Retinal Detachment Surgery in a Pediatric Population

Read, Sarah P.; Aziz, Hassan A.; Kuriyan, Ajay E.; Kothari, Nikisha; Davis, Janet L.; Smiddy, William E.; Flynn, Harry W.; Murray, Timothy G.; Berrocal, Audina M.

doi:10.1097/iae.0000000000001725

Cited by 53 publications

(52 citation statements)

References 21 publications

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“…In addition to these variables, the recurring retinal detachments during follow-up were also associated with a worse prognosis (OR: 0.149, 95% CI: 0.037–0.597). These findings are similar to the results of other studies of adult or pediatric retinal detachment [ 2 , 3 , 10 , 11 ]. Although these variables are found to be predictors of a worse outcome after retinal detachment surgery, there is no scoring system that incorporates these variables.…”

Section: Discussionsupporting

confidence: 91%

Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

Yaşa

Erdem

Ürdem

et al. 2018

Journal of Ophthalmology

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Purpose We report the clinical characteristics, prognostic factors, and surgical outcomes for 23-gauge pars plana vitrectomy (23-G PPV) in pediatric cases of traumatic retinal detachment (RD). Methods Medical records of pediatric patients who underwent 23-G PPV to treat traumatic retinal detachment were retrospectively reviewed. These patients underwent a follow-up examination at least 1 year following surgery. Associations between various preoperative factors and anatomical and visual outcomes were analyzed. An Ocular Trauma Score (OTS) and a Pediatric Ocular Trauma Score (POTS) were calculated for each patient. Raw scores were converted to their corresponding OTS and POTS categories. Final visual acuities by categories were compared with those in the OTS and POTS studies. Results The mean age of the patients was 9 ± 4 years, and the male-to-female ratio was 4.7 : 1. The mean follow-up time was 23 ± 14 months. Anatomical success was achieved in 72% of the eyes, and functional success (>5/200) was achieved in 37% of the eyes. Functional success was less common among patients with visual acuities less than hand motion, macula-off retinal detachment, proliferative vitreoretinopathy at presentation, and recurrent retinal detachment during follow-up. When we compared the categorical distribution of final visual acuities in all categories, our results were significantly different than those suggested by OTS and POTS. Conclusions Visual outcomes are poorer compared to anatomical outcomes. OTS and POTS do not provide reliable prognostic information if the patient has RD. Presenting visual acuity, the presence of macula-off RD, and PVR are all important predictors of final visual acuity.

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Section: Discussionsupporting

confidence: 91%

Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

Yaşa

Erdem

Ürdem

et al. 2018

Journal of Ophthalmology

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“…Many studies [6][7][8][9] discussed pediatric traumatic retinal detachment from many aspects such as the clinical features, the anatomical and visual outcomes, and the risk factors. Neither of these studies discussed the effect of change in the surgical technique on the outcomes, ie, whether abundant use of encircling band has any effect on either anatomical or visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison Between Pars Plana Vitrectomy with and without Encircling Band in the Treatment of Pediatric Traumatic Rhegmatogenous Retinal Detachment</p>

Ghoraba¹,

Mansour²,

Abdelhafez³

et al. 2020

OPTH

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Background and Objectives: To compare anatomical and visual results of pars plana vitrectomy (PPV) with or without additional encircling band in the management of pediatric traumatic rhegmatogenous retinal detachment (RD) in a tertiary referral center. Methods: A retrospective review of children diagnosed with traumatic rhegmatogenous retinal detachment treated by pars plana vitrectomy with or without encircling band. Results: One hundred thirty-nine eyes of 139 children diagnosed with traumatic rhegmatogenous retinal detachment. Surgeries were performed between May 2011 and November 2016. Patients were followed up for at least 18 months after last intervention. The included eyes were categorized into two groups. Group A (vitrectomy with additional encircling band) included 72 eyes of 72 children; 58 boys and 14 girls. Group B (vitrectomy without encircling band) included 67 eyes of 67 children; 58 boys and 9 girls. In group A, the mean age was 9.21±3.24. Attached retina was achieved in 61% (44 out of 72 eyes), of which 34 eyes remained attached after silicon oil removal, and 10 eyes remained attached under silicon oil tamponade. Recurrent RD under oil was present in 28 eyes (38.9%). In group B, the mean age was 11.06±3.64. Attached retina was present in 61.2% (41 out of 67 eyes), of which 30 eyes remained attached after oil removal, and 11 eyes remained attached under silicon oil tamponade. Recurrent RD was present in 26 eyes (38.8%). In group A, the final visual acuity (VA) ranged from NLP to 0.5; 58.7% of patients achieved VA more than counting fingers at 1 meter, and 34.6% of patients achieved VA of 0.05 or more. In group B, the final postoperative VA ranged from NLP to 0.9; 16% of patients achieved VA from counting fingers at 1 meter to 0.05, and 29.2% achieved VA of 0.05 or more. Conclusion: Although no statistically significant difference between the two groups (combined vitrectomy and encircling band versus vitrectomy alone in pediatric traumatic retinal detachment), it is wise to consider adding encircling band in severe trauma cases.

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“…Estimates of anatomical success ranges from 10 to 88% depending on etiology and surgical approach, with most failures caused by proliferative vitreoretinopathy (PVR). 4 …”

Section: Discussionmentioning

confidence: 99%

“…In a large case series, of 178 eyes in the pediatric population that underwent retinal detachment repair, 9 (4.3%) were secondary to XLRS. 4 These eyes were repaired by PPV/oil or gas, or scleral buckle/PPV/oil or gas. Although 100% final attachment rate was reported, 5 eyes (56%) had re-detachment and 7 eyes (78%) required more than 1 surgery.…”

Section: Discussionmentioning

confidence: 99%

Retinal detachment repair with perfluoro-N-octane endotamponade in an infant with juvenile X-linked retinoschisis

Chiang

Chang

Harper

2020

American Journal of Ophthalmology Case Reports

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Purpose We present a case of successful surgical management of an infant with X-linked retinoschisis with a giant retinal tear and retinal detachment of the right eye. Observations A 10-month-old male presented with retinoschisis of both eyes and a retinal detachment of the right eye. The patient underwent two-stage pars plana vitrectomy utilizing perfluoro-N-octane to stabilize the detached retina and facilitate posterior hyaloid separation. Retained perfluoro-N-octane tamponade was later exchanged with silicone oil. The retina remained attached at last follow up. Conclusions and Importance Retinal detachment repair in infants presents unique challenges. This is a safe and effective strategy for complex retinal detachment repair in the infant population.

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Retinal Detachment Surgery in a Pediatric Population

Abstract: Visual and anatomical outcomes varied among categories of RD. Rhegmatogenous retinal detachments were associated with the best outcomes (anatomical success and globe conservation), whereas TRDs generally had poorer visual and anatomical outcomes.

Cited by 53 publications

References 21 publications

Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

<p>Comparison Between Pars Plana Vitrectomy with and without Encircling Band in the Treatment of Pediatric Traumatic Rhegmatogenous Retinal Detachment</p>

Retinal detachment repair with perfluoro-N-octane endotamponade in an infant with juvenile X-linked retinoschisis

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