title: The effect of cancer therapies on pediatric anophthalmic sockets.
abstract: OBJECTIVE
  To determine the impact of chemotherapy or external beam radiotherapy (EBRT) on pediatric anophthalmic sockets.
  
  
  METHODS
  A retrospective, nonrandomized, interventional cohort study.
  
  
  METHODS
  A total of 135 sockets of 133 children undergoing enucleation from late 1999 to early 2009 at the St. Jude Children's Research Hospital were included.
  
  
  METHODS
  A retrospective chart review of outcomes after enucleation in patients treated with systemic chemotherapy or orbital EBRT either before or after removal of the eye compared with patients who received no other treatment.
  
  
  METHODS
  Incidence of implant exposure, migration, extrusion, socket contracture, and pyogenic granuloma formation.
  
  
  RESULTS
  Retinoblastoma was the primary diagnosis in 128 eyes (95%). Median follow-up was 3.6 years (range, 0.1-9.3 years). Event-free course was observed in 94 sockets (69.6%). Complications included implant exposure (n = 28, 20.7%), socket contracture (n = 16, 11.9%), pyogenic granuloma (n = 9, 6.7%), implant extrusion (n = 3, 2.2%), and migration (n = 2, 1.5%). Exposure resolved in 21 sockets (77.8%) and improved in 2 sockets (11.1%); 1 patient with exposure died. Use of prior, adjuvant, or subsequent chemotherapy increased the long-term risk of exposure (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.4-9.4), and contracture (OR could not be calculated, P<0.0001). External beam radiotherapy greatly increased the risk of contracture (OR 24.0; 95% CI, 6.9-82.8) and exposure (OR 2.89; 95% CI, 1.1-7.9).
  
  
  CONCLUSIONS
  In this unique pediatric population with cancer, chemotherapy and EBRT had an additive effect, significantly increasing the incidence of exposure and socket contracture.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Shildkrot
authors.forename: Maria
authors.initials: M
authors.lastname: Kirzhner
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Qaddoumi
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Wilson
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003286:Contracture / Q000209:etiology; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D017789:Granuloma, Pyogenic / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009915:Orbit / Q000187:drug effects* / Q000528:radiation effects*; D020273:Orbital Implants; D011183:Postoperative Complications; D011878:Radiotherapy; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012175:Retinoblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents