Surgery

Surgery for pediatric retinoblastoma, called enucleation, requires the eye to be removed in order to remove the cancerous tissue. Surgery is reserved as a last resort when treating pediatric retinoblastoma, due to the risk of visual impairment, but unfortunately it is used in a majority of cases. Removing the eye becomes necessary when the tumor has grown too large to respond to other forms of treatment quickly enough, and can decrease the risk of cancer spreading to other parts of the body. In most cases, vision in the eye that must be removed has already been destroyed by the retinoblastoma.

Pediatric Retinoblastoma Enucleation

During enucleation, the entire eye is removed, along with part of the optic nerve. This procedure is done under general anesthesia.  A ball that is specially made from rubber, plastic, or coral is placed into the socket to fill the cavity and prevent contamination. The surgery is uncomplicated in most cases, lasting one hour or less, and the child can return home the same day. Blinking and tearing are typically unaffected by enucleation.

Fitting for a Prosthetic Eye

Approximately three weeks after the surgery, the patient may be fitted for a prosthetic eye by an ocularist. This prosthetic eye is attached to the eye muscles, to allow normal movement. The prosthetic eye is carefully matched to the other eye, and it is typically difficult to tell the real eye from the prosthetic.

Removal of Both Eyes

If both eyes are affected by retinoblastoma, the physician and patient must make the decision to either remove both eyes or remove the eye that has been affected the most and treat the other eye using other methods of treatment. If both eyes are removed, the patient will be totally blind, but it may be necessary in some cases to preserve life. If there is any chance of preserving eyesight in one eye, the physician will typically opt to only remove one eye.

Retinoblastoma Surgery Side Effects

Blindness in the eye that has been removed is unavoidable, as there is no way to restore vision to an eye that has been removed. In some cases, removing the eye affected by retinoblastoma will cause the bone and tissue around the eye to grow differently, giving the eye area a sunken appearance. Bleeding may occur during and after surgery, and infection is a risk with any surgery. If the eye is not cared for properly after surgery, infection may also occur.