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

Abstract

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.

Pediatric rhegmatogenous retinal detachment: A meta-analysis of clinical features, surgical success rate, and prognostic factors

“…[ 8 ] with RS = 98%, n = 104, and Ghoraba et al . [ 29 ] with RS = 61%, n = 139, respectively. The most accurate results (the narrowest CI for RS) were reported by Errera et al .…”

“…[ 8 ] reported the highest RS = 95% (95% CI: 89.12%–100%) and Ghoraba et al . [ 29 ] reported the lowest RS = 61% (95% CI: 53.16%–68.84%). Oono et al .…”

Successful surgical treatment of traumatic macular hole with total rhegmatogenous retinal detachment in a child

“…Moreover, the buckle may decrease traction from PVR. A suggested advantage is that the buckle might decrease the need for retinotomies and/or retinectomies or decrease their size [17].…”

Risk factors and prognosis of pediatric rhegmatogenous retinal detachment in Egypt: a university hospital based study

“…Additional challenges found in the pediatric age group are posed by the presence of systemic comorbidities as prematurity and connective tissue disorders, poor younger children cooperation during examinations, the difficulty with postoperative positioning, bilateral detachments, and a relatively high rate of trauma [6][7][8][9] . Despite the difficulty in managing these cases, successful reattachment of the retina is possible in the majority of cases [10][11][12][13] . While most retinal detachments in the adult population are related to myopia and posterior vitreous detachment (PVD), previous reports have highlighted the etiology in pediatric age group to be trauma, myopia, previous intraocular surgery and congenital or developmental anomalies being the most Int J Ophthalmol, Vol.…”