Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Cami Street Number:2, Beyoglu, Istanbul, Turkey.
Okmeydani Prof. Dr. Cemil Tascioglu State Hospital, University of Health Sciences, Istanbul, Turkey.
Int Ophthalmol. 2022 Nov;42(11):3469-3478. doi: 10.1007/s10792-022-02346-x. Epub 2022 May 16.
To evaluate the characteristics and analyze the results of patients who underwent pars plana vitrectomy (PPV) as the first surgery due to rhegmatogenous retinal detachment (RRD) in pediatric age.
The records of pediatric patients who underwent PPV alone due to RRD were reviewed retrospectively. The best corrected visual acuity (BCVA) values were recorded before and after the surgery. Complications during and after the operation, postoperative recurrences were followed-up.
One hundred and six patients included in the study were followed-up for an average of 24.20 ± 11.38 months. The final mean BCVA showed a statistically significant improvement compared to the initial mean BCVA (p < 0.001). During the postoperative follow-up period, recurrent retinal detachment was seen in 31.1% of patients. Anatomical success was achieved at a rate of 68.9% after the first surgery and increased to 95.3% after repeated operations (in 78.3% without any tamponade). Both anatomical and functional success of patients with proliferative vitreoretinopathy (PVR) grade C or worse and patients with macula-off retinal status were poorer (each p value < 0.05). The effect of the etiological factor on anatomical and functional success was not significant (each p value > 0.05).
Satisfactory results can be obtained with PPV alone in pediatric RRD. However, it should be noted that postoperative complications and recurrences occur at a high rate and that repeated surgeries are often required. The presence of PVR and macular involvement are seen as negative prognostic factors to the success of surgery.
评估儿童孔源性视网膜脱离（RRD）患者行单纯玻璃体切除术（PPV）作为首诊手术的特点并分析其结果。
回顾性分析了因 RRD 行单纯 PPV 的儿童患者的病历。记录术前和术后的最佳矫正视力（BCVA）值。记录术中及术后并发症，随访术后复发情况。
本研究共纳入 106 例患者，平均随访 24.20±11.38 个月。与初始平均 BCVA 相比，最终平均 BCVA 有统计学显著改善（p<0.001）。在术后随访期间，31.1%的患者出现复发性视网膜脱离。首次手术后解剖成功率为 68.9%，重复手术后增加至 95.3%（78.3%无需任何眼内填充物）。增殖性玻璃体视网膜病变（PVR）C 级或更高级别和黄斑脱离的患者的解剖和功能成功率较差（p 值均<0.05）。病因因素对解剖和功能成功率的影响无统计学意义（p 值均>0.05）。
PPV 单独治疗儿童 RRD 可获得满意的效果。然而，应注意术后并发症和复发的发生率较高，且常需重复手术。存在 PVR 和黄斑受累被视为手术成功的负面预后因素。
