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Endoresection

The tumour is cut into tiny fragments, which are sucked up a fine, metal tube that is passed through a hole in the retina. Laser treatment is administered during the operation to ‘weld’ the retina in place. The eye is filled with silicone oil for about twelve weeks to hold the retina in place until scarring has firmly welded the retina in position.

 

 

Fig5-5

 

The drawings show (a) removing the tumour through a hole in the retina; (b) replacing the intra-ocular water with air, to flatten the retina; (c) administering laser treatment to kill any remaining tumour and to 'weld' the retina in place; and (d) filling the eye with a silicone bubble, which acts as a 'splint', keeping the retina in place, and preventing bleeding. The oil is removed after 12 weeks.

 

This operation is usually performed to remove moderately sized tumours after radiotherapy if they become toxic to the eye. In rare cases when we perform endoresection as the first procedure, laser treatment and perhaps radiotherapy can subsequently be administered to prevent tumour recurrence. Some surgeons administer the radiotherapy before the endoresection, to eliminate any risk of tumour seeding to other parts of the eye and extraocularly.

 

The treatment involves:

  • a two-hour operation under general anaesthesia, and
  • after approximately 12 weeks, a 30- minute operation under local anaesthesia to remove the silicone oil.