Офтальмохирургия. 2021; : 65-70
Результаты хирургии катаракты у детей с ретинобластомой
https://doi.org/10.25276/0235-4160-2021-3-65-70Аннотация
Цель. Представить собственные результаты хирургии катаракты (ХК) у детей с ретинобластомой (РБ). Материал и методы. В период с 2012 по 2020 г. ХК при РБ проведена у 21 детей (22 глаза) в возрасте от 28 до 155 месяцев (средний – 65 мес.). Опухоли группы В имели место в 2 случаях, группы С – в 4, группы D – в 14, группы Е – в 1. В 8 случаях катаракта имела место на единственном глазу. У 18 пациентов наблюдалась заднекапсулярная катаракта, у 3 – полная. Во всех случаях наличие катаракты затрудняло оценку состояния опухоли в динамике. Всем детям перед проведением хирургии катаракты (ХК) проводилась системная полихимиотерапия (ПХТ), у части из них также проводились селективная интраартериальная химиотерапия (СИАХТ), интравитреальная химиотерапия (ИВХТ), дистанционная лучевая терапия (ДЛТ), стереотаксическая радиохирургия «Гамма-нож» (СТРХ) и локальные виды лечения (брахитерапия, транспупиллярная термотерапия, криодеструкция). На момент проведения ХК во всех случаях признаки прогрессии опухоли отсутствовали. Интервал между подтверждением полной регрессии опухоли и проведением ХК составил от 6 до 75 месяцев (в среднем 23 мес.). Результаты. Во всех глазах достигнута полная прозрачность оптических сред. Осложнений после проведения ХК не наблюдалось ни у одного пациента. У 12 пациентов из 21 отмечено улучшение остроты зрения (ОЗ), у остальных – в силу возраста определить ОЗ не удалось. Признаков рецидива и/или диссеминации РБ после проведенной ХК при сроках наблюдения от 3 до 60 месяцев (в среднем 29 мес.) не отмечено. Заключение. Собственный опыт ХК у детей с полной регрессией РБ показал себя безопасным и эффективным способом улучшения зрительных функций и достижения прозрачности оптических сред у детей с РБ.
Список литературы
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11. Medsinge A, Nischal KK. Pediatric cataract: challenges and future directions. Clin Ophthalmol. 2015;77. doi: 10.2147/OPTH.S59009
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13. Payne JF, Hutchinson AK, Hubbard III GB, Lambert SR. Outcomes of cataract surgery following radiation treatment for retinoblastoma. J AAPOS. 2009;13(5): 454– 458. doi: 10.1016/j.jaapos.2009.06.002
14. Kase S, Parikh JG, Youssef PN, Murphree AL, Rao NA. Transforming growth factor β in retinoblastoma-related cataract. Arch Ophthalmol. 2008 Nov 10;126(11):1539– 1542. doi: 10.1001/archopht.126.11.1539
15. Brooks HL, Meyer D, Shields JA, Balas AG, Nelson LB, Fontanesi J. Removal of radiation-induced cataracts in patients treated for retinoblastoma. Arch Ophthalmol. 1990;108(12): 1701–1708. doi: 10.1001/archopht.1990.01070140055028
16. Moshfeghi DM, Wilson MW, Grizzard S, Haik BG. Intraocular surgery after treatment of germline retinoblastoma. Arch Ophthalmol. 2005;123(7): 1008–1012. doi: 10.1001/archopht.123.7.1008
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18. Yarovoy AA, Ushakova TL, Gorshkov IM, Polyakov VG, Golubeva OV, Gorovtsova OV, Krivovyaz OS. Intraocular surgery with melphalan irrigation for vitreous hemorrhage in an only eye with retinoblastoma. Eur J Ophthalmol. 2016;26(1): 17–19. doi: 10.5301/ejo.5000683
19. Stathopoulos C, Sergenti J, Gaillard M-C, Munier FL, Daruich A. Pars plana vitrectomy under melphalan irrigation for recurrent retinal detachment in eyes treated for retinoblastoma: a case report. BMC Ophthalmol. 2020;20(1): 34. doi: 10.1186/s12886-020-1315-7
20. Ohshima K, Kaneko T, Takagi S, Kaneko A, Yokouchi Y, Takeuchi S. Clinicopathological investigation of a retinoblastoma eye enucleated after vitreous surgery with melphalan perfusion. Jpn J Ophthalmol. 2009 Mar 1;53(2): 186–188. doi: 10.1007/s10384-008-0636-5
21. Miller DM, Murray TG, Cicciarelli NL, Capo H, Markoe AM. Pars plana lensectomy and intraocular lens implantation in pediatric radiation-induced cataracts in retinoblastoma. Ophthalmology. 2005;112(9): 1620–1624. doi: 10.1016/j.ophtha.2005.04.017
22. Bhattacharjee H, Bhattacharjee K, Chakraborty D, Talukdar M, Das D. Cataract surgery and intraocular lens implantation in a retinoblastoma case treated by externalbeam radiation therapy. J Cataract Refract Surg. 2003;29(9): 1837–1841. doi: 10.1016/s0886-3350(03)00119-6
23. Sinha R, Titiyal JS, Sharma N, Vajpayee RB. Management of radiotherapyinduced cataracts in eyes with retinoblastoma. J Cataract Refract Surg. 2004;30(5): 1145–1146. doi: 10.1016/j.jcrs.2004.03.020
24. Kim HM, Lee BJ, Kim JH, Yu YS. Outcomes of cataract surgery following treatment for retinoblastoma. Korean J Ophthalmol. 2017;31(1): 52–57. doi: 10.3341/kjo.2017.31.1.52
Fyodorov Journal of Ophthalmic Surgery. 2021; : 65-70
Results of cataract surgery in children with retinoblastoma
https://doi.org/10.25276/0235-4160-2021-3-65-70Abstract
Purpose. To present results of cataract surgery in children with retinoblastoma. Material and methods. Within the period from 2012 to 2020, cataract surgery was performed in 21 children (22 eyes) with retinoblastoma aged 28 to 155 months (average – 65 months). Tumors of group B occurred in 2 cases, group C – in 4, group D – in 14, group E – in 1. In 8 cases, cataract occurred in a single eye. Posterior capsular cataract was observed in 18 patients, total – in 3. In all cases, the presence of cataract impeded the control of the tumor. Before cataract surgery all children underwent systemic chemotherapy, some of them also underwent intra-arterial and/or intravitreal chemotherapy, external beam radiotherapy, Gamma Knife stereotactic radiosurgery and local treatment modalities (episcleral plaque brachytherapy, thermotherapy, cryotherapy). There were no signs of tumor progression in all cases at the time of cataract surgery. The mean interval between complete tumor regression and cataract surgery was 23 months (range 6–75 months). Results. Full transparency of optical media was achieved in all eyes after surgery. No intraoperative and postoperative complications occurred. The final visual acuity was improved in 12 eyes, in the rest visual acuity could not be determined due to age. There were no signs of tumor recurrence or metastases in mean follow-up after surgery of 29 months (range 3–60). Conclusion. Our experience of cataract surgery in children with complete regression of retinoblastoma was proved to be a safe and effective way to improve visual functions and achieve transparency of optical media.
References
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2. Ushakova T.L. Sovremennye podkhody k lecheniyu retinoblastomy. Vestnik RONTs im. N.N. Blokhina RAMN. 2011;22(2).
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4. Fernandes AG, Pollock BD, Rabito FA. Retinoblastoma in the United States: A 40-year incidence and survival analysis. J Pediatr Ophthalmol Strabismus. 2018;55(3): 182–188. doi: 10.3928/01913913-20171116-03
5. MacCarthy A, Birch JM, Draper GJ, Hungerford JL, Kingston JE, Kroll ME, Stiller CA, Vincent TJ, Murphy MF. Retinoblastoma: treatment and survival in Great Britain 1963 to 2002. Br J Ophthalmol. 2009;93(1): 38–39. doi: 10.1136/bjo.2008.139626
6. Chen Q, Zhang B, Dong Y, Mo X, Zhang L, Xia J, Zhang J, Zhang S. Intra-arterial chemotherapy as primary or secondary treatment for infants diagnosed with advanced retinoblastoma before 3 months of age. BMC Cancer. 2019;19(1): 693. doi: 10.1186/s12885-019-5844-5
7. Shields CL, Douglass AM, Beggache M, Say EA, Shields JA. Intravitreous chemotherapy for active vitreous seeding from retinoblastoma. Retina. 2016;36(6): 1184–1190. doi: 10.1097/IAE.0000000000000903
8. Portellos M, Buckley EG. Cataract surgery and intraocular lens implantation in patients with retinoblastoma. Arch Ophthalmol. 1998;116(4): 449–452. doi: 10.1001/archopht.116.4.449
9. Chodick G, Kleinerman RA, Stovall M, Abramson DH, Seddon JM, Smith SA, Tucker MA, Chodick G. Risk of cataract extraction among adult retinoblastoma survivors. Arch Ophthalmol. 2009;127(11): 1500–1504. doi:10.1001/archophthalmol.2009.271
10. Shields CL, Shields JA, Cater J, Othmane I, Singh AD, Micaily B. Plaque radiotherapy for retinoblastoma: long-term tumor control and treatment complications in 208 tumors. Ophthalmology. 2001;108(11): 2116–2121. doi: 10.1016/S01616420(01)00797-7
11. Medsinge A, Nischal KK. Pediatric cataract: challenges and future directions. Clin Ophthalmol. 2015;77. doi: 10.2147/OPTH.S59009
12. Honavar SG, Shields CL, Shields JA, Demirci H, Naduvilath TJ. Intraocular surgery after treatment of retinoblastoma. Arch Ophthalmol. 2001;119(11): 1613– 1621. doi: 10.1001/archopht.119.11.1613
13. Payne JF, Hutchinson AK, Hubbard III GB, Lambert SR. Outcomes of cataract surgery following radiation treatment for retinoblastoma. J AAPOS. 2009;13(5): 454– 458. doi: 10.1016/j.jaapos.2009.06.002
14. Kase S, Parikh JG, Youssef PN, Murphree AL, Rao NA. Transforming growth factor β in retinoblastoma-related cataract. Arch Ophthalmol. 2008 Nov 10;126(11):1539– 1542. doi: 10.1001/archopht.126.11.1539
15. Brooks HL, Meyer D, Shields JA, Balas AG, Nelson LB, Fontanesi J. Removal of radiation-induced cataracts in patients treated for retinoblastoma. Arch Ophthalmol. 1990;108(12): 1701–1708. doi: 10.1001/archopht.1990.01070140055028
16. Moshfeghi DM, Wilson MW, Grizzard S, Haik BG. Intraocular surgery after treatment of germline retinoblastoma. Arch Ophthalmol. 2005;123(7): 1008–1012. doi: 10.1001/archopht.123.7.1008
17. Yarovoi A.A., Gorshkov I.M., Ushakova T.L., Yarovaya V.A., Kotova E.S., Kotel'nikova A.V. Khirurgicheskoe lechenie gemoftal'ma s odnovremennoi irrigatsiei melfalana u patsientov s retinoblastomoi. Rossiiskaya detskaya oftal'mologiya. 2020;2: 20–25. doi: 10.25276/2307-6658-2020-2-20-25
18. Yarovoy AA, Ushakova TL, Gorshkov IM, Polyakov VG, Golubeva OV, Gorovtsova OV, Krivovyaz OS. Intraocular surgery with melphalan irrigation for vitreous hemorrhage in an only eye with retinoblastoma. Eur J Ophthalmol. 2016;26(1): 17–19. doi: 10.5301/ejo.5000683
19. Stathopoulos C, Sergenti J, Gaillard M-C, Munier FL, Daruich A. Pars plana vitrectomy under melphalan irrigation for recurrent retinal detachment in eyes treated for retinoblastoma: a case report. BMC Ophthalmol. 2020;20(1): 34. doi: 10.1186/s12886-020-1315-7
20. Ohshima K, Kaneko T, Takagi S, Kaneko A, Yokouchi Y, Takeuchi S. Clinicopathological investigation of a retinoblastoma eye enucleated after vitreous surgery with melphalan perfusion. Jpn J Ophthalmol. 2009 Mar 1;53(2): 186–188. doi: 10.1007/s10384-008-0636-5
21. Miller DM, Murray TG, Cicciarelli NL, Capo H, Markoe AM. Pars plana lensectomy and intraocular lens implantation in pediatric radiation-induced cataracts in retinoblastoma. Ophthalmology. 2005;112(9): 1620–1624. doi: 10.1016/j.ophtha.2005.04.017
22. Bhattacharjee H, Bhattacharjee K, Chakraborty D, Talukdar M, Das D. Cataract surgery and intraocular lens implantation in a retinoblastoma case treated by externalbeam radiation therapy. J Cataract Refract Surg. 2003;29(9): 1837–1841. doi: 10.1016/s0886-3350(03)00119-6
23. Sinha R, Titiyal JS, Sharma N, Vajpayee RB. Management of radiotherapyinduced cataracts in eyes with retinoblastoma. J Cataract Refract Surg. 2004;30(5): 1145–1146. doi: 10.1016/j.jcrs.2004.03.020
24. Kim HM, Lee BJ, Kim JH, Yu YS. Outcomes of cataract surgery following treatment for retinoblastoma. Korean J Ophthalmol. 2017;31(1): 52–57. doi: 10.3341/kjo.2017.31.1.52
