Facoemulsificación en pacientes con retinoblastoma y catarata por radioterapia: resultados y complicaciones / Outcomes and complications after phacoemulsification in retinoblastoma patients with cataract after radiation treatment

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

PURPOSE: To describe the visual outcome and complications associated with phacoemulsification in patients with bilateral retinoblastoma (Rb), with lens o pacification 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<.05). The visual acuity decreased in one patient with vitreous haemorrhage and secondary glaucoma, and 2 patients with exudative maculopathy secondary to radiation. Mean follow up was 46 months and not a single patient showed tumour 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 tumour

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.

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<.05). The visual acuity decreased in one patient with vitreous haemorrhage and secondary glaucoma, and 2 patients with exudative maculopathy secondary to radiation. Mean follow up was 46 months and not a single patient showed tumour 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 tumour.