Laser Therapy (Photocoagulation or Thermotherapy) for Retinoblastoma

Lasers are highly focused beams of light that can be used to heat and destroy body tissues. Different types of laser therapy can sometimes be used to treat small retinoblastoma tumors.

Laser photocoagulation

Photocoagulation is a type of treatment that uses a laser beam aimed through the pupil (the dark spot in the front of the eye). The laser is focused on the blood vessels that surround and supply the tumor, destroying them by heating them. Photocoagulation is effective only for smaller tumors toward the back of the eye.

Your child will be under general anesthesia (in a deep sleep) during the treatment. The treatment is usually given 2 or 3 times, with about a month between treatments.

Possible side effects

In some cases, laser therapy can damage the retina, which can lead to blind spots or temporarily cause the retina to detach from the back of the eyeball.

Transpupillary thermal therapy (TTT)

For this treatment, also just called thermotherapy, the doctor uses a different type of laser than what’s used in photocoagulation. This laser applies infrared light directly to the tumor to heat and kill the tumor cells. The temperatures aren’t quite as high as those used in photocoagulation, so some of the blood vessels on the retina may be spared.

Thermotherapy can be used alone for very small tumors. For larger tumors, it can be used along with chemotherapy (called thermochemotherapy) or with radiation therapy (called thermoradiotherapy). Heat seems to help these other treatments work better.

The treatment is given while the child is asleep (under general anesthesia), usually for about 10 minutes at a time. Typically, 3 treatments about a month apart are needed to control each tumor. When used as part of thermochemotherapy, the heat is usually applied at a lower temperature over a slightly longer period of time, starting within a few hours after chemotherapy.

Possible side effects

Thermotherapy can sometimes cause part of the iris (the colored part of the eye) to shrink. Other possible effects include clouding of part of the eye lens or damage to the retina, which might affect vision.

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Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Hurwitz RL, Shields CL, Shields JA, et al. Chapter 27: Retinoblastoma. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016.

Kaufman PL, Kim J, Berry JL. Retinoblastoma: Treatment and outcome. UpToDate. Accessed
www.uptodate.com/contents/retinoblastoma-treatment-and-outcome on September 25, 2018.

National Cancer Institute. Retinoblastoma Treatment (PDQ®). 2018. Accessed at www.cancer.gov/types/retinoblastoma/hp/retinoblastoma-treatment-pdq on September 25, 2018.

Rodriguez-Galindo C, Orbach DB, VanderVeen D. Retinoblastoma. Pediatr Clin North Am. 2015;62(1):201-223.

Last Medical Review: December 3, 2018 Last Revised: December 3, 2018

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