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Worldwide enucleation techniques and materials for treatment of retinoblastoma: an international survey.

Mourits DL, Hartong DT, Bosscha MI, Kloos RJ, Moll AC - PLoS ONE (2015)

Bottom Line: Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles.Pegging is done by two surgeons.Considerations for the use of different techniques are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.

ABSTRACT

Purpose: To investigate the current practice of enucleation with or without orbital implant for retinoblastoma in countries across the world.

Methods: A digital survey identifying operation techniques and material used for orbital implants after enucleation in patients with retinoblastoma.

Results: We received a response of 58 surgeons in 32 different countries. A primary artificial implant is routinely inserted by 42 (72.4%) surgeons. Ten (17.2%) surgeons leave the socket empty, three (5.2%) decide per case. Other surgeons insert a dermis fat graft as a standard primary implant (n=1), or fill the socket in a standard secondary procedure (n=2; one uses dermis fat grafts and one artificial implants). The choice for porous implants was more frequent than for non-porous implants: 27 (58.7%) and 15 (32.6%), respectively. Both porous and non-porous implant types are used by 4 (8.7%) surgeons. Twenty-five surgeons (54.3%) insert bare implants, 11 (23.9%) use separate wrappings, eight (17.4%) use implants with prefab wrapping and two insert implants with and without wrapping depending on type of implant. Attachment of the muscles to the wrapping or implant (at various locations) is done by 31 (53.4%) surgeons. Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles. Measures to improve volume are implant exchange at an older age (n=4), the use of Restylane SQ (n=1) and osmotic expanders (n=1). Pegging is done by two surgeons.

Conclusion: No (worldwide) consensus exists about the use of material and techniques for enucleation for the treatment of retinoblastoma. Considerations for the use of different techniques are discussed.

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Related in: MedlinePlus

World map with included countries in dark.
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Mentions: The survey was initially sent to 220 recipients. Thirty invitations were bounced because of an invalid email address, 2 were rejected. Thirty-one ophthalmologists were suggested to us by other recipients. In total 68 ophthalmologists from 37 different countries responded. Five did not meet the inclusion criteria (either no treating physician of retinoblastoma or a treating physician but not performing enucleations) and five others did not complete the survey. A total of 58 surgeons of 32 different countries returned a completed survey, of whom 33 surgeons were practicing in developed countries and 25 surgeons in undeveloped or developing countries (according to the UN list and CIA (2008). "Appendix B. International Organizations and Groups." World Fact book. Retrieved 2008–04–10). See Fig. 1.


Worldwide enucleation techniques and materials for treatment of retinoblastoma: an international survey.

Mourits DL, Hartong DT, Bosscha MI, Kloos RJ, Moll AC - PLoS ONE (2015)

World map with included countries in dark.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4358947&req=5

pone.0121292.g001: World map with included countries in dark.
Mentions: The survey was initially sent to 220 recipients. Thirty invitations were bounced because of an invalid email address, 2 were rejected. Thirty-one ophthalmologists were suggested to us by other recipients. In total 68 ophthalmologists from 37 different countries responded. Five did not meet the inclusion criteria (either no treating physician of retinoblastoma or a treating physician but not performing enucleations) and five others did not complete the survey. A total of 58 surgeons of 32 different countries returned a completed survey, of whom 33 surgeons were practicing in developed countries and 25 surgeons in undeveloped or developing countries (according to the UN list and CIA (2008). "Appendix B. International Organizations and Groups." World Fact book. Retrieved 2008–04–10). See Fig. 1.

Bottom Line: Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles.Pegging is done by two surgeons.Considerations for the use of different techniques are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.

ABSTRACT

Purpose: To investigate the current practice of enucleation with or without orbital implant for retinoblastoma in countries across the world.

Methods: A digital survey identifying operation techniques and material used for orbital implants after enucleation in patients with retinoblastoma.

Results: We received a response of 58 surgeons in 32 different countries. A primary artificial implant is routinely inserted by 42 (72.4%) surgeons. Ten (17.2%) surgeons leave the socket empty, three (5.2%) decide per case. Other surgeons insert a dermis fat graft as a standard primary implant (n=1), or fill the socket in a standard secondary procedure (n=2; one uses dermis fat grafts and one artificial implants). The choice for porous implants was more frequent than for non-porous implants: 27 (58.7%) and 15 (32.6%), respectively. Both porous and non-porous implant types are used by 4 (8.7%) surgeons. Twenty-five surgeons (54.3%) insert bare implants, 11 (23.9%) use separate wrappings, eight (17.4%) use implants with prefab wrapping and two insert implants with and without wrapping depending on type of implant. Attachment of the muscles to the wrapping or implant (at various locations) is done by 31 (53.4%) surgeons. Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles. Measures to improve volume are implant exchange at an older age (n=4), the use of Restylane SQ (n=1) and osmotic expanders (n=1). Pegging is done by two surgeons.

Conclusion: No (worldwide) consensus exists about the use of material and techniques for enucleation for the treatment of retinoblastoma. Considerations for the use of different techniques are discussed.

Show MeSH
Related in: MedlinePlus