New procedure aims to save vision of children with eye cancer

J. William Harbour, MD, is one of only a few doctors nationwide to use the approach for treating a rare, childhood eye cancer, called retinoblastoma. Harbour, the Paul A. Cibis Distinguished Professor of Ophthalmology and Visual Sciences, performs the surgery at St. Louis Children's Hospital. He implants a small disc, or plaque, which stays in the eye for three days before a second surgery to remove it.

"The standard of care for retinoblastoma is chemotherapy, followed by laser and freezing treatments to eliminate the last remnants of tumors," Harbour says. "But occasionally there will be a tumor that doesn't respond to chemotherapy or is too large to treat with a laser or freezing treatment. That's where this plaque treatment comes in. It gives us an option that may allow us to save the eyes of a young child."

Retinoblastoma, as the name suggests, is characterized by tumors in the eye's retina. It is extremely rare, affecting about one child in 20,000. In the United States, about 200 children each year are diagnosed with retinoblastoma. Approximately 40 percent of them develop tumors in both eyes, so in cases where the tumors prove resistant to chemotherapy, very young children and their parents are faced with a choice between a life without eyes and a high risk of death.

That's why Harbour, also a professor of cell biology and of molecular oncology and director of ocular oncology at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, and a handful of other eye cancer specialists have recently started using the plaque method to treat the cancer and possibly save the eyes.