Shri Bhagawan Mahavir Vitreo-Retinal Services, Sankara Nethralaya, Chennai, India.
Eye (Lond). 2018 Feb;32(2):345-351. doi: 10.1038/eye.2017.175. Epub 2017 Sep 1.
PurposeTo report the incidence rate, management, and surgical outcomes of rhegmatogenous retinal detachment (RRD) in children who underwent pars plana vitrectomy (PPV) with sutured scleral-fixated intraocular lens implantation (SSFIOL).Patients and methodsOf the 279 eyes of 230 children who underwent PPV with SSFIOL at a tertiary eye care centre, 16 eyes of 15 children developed RRD. Retrospective analysis of the surgical details of RRD, the structural and functional outcomes was done.ResultsOf the 279 eyes of 230 children who underwent PPV with SSFIOL, RRD was seen in 5.7% of the eyes. Average age was 10.7 years (range 4-15 years). Indication for SSFIOL implantation was congenital subluxation of lens (8 eyes) and traumatic aphakia or lens subluxation (4 eyes each). PPV was done in 15 of the 16 eyes, and 1 patient underwent scleral buckling. Retina was attached at the last follow-up visit in 87.5% of the eyes with median number of surgeries being 1. BCVA at the time of retinal detachment, multiple surgeries, and PVR at presentation were associated with poor visual outcome.ConclusionSurgery for SSFIOL in our series of paediatric eyes was complicated by vision-threatening RRD in 5.7% of cases. Surgical outcome in eyes with RRD without PVR was better (100%) than that in those, where PVR had already set in (75%). Need for regular follow-up and self-monitoring of vision should be emphasized and discussed with the parents before surgical intervention.
报告接受巩膜扣带固定眼内晶状体植入术(SSFIOL)的儿童行睫状体平坦部玻璃体切除术(PPV)后孔源性视网膜脱离(RRD)的发生率、处理方法和手术结果。
在一家三级眼科中心,对 230 名儿童的 279 只眼行 PPV 联合 SSFIOL 治疗,其中 15 名儿童的 16 只眼发生 RRD。回顾性分析 RRD 的手术细节、结构和功能结果。
在 279 只眼的 230 名儿童中,有 5.7%的眼发生 RRD。平均年龄为 10.7 岁(4-15 岁)。SSFIOL 植入的适应证为先天性晶状体半脱位(8 只眼)和外伤性无晶状体或晶状体半脱位(各 4 只眼)。16 只眼中的 15 只眼接受了 PPV,1 只眼接受了巩膜扣带术。87.5%的眼在最后一次随访时视网膜复位,中位数手术次数为 1 次。视网膜脱离时的 BCVA、多次手术和 PVR 与较差的视力预后相关。
在我们的儿童眼系列中,SSFIOL 手术并发症导致 5.7%的病例发生威胁视力的 RRD。无 PVR 的 RRD 眼的手术结果(100%)优于已经发生 PVR 的眼(75%)。在手术干预之前,应强调并与家长讨论定期随访和视力自我监测的必要性。