TY - JOUR
T1 - Cosmetic results of enucleation and/or external beam radiation therapy in 195 retinoblastoma survivors
AU - Mourits, Daphne L.
AU - Hartong, Dyonne T.
AU - Lissenberg-Witte, Birgit I.
AU - Bosscha, Machteld I.
AU - Tan, H. Stevie
AU - Moll, Annette C.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85043531830&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29537141
U2 - https://doi.org/10.1111/aos.13729
DO - https://doi.org/10.1111/aos.13729
M3 - Article
C2 - 29537141
SN - 1755-375X
VL - 96
SP - 631
EP - 640
JO - Acta ophthalmologica
JF - Acta ophthalmologica
IS - 6
ER -