Dr. SURBHI AGRAWAL

, Dr. MAHESH P. SHANMUGAM, Dr. DIVYANSH MISHRA, Dr. RAJESH RAMANJULU

Abstract

A known case of unilateral Group D Retinoblastoma presented with total rhegmatogenous retinal detachment with a break at posterior edge of tumor. The child had received 6 cycles of intravenous chemotherapy with partial regression and was undergoing sequential local therapy. The parents were not desirous of enucleation and there was good visual potential. Therefore, a standard 23G vitrectomy with protocol to minimize tumor spillage was planned. Under Topotecan infusion posterior vitreous detachment was extended beyond the tumor. As the tumor was interfering with retinal apposition at the break, endoresection of tumor was done and haemostasis secured. Calcific tumor residue could not be removed using the cutter and was isolated from the surrounding retina (attempting removal could result in spillage). Retina was reattached with fluid air exchange. Residual tumor and break treated with endolaser. Silicone oil tamponade was used. Additional systemic chemotherapy (prophylactic) was advised.