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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Outcomes and complications after phacoemulsification in retinoblastoma patients ...
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Vol. 92. Issue 4.
Pages 160-165 (April 2017)
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Vol. 92. Issue 4.
Pages 160-165 (April 2017)
Original article
Outcomes and complications after phacoemulsification in retinoblastoma patients with cataract after radiation treatment
Facoemulsificación en pacientes con retinoblastoma y catarata por radioterapia: resultados y complicaciones
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M. Velásquez-Aguilara, H. Matiz-Morenob, M. Amato-Almanzaa, C.Y. Chen-Lópezb, G. Márquez-Garcíab, M.A. Ramírez-Ortiza,
Corresponding author
marco@unam.mx

Corresponding author.
a Servicio de Oftalmología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
b Instituto Oftalmológico Conde de Valenciana, Mexico City, Mexico
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Tables (2)
Table 1. Demographic and clinic characteristics of patients with bilateral retinoblastoma treated with external radiotherapy and submitted to cataract surgery.
Table 2. Pre- and postoperative visual acuity and complications affecting final visual acuity in patients with bilateral retinoblastoma treated with external radiotherapy and submitted to cataract surgery in their single eye.
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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<0.05). The visual acuity decreased in one patient with vitreous hemorrhage and secondary glaucoma, and 2 patients with exudative maculopathy secondary to radiation. Mean follow up was 46 months and not a single patient showed tumor 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 tumor.

Keywords:
Retinoblastoma
Cataract
Phacoemulsification
Radiation-induced abnormalities
Resumen
Objetivo

Describir los resultados visuales y las complicaciones asociadas al tratamiento quirúrgico de catarata secundaria a radioterapia externa en pacientes con retinoblastoma (Rb) bilateral.

Métodos

Se realizó un estudio descriptivo de aquellos pacientes que acudieron al Hospital Infantil de México Federico Gómez de enero de 1997 a agosto de 2015 con diagnóstico de Rb y que desarrollaron catarata secundaria al tratamiento con radioterapia externa. Se realizó un análisis estadístico utilizando el programa Stata 10.

Resultados

Se incluyeron 15 pacientes. La edad promedio de facoemulsificación fue 7,5 años. La agudeza visual preoperatoria promedio fue 1,0LogMAR (rango 0,4 a 1,6), mientras que la capacidad visual mejor corregida postoperatoria fue en promedio 0,7LogMAR (rango 0,1 a 1,6). Doce pacientes presentaron mejoría de la agudeza visual de al menos 2 líneas (p<0,05). Una paciente presentó hemorragia vítrea densa y glaucoma secundario, y 2 pacientes desarrollaron maculopatía exudativa por radioterapia. El seguimiento promedio fue de 46 meses, durante el cual no se presentaron reactivaciones tumorales.

Conclusiones

La facoemulsificación produce mejoría visual estadísticamente significativa. Estos pacientes tienen un riesgo incrementado de complicaciones oculares a medio y largo plazo, originadas por el tratamiento del Rb intraocular con radioterapia. Es importante un estrecho seguimiento debido a la posibilidad de recurrencia del Rb.

Palabras clave:
Retinoblastoma
Catarata
Facoemulsificación
Alteraciones inducidas por radioterapia

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