PDF(Pubmed)
Abstract：
Introduction: Intraocular surgeries are conventionally contraindicated for patients with active retinoblastoma (Rb) due to the potential risk of tumor dissemination. However, surgery is occasionally necessary to preserve vision in patients with a single eye when the eye is complicated by rhegmatogenous retinal detachment (RRD). Objective: This study aims to evaluate the outcomes of surgical repair for RRD in pediatric patients with active Rb utilizing a non-drainage scleral buckling approach. Results: This cohort included six eyes from six patients who harbored active Rb and presented with RRD; one had a concurrent tractional component. All eyes (100%) had active intraocular Rb and were undergoing active therapy (systemic chemotherapy, cryotherapy, and thermal laser therapy) when RRD developed. RRD consistently manifested at the site of recent cryotherapy in all cases. RRD repair in the affected eyes was performed by scleral buckling without subretinal fluid drainage. Five of the six eyes (83%) achieved complete retinal reattachment. One eye (17%) with a tractional component exhibited partial reattachment and was eventually enucleated due to persistent active disease. At a median follow-up of 15 months (range 12-180 months) after scleral buckling, all five eyes had persistent retinal attachment, and no case developed orbital or distant metastasis. Conclusions: Our study demonstrates that nondrainage scleral buckling is an effective and safe method for the surgical repair of RRD in eyes harboring active Rb, as most cases achieved persistent complete retinal reattachment without the risk of tumor spread.
摘要：
简介：由于肿瘤扩散的潜在风险，活动性视网膜母细胞瘤（Rb）患者通常禁用眼内手术。然而,当单只眼睛并发孔源性视网膜脱离（RRD）时，有时需要手术来保护视力。目的：本研究旨在评估使用非引流巩膜扣带法对患有活动性Rb的小儿患者进行RRD手术修复的结果。结果：该队列包括来自六名患者的六只眼睛，这些患者具有活跃的Rb并表现为RRD；一个具有并发的牵引成分。所有眼睛（100％）都有活跃的眼内Rb，并且正在接受积极治疗（全身化疗，冷冻疗法,和热激光治疗）当RRD发展时。在所有情况下，RRD始终在最近的冷冻治疗部位表现出来。受影响的眼睛的RRD修复是通过巩膜扣带术进行的，没有视网膜下引流液。六只眼睛中有五只（83％）实现了完全的视网膜复位。一只具有牵引成分的眼睛（17％）表现出部分重新附着，并由于持续的活动性疾病而最终摘除。在巩膜扣带后15个月（范围12-180个月）的中位随访，所有五只眼睛都有持续的视网膜附着，无眼眶或远处转移。结论：我们的研究表明，非引流巩膜扣带术是一种有效且安全的方法，用于保留活动Rb的眼睛RRD的手术修复。因为大多数病例实现了持续的完全视网膜复位而没有肿瘤扩散的风险。
