COBALT PLAQUES IN ADVANCED RETINOBLASTOMA
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Abstract:
Seventy-one eyes of 64 patients with advanced retinoblastoma received 81 cobalt plaques for the treatment of advanced retinoblastoma. Sixty-three of the 64 patients had bilateral retinoblastoma. Fifty of the 63 patients with bilateral retinoblastoma had already had an enucleation of the fellow eye at the time of insertion of the plaque. Of the 64 patients who received a plaque, 60 had already failed prior therapy to the eye. More than half (45-81) of the tumors were larger than 10 mm in base diameter and 70 of the 81 tumors were either in the ciliary body, anterior chamber, or seeded into the vitreous. Eight of the 64 patients died of metastatic retinoblastoma (12.5%), and four of the survivors developed second nonocular tumors. In 44 of the 71 eyes, enucleation was prevented by the plaque. Of the 27 who required enucleation, 21 did so because of continued tumor growth.Keywords:
Retinoblastoma
Eye Enucleation
Seventy-one eyes of 64 patients with advanced retinoblastoma received 81 cobalt plaques for the treatment of advanced retinoblastoma. Sixty-three of the 64 patients had bilateral retinoblastoma. Fifty of the 63 patients with bilateral retinoblastoma had already had an enucleation of the fellow eye at the time of insertion of the plaque. Of the 64 patients who received a plaque, 60 had already failed prior therapy to the eye. More than half (45-81) of the tumors were larger than 10 mm in base diameter and 70 of the 81 tumors were either in the ciliary body, anterior chamber, or seeded into the vitreous. Eight of the 64 patients died of metastatic retinoblastoma (12.5%), and four of the survivors developed second nonocular tumors. In 44 of the 71 eyes, enucleation was prevented by the plaque. Of the 27 who required enucleation, 21 did so because of continued tumor growth.
Retinoblastoma
Eye Enucleation
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To evaluate complications and risk factors associated with the placement of wrapped and unwrapped porous polyethylene (PP) spherical implants after evisceration, enucleation, or secondary implantation.A retrospective, interventional, noncomparative case series of consecutive cases of PP implant placement after anophthalmic socket surgery performed by three surgeons over a 5-year period. A PP spherical implant was placed in 133 patients, 61 women (2 bilaterally) and 72 men (1 bilaterally). There were 91 enucleations, 30 eviscerations, and 15 secondary implant placements. Sixty-six (48.5%) implants were wrapped prior to placement. Parameters evaluated included: age, sex, prior ocular surgery or radiation treatment, indications for surgery, procedure performed, size of PP sphere, material used to wrap the implant, and complications.A total of 17 of 136 (12.5%) cases had documented postoperative complications, with implant exposure being the most common. In 5 patients (3.7%), implant exposure developed: 1 after evisceration and 4 after primary enucleation. Three of the five exposures were small and resolved with either observation alone or in one case with surgical revision of the socket. In two cases, the exposures were large enough that removal of the implant was indicated, one after evisceration and the other after enucleation with placement of a wrapped PP sphere.Our series revealed no significant difference in exposure rate between wrapped and unwrapped PP sphere implants, nor was the exposure rate affected by whether an eye was eviscerated or enucleated.
Evisceration (ophthalmology)
Eye Enucleation
Prosthesis Implantation
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To evaluate the enucleation rate for children with unilateral sporadic retinoblastoma based on initial external findings detected by the family and the pediatrician.A retrospective, nonrandomized review was performed on 257 consecutive patients with unilateral sporadic retinoblastoma treated at a major ocular oncology center. Data were gathered regarding the initial external clinical finding noted by the family members, pediatrician, and ocular oncologist and then correlated with the final resulted in enucleation in 77%. Specifically, enucleation was necessary in 75% of patients with pediatrician-detected leukocoria, 46% of those with pediatrician-detected strabismus, and 86% of those with pediatrician-detected red eye, heterochromia, decreased visual acuity, or an unspecified eye problem. Enucleation was necessary in 81% of those patients in whom an ocular oncologist detected any external finding such as leukocoria, strabismus, red eye, heterochromia, or buphthalmos and in only 33% of those without external findings.Children with retinoblastoma who present with obvious external findings of leukocoria, strabismus, or red eye detectable by their family or pediatrician most often require enucleation. Children who manifest no obvious external findings can often avoid enucleation.
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Background: Retinal dysplasia is a congenital ocular pathology that can mimic as retinoblastoma caused by abnormal proliferation of retinal tissue. Objective: To present a case of retinal dysplasia misdiagnosed clinically as retinoblastoma and underwent enucleation surgery.Result: A 7 years old female underwent enucleation surgery as she was diagnosed clinically as retinoblastoma. Both of them could present with leucocoria and histologically can show rossettes formation. It is important to differentiate both these entities inorder to avoid enucleation in case of retinal dysplasia.
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Eye Enucleation
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Evisceration (ophthalmology)
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ABSTRACT We correlated the pathologic diagnosis with the preoperative clinical diagnosis of retinoblastoma in children treated by enucleation within the United States and Canada between the years 1974 and 1980. In order to avoid inappropriate selectivity and institutional bias, we studied only those cases submitted directly to the Registry of Ophthalmic Pathology in which the enucleated eyes had not been examined initially at the local hospital. Of the 56 eyes removed because of suspected retinoblastoma, 15 (26.8%) did not contain a malignant tumor. In two cases enucleation was delayed because retinoblastoma was not considered initially in the differential diagnosis of spontaneous hyphema. During the same period, two of 268 eyes that were enucleated for reasons other than suspected retinoblastoma were found to contain a retinoblastoma. The diagnostic error rate in our study reflects the persistent difficulty in diagnosing retinoblastoma in eyes with opaque media and retinal detachment.
Retinoblastoma
Hyphema
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Despite considerable advances in the treatment of retinoblastoma tumor growths cannot be arrested in a proportion of cases. The consent fro the removal of both eyes constitutes a burdensome decision on the part of the child's parents, so that it is quite frequently refused. A short movie illustrating the behaviour of a 6-year-old boy, who had undergone bilateral enucleation because of retinoblastoma should aid the parents having to face a similar situation.
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