内障手术的长期视觉效果及并发症。
我们回顾了首尔国立大学儿童医院接受白内障摘除及人工晶状体植入手术患者的病历,这些患者的白内障是在视网膜母细胞瘤治疗后发生的继发性白内障。
在1990年至2014年期间,147例患者的208只眼睛在首尔国立大学儿童医院接受了视网膜母细胞瘤的保眼治疗(放疗、化疗和局部治疗)。在这些眼睛中,14例患者的17只眼睛检测出继发性白内障,5例患者的5只眼睛接受了白内障手术。白内障形成的中位年龄为97个月(范围38至153个月)。视网膜母细胞瘤诊断与白内障形成之间的中位间隔时间为79个月(范围29至140个月)。所有患者均通过巩膜隧道切口进行晶状体冲洗吸出后植入后房型人工晶状体。2只眼睛进行了前部玻璃体切除术和后囊切开术,随后1只眼睛进行了激光囊切开术。未发生术中及术后并发症。术后中位随访时间为36个月(范围14至47个月)。所有5只眼睛的最终最佳矫正视力均有提高。未发生眼内肿瘤复发或转移。
在视网膜母细胞瘤消退后,我们系列研究中的白内障摘除与肿瘤复发或转移无关。每位患者的视力均有改善。