Intraocular Surgery for Retinoblastoma: An Evaluation of Current Evidence

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Surgical Oncology

Background:

• Retinoblastoma (Rb) is the most common intraocular malignancy in children.
• Disease spread beyond the eye, especially to the central nervous system, significantly impacts prognosis.
• Historically, intraocular surgery for active Rb was contraindicated due to the risk of extraocular spread.

Purpose of the Study:

• To review the evolving role of intraocular surgery in the management of retinoblastoma.
• To explore surgical techniques for chemotherapy delivery and treatment of ocular sequelae.
• To discuss the safety and efficacy of various surgical interventions in Rb patients.

Main Methods:

• Review of current literature on intraocular surgical techniques for retinoblastoma.
• Description of intravitreal and intracameral chemotherapy delivery methods.
• Discussion of vitrectomy, endoresection, cataract, retinal, and glaucoma surgery in Rb patients.

Main Results:

• Intraocular surgery is established for chemotherapy delivery and managing treated Rb.
• Surgical techniques for vitreous seeds and active retinal tumors (vitrectomy, endoresection) are discussed.
• Methods to optimize visual outcomes and manage ocular sequelae post-treatment are outlined.

Conclusions:

• The role of intraocular surgery in Rb management is expanding, particularly for chemotherapy delivery and post-treatment care.
• Surgery for active Rb remains debated but is likely to broaden with safer techniques.
• Continued development of surgical modalities promises improved outcomes for retinoblastoma patients.