Effect of flurbiprofen sodium on pupillary dilatation during scleral buckling surgery.

Maintenance of pupillary dilatation is necessary for success of scleral buckling procedures. The efficacy of 0.03% flurbiprofen in preventing intraoperative miosis was evaluated by a prospective randomized, double-masked controlled trial of 60 patients. Thirty patients received 0.03% flurbiprofen 6 times at 15 minute intervals 90 minutes preoperatively in addition to the routine dilation regimen. The treated group had a mean pupillary decrease of 1.88 mm and the control group had a decrease of 1.57 mm (p > 0.05). Flurbiprofen did not affect the pupillary size at any step of the surgery. Factors such as age of the patient, lens status, number of cryo applications, duration of surgery, and the size and extent of buckle were assessed. The use of flurbiprofen did not affect the mean pupillary change for any of these groups. Preoperative use of flurbiprofen does not significantly decrease intraoperative miosis during scleral buckling procedures.

New tumours in non-enucleated eyes of bilateral retinoblastoma patients.

Forty non-enucleated eyes with bilateral retinoblastoma which were treated by external beam radiation therapy (EBRT), transconjunctival cryopexy, and photocoagulation were retrospectively analysed for the age of onset and location of new intraocular tumours. Of these 40 eyes, 9 (22.5%) eyes developed 17 new tumour foci over a mean follow-up of 3 years. The risk of new tumour formation was age-related being 47% in children with age at onset of retinoblastoma less than 1 year compared to 4.4% in older children (P < 0.001). Four eyes (44%) had 2 episodes of tumour formation. All tumour foci developed within 11 months of initial treatment at an average episode interval of 4.0 months. In 89% of cases, new lesions ceased to occur by 18 months of age. Our study clearly shows that EBRT did not prevent development of new lesions. The tumour islands which developed in the peripheral retina in 88% of cases were successfully treated with transconjunctival cryopexy. In 8 cases (89%), the eye could be salvaged. All young bilateral retinoblastoma patients should undergo frequent periodic detailed examination of the retinal periphery with 360 degrees scleral depression to pick up new tumour lesion early and to treat them effectively with simple globe saving methods.