Surgical Outcomes in Radiation-induced Cataracts After External-beam Radiotherapy in Retinoblastoma

Abstract

Objectives: To investigate visual outcomes, surgical complications and tumor recurrence among children with retinoblastomaundergoing phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation for radiation-induced cataract secondaryto external beam radiotherapy.Materials and Methods: The medical records of all patients treated by phacoemulsification and PCIOL implantation for radiationinducedcataract after external beam radiotherapy for retinoblastoma at a single institution between 1980 and 2014 were reviewedretrospectively. The study included 6 eyes of 6 children (4 girls, 2 boys).Results: Four patients had bilateral and two patients had unilateral retinoblastoma. The median age at diagnosis of retinoblastomawas 28.3 months (range, 12-96 months). All patients received chemoreduction (OPEC protocol) and external beam radiotherapy withor without local ophthalmic therapies and developed radiation-induced cataracts. The median interval from retinoblastoma diagnosis tocataract surgery was 96.3 months (range, 73-122 months). Time interval between surgery and last retinoblastoma treatment was 67.2months. Postoperative complications included iridocyclitis in 2 eyes and posterior capsule opacification in all eyes. The mean follow-upafter surgery was 105.8 months (range, 59-120 months). Final visual acuity was better in all eyes than preoperative visual acuities.Conclusion: Phacoemulsification and PCIOL implantation is an effective method of managing radiation-induced cataracts in eyes withpreviously treated retinoblastoma. However, visual acuity was limited by the presence of primary macular tumor.