Department of Surgery, The Vision Center, Children's Hospital Los Angeles, Los Angeles, California.
Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
Retina. 2020 Nov;40(11):2083-2090. doi: 10.1097/IAE.0000000000002746.
To report on the indications, outcomes, and complications of endoscopic vitrectomy in a large cohort of pediatric vitreoretinal patients.
This is a retrospective interventional case series consisting of 244 eyes of 211 patients aged 18 years or younger undergoing a total of 326 endoscopic vitrectomies from 2008 to 2017. A 23-gauge vitrectomy was performed with use of a 19-gauge endoscope.
Two hundred and eleven patients with a mean age of 7.5 years (range: 0-18 years) and median follow-up since last surgery of 28 months (range: 3 months-8.7 years) were included. The most common indication for endoscopic vitrectomy was retinal detachment (234/326; 72%) with proliferative vitreoretinopathy (162/234; 69%). Other diagnoses included trauma (25%), retinopathy of prematurity (15%), and glaucoma (9%). Twenty-five percent of surgeries (80/326) were performed on eyes with significant corneal opacities. Retinal reattachment was achieved in 67% of eyes with retinal detachment (119/178). Visual acuity improved in 26% of retinal detachment eyes versus 53% of nonretinal detachment eyes (P = 0.005). Surgical complications included band keratopathy (15%), hypotony (8%), cataract (7%), and elevated intraocular pressure (3%).
In this large series of pediatric endoscopic vitreoretinal surgeries, anatomic outcomes and complication rates were comparable with previous studies.
报告在一个大型儿科玻璃体视网膜患者队列中，内镜玻璃体切除术的适应证、结果和并发症。
这是一项回顾性的介入性病例系列研究，纳入了 2008 年至 2017 年间 211 名 18 岁或以下的患者的 244 只眼，共行 326 例内镜玻璃体切除术。采用 23-G 玻璃体切割术联合 19-G 内镜进行手术。
211 名患者的平均年龄为 7.5 岁（范围：0-18 岁），末次手术后的中位随访时间为 28 个月（范围：3 个月-8.7 年）。内镜玻璃体切除术最常见的适应证是视网膜脱离（234/326；72%），伴增生性玻璃体视网膜病变（162/234；69%）。其他诊断包括外伤（25%）、早产儿视网膜病变（15%）和青光眼（9%）。25%（80/326）的手术是在角膜混浊明显的眼中进行的。视网膜脱离的眼有 67%（119/178）实现了视网膜再附着。与视网膜脱离眼相比，非视网膜脱离眼的视力提高了 26%（53%）（P = 0.005）。手术并发症包括带状角膜病变（15%）、低眼压（8%）、白内障（7%）和眼内压升高（3%）。
在这项大型儿科内镜玻璃体视网膜手术系列研究中，解剖学结果和并发症发生率与既往研究相当。
