Rhegmatogenous and tractional retinal detachment in eyes with retinoblastoma: a retrospective surgical case series from a tertiary eye center

PURPOSE: To evaluate the clinical characteristics, management strategies, and surgical outcomes of tractional and/or rhegmatogenous retinal detachment (TRD/RRD) in eyes with retinoblastoma (RB). METHODS: A retrospective surgical case series of patients with treated RB at a tertiary referral center (June 2014-April 2025) who developed non-exudative retinal detachment (RD) was conducted. The data included demographics, tumor activity, RB treatment modalities received, RD features, surgical approach, complications, anatomical reattachment, and final visual acuity. RESULTS: Seven eyes of seven patients (0.9%) developed TRD or RRD. Four eyes had RRD, two had combined RRD/TRD, and one had TRD. Early RRD during active RB was treated with nondrainage scleral buckling (n = 2), whereas late detachments after complete tumor regression underwent pars plana vitrectomy with silicone oil tamponade (n = 4). Anatomical reattachment at one year was achieved in 83.3% of the operated eyes (five of six eyes undergoing surgery), with no cases of tumor seeding or reactivation observed. One eye was enucleated due to tumor progression. Visual acuity improved to baseline or better in 71.4% of the eyes. CONCLUSIONS: In this small series, early RRD during active RB was managed with nonsurgical scleral buckling without evidence of tumor dissemination, and late complex RRD after confirmed tumor quiescence was treated with pars plana vitrectomy and silicone oil tamponade with favorable anatomical outcomes. No tumor seeding or reactivation was observed in any case. However, these findings should be interpreted with caution, given the small sample size, and do not allow definitive conclusions regarding oncologic safety.