About Your Ophthalmic Artery Chemosurgery for Pediatric Patients

This information describes what to expect during and after your ophthalmic (op-thal-mik) artery chemosurgery (OAC). For the rest of this resource, our use of the words “you” and “your” refers to you or your child.

Dr. Abramson and our retinoblastoma team, has recommended ophthalmic artery chemosurgery (OAC) to treat your retinoblastoma. It is an outpatient procedure used to treat tumors in the eye. Ophthalmic artery chemosurgery (OAC) allows chemotherapy to be injected directly into your ophthalmic artery (a blood vessel in the eye).

Your procedure will be performed by Dr. Pierre Gobin. He is an interventional radiologist at New York-Presbyterian Weill Cornell Hospital. You will need to fast for this procedure. Dr. Gobin’s staff will give you more information on how you should prepare.

About Your Procedure

You will be given anesthesia (medication to make you sleepy). Once you are asleep, a tiny catheter (a small, flexible tube about half of the diameter of angel hair pasta) will be inserted into one of the femoral arteries, blood vessels in your upper leg. It will be threaded through the arteries in your body to your ophthalmic artery (see figure 1).

Tiny drops (about one-fifth of a teaspoon) of chemotherapy will be placed into the catheter and will go into your treated eye. Depending on the extent of your retinoblastoma, you may receive 1 to 3 of the following medications:

  • Melphalan
  • Topotecan
  • Carboplatin

After the chemotherapy is administered, the catheter will be removed and a pressure dressing will be placed on the insertion site in the upper leg. Your nurse will place a knee brace on your knee and you will be awakened.

Figure 1. Inserting the catheter

This procedure takes about 60 minutes.

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After Your Procedure

You will spend 5 hours in the Post Anesthesia Care Unit (PACU), which is the recovery room.

While you are in the PACU, your nurse will check your upper leg and pulse. He or she will instruct you to resume drinking and eating when you are fully awake. When your nurse sees that you are ready, he or she will remove the knee brace and you will be discharged from the hospital.


Dr. Gobin may prescribe a steroid to take by mouth called prednisone. It will help to decrease swelling and irritation of your treated eye. Take this medication with food to prevent stomach upset, as directed by your doctor or nurse.

You may be prescribed ondansetron (Zofran®) for nausea or vomiting.  Take this medication as directed by your doctor or nurse.

You may be prescribed Tobradex® eye ointment. This medication is a combination of antibiotic and steroid used to decrease swelling and prevent infection in your treated eye. Use this medication as directed by your doctor or nurse.

Side Effects

You may experience some side effects after your procedure. These include:

  • Nausea
  • Vomiting
  • Redness, swelling or bruising in the upper leg area
  • Swelling in the treated eye; this may cause difficulty opening your eye
  • Mild discomfort in the treated eye

These side effects will improve after the first 2 to 3 days.

You may also experience some side effects starting 1 to 2 weeks after your procedure. These include:

  • Loss of lashes in the treated eye
  • Decrease in white blood cell count, also called neutropenia
  • Swelling in the treated eye that may last several days to a few weeks
  • Redness above the eyebrow and forehead of the treated eye that may last several weeks
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Follow- Up

You will need to have your blood drawn 7 to 10 days after your procedure. You or your healthcare provider will need to fax these results to Dr. Gobin at 212-746-6653 and Dr. Abramson at 646-227-7275.

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Call Your Healthcare Provider if You Have:

  • Redness or swelling in the treated eye lasting more than 2 weeks
  • Increased redness swelling, or pain in the upper leg
  • Nausea or vomiting lasting longer than 2 to 3 days
  • A temperature of 100.4° F (38° C) or higher
  • Pain in the treated eye lasting more than a few days
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Contact Information

If you have any questions or concerns, about your prescription or your procedure, please call Dr. Gobin’s office. You can reach him Monday through Friday from 9:00 am to 5:00 pm at 212-746-4998. After 5:00 pm, during the weekend and on holidays, please ask to speak with the doctor on call.

For all other questions, please call the MSK Retinoblastoma Clinic. You can reach them Monday through Friday from 9:00 am to 5:00 pm at 212-639-7232. After 5:00 pm, during the weekend and on holidays, please call 212-639-2000 and ask to speak with the covering ophthalmologist or pediatric fellow on call.

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