Radiation-induced cataract in retinoblastoma patients may be treated with surgery

Br J Ophthalmol. 2011;95(2):227-230.

Cataract surgery may be considered a safe treatment option for radiation-induced cataract in children with retinoblastoma, according to a study.

"This study represents the third largest one in the field of radiation-induced cataract and the largest one using lens aspiration technique," the study authors said.

Researchers evaluated 21 eyes of 20 consecutive retinoblastoma patients in the retrospective, non-comparative case series. Of the eyes, 18 had Reese-Ellsworth stage V or ABC classification group D/E retinoblastoma.

All but one eye underwent external beam radiotherapy, and about half underwent external beam radiotherapy with brachytherapy. A median interval of 21.5 months passed before cataract surgery was performed.

Thirteen eyes (61%) underwent phacoaspiration, and eight eyes (39%) underwent extracapsular cataract extraction; 19 eyes (90%) received IOL implantation. More than half of the eyes underwent posterior capsulorrhexis or capsulotomy, and 28% had an anterior vitrectomy, according to the study.

After the procedures, 13 eyes had visual acuity that was 20/200 or greater, and five eyes had visual acuity that was less than 20/200. However, the authors noted that "the visual prognosis is limited by the initial tumor involvement of the macula and by corneal complications of radiotherapy."

Three eyes experienced tumor recurrence in the mean follow-up period of 90 ± 69 months.

The authors recommended that physicians wait a minimum of 9 months before performing cataract surgery on patients treated for retinoblastoma.