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  • Title: Cosmetic results of enucleation and/or external beam radiation therapy in 195 retinoblastoma survivors.
    Author: Mourits DL, Hartong DT, Lissenberg-Witte BI, Bosscha MI, Tan HS, Moll AC.
    Journal: Acta Ophthalmol; 2018 Sep; 96(6):631-640. PubMed ID: 29537141.
    Abstract:
    PURPOSE: To report the cosmetic outcome and late effects of enucleation and/or irradiation for retinoblastoma and to evaluate the role of orbital implants. METHODS: Patients (age >4 years) enucleated and/or irradiated for retinoblastoma, visiting the hospital for routine follow-up (April 2013 to May 2015), were included in our cross-sectional study. Data were obtained via clinical records, questionnaires, physical measurements and standardized photographs. Two independent observers scored the cosmetic features: upper eyelid position, lower eyelid position, volume deficiency, and prosthesis motility and overall cosmetic appearance. RESULTS: A total of 195 patients participated. Ptosis was seen in 45 (28.3%) patients, lower lid sagging in 45 (28.3%). Both complications were associated with the orbital implant; ptosis being more common with increasing implant size (5.6% without implant, 16.7% with small implant, 37.1% with medium implant and 76.9% with large implant) and lower lid sagging being more common in patients without implant (20% with implant versus 37.5% without). Volume loss of the superior sulcus was seen in 107 sockets (66.9%), most frequent in additionally irradiated patients (χ2 (2) = 42.7, p < 0.001) and in patients without implant (χ2 (2) = 11.92, p = 0.003). Prosthesis motility was better in patients with orbital implant, regardless of the size. CONCLUSION: Minor late and potentially treatable effects were seen in patients with implant. Larger sized implants were associated with a higher incidence of ptosis; implant size did not affect subjective outcome with respect to volume or prosthetic motility. Treatment with EBRT had a less favourable outcome.
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