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Trabeculectomy in eyes with unsuspected retinoblastoma
Bhavna Chawla1, Maya Hada1, Rachna Seth2
1a Ocular Oncology & Pediatric Ophthalmology Service, Dr Rajendra Prasad Center for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
Background:
To report the management and clinical outcome of children with unsuspected retinoblastoma who underwent trabeculectomy surgery.
Methods:
Three children who presented to us after trabeculectomy surgery were diagnosed with retinoblastoma. They were treated with enucleation of the affected eye. Histopathology of the enucleated eyeball showed tumor infiltration into the iris and the ciliary body in two cases, and massive choroidal invasion in the third case. Six cycles of adjuvant systemic chemotherapy with carboplatin, vincristine and etoposide were given.
Results:
The follow-up ranged from 18-48 months. At last follow-up, all children were alive and well, with no local recurrence or systemic metastasis.
Conclusions:
The management of retinoblastoma with operated trabeculectomy is challenging due to risk of tumor dissemination. Timely intervention can result in good clinical outcome. Nevertheless, a meticulous posterior segment evaluation to rule out retinoblastoma in children presenting with buphthalmos or secondary glaucoma should always be considered.
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