Yokoyama Toshiyuki, Kanbayashi Koki, Yamaguchi Tamaki
Department of Ophthalmology, Juntendo University Nerima Hospital, Tokyo, Japan.
Clin Ophthalmol. 2015 Jan 23;9:169-73. doi: 10.2147/OPTH.S75648. eCollection 2015.
To assess the treatment of pediatric patients with rhegmatogenous retinal detachment (RRD) by scleral buckling with chandelier illumination.
Three eyes were treated in three patients, healthy boys aged 7 years, 12 years, and 11 years, with RRD, macular involvement, and small retinal holes, of which two were preoperatively undetectable. Conventional scleral buckling with cryoretinopexy was performed under the contact lens for vitreous surgery or noncontact wide-angle viewing system using 27-gauge twin chandelier illumination.
The only known predisposing factor for retinal detachment was myopia stronger than 3 D with lattice retinal degeneration in two of the three patients. Retinal reattachment was achieved in all cases without intra- or postoperative complications. However, visual recovery was limited in one of the three patients.
Scleral buckling with chandelier illumination is effective for pediatric RRD, especially if the retinal hole is difficult to detect preoperatively. However, visual recovery was sometimes limited because of macular involvement due to late diagnosis, which is one of the characteristic features of pediatric RRD.
评估采用吊灯照明巩膜扣带术治疗小儿孔源性视网膜脱离（RRD）的效果。
对3例患有RRD、黄斑受累且有小视网膜裂孔的患儿（分别为7岁、12岁和11岁的健康男孩）的3只眼睛进行治疗，其中2个视网膜裂孔术前未被发现。在用于玻璃体手术的接触镜或使用27G双吊灯照明的非接触广角观察系统下，进行常规巩膜扣带术联合冷冻视网膜固定术。
视网膜脱离唯一已知的诱发因素是3例患者中有2例近视度数超过3D并伴有视网膜格子样变性。所有病例均实现视网膜复位，无术中或术后并发症。然而，3例患者中有1例视力恢复有限。
吊灯照明巩膜扣带术对小儿RRD有效，尤其是术前难以发现视网膜裂孔时。然而，由于小儿RRD的特征之一是诊断较晚导致黄斑受累，视力恢复有时会受到限制。
