Orbital Complications and Cost Analysis of Enucleation by Myoconjunctival versus Conventional Techniques for Retinoblastoma

Author:

Lando LeonardoORCID,Mallipatna AshwinORCID,Kletke Stephanie N,Gallie Brenda

Abstract

<b><i>Introduction:</i></b> The aim of the study was to compare complication rates and hospital costs of myoconjunctival versus conventional enucleation techniques in retinoblastoma. <b><i>Methods:</i></b> This retrospective cohort and cost analysis reviewed patients with retinoblastoma treated by primary or secondary enucleation between 2003 and 2021 and a minimum 6-month follow-up. Cases were reviewed for three postsurgical complications: chronic conjunctivitis, implant exposure/extrusion, and cellulitis. Cases were excluded if surgery was performed elsewhere or documentation was incomplete. Treatment costs were estimated based on two sample cases billed in 2021 that manifested the studied complications and represented each of the two surgical techniques. Univariate and multivariate analyses were applied to compare complication rates and treatment costs. <b><i>Results:</i></b> Included were 180 eyes (179 patients); 239 eyes (227 patients) were excluded. Patients had median age of 18.9 (0–104.4) months at diagnosis, the majority were male (94, 52%), with unilateral (115, 64%) group D or E (163, 91%) eyes. Enucleation was performed by conventional techniques in 107 eyes (59%) and by myoconjunctival approach in 73 (41%). Orbital complications occurred in 61 eyes (34%) during a median follow-up of 7.9 (0.5–33.7) years, more frequently in the conventional technique group (<i>p</i> = 0.014). The myoconjunctival technique had significantly lower costs for implant price (<i>p</i> &lt; 0.001) and estimated treatment cost, including complication management (<i>p</i> &lt; 0.001). <b><i>Conclusion:</i></b> Enucleation by myoconjunctival technique showed significantly less complication burden and treatment cost, indicating advantages over conventional approaches. Study limitations include the retrospective nature, confounders’ complexity, and follow-up time variations.

Publisher

S. Karger AG

Subject

General Nursing

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Ophthalmic rehabilitation in oncology care;Canadian Journal of Ophthalmology;2024-08

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