The recommendations for pediatric vitreoretinal surgery

Abstract

Pediatric vitreoretinal surgery (PVRS) has important differences compared to that in adults. The main indications for PVRS include rhegmatogenous retinal detachments (RRD) caused by trauma, congenital retinoschisis, Marfan, Stickler or morning-glory syndrome, peripheral retinal degenerations, fundus coloboma, retinoblastoma, myopia, previous ocular surgery and tractional retinal detachments (TRD) caused by retinopathy of prematurity (ROP), persistent fetal vasculature (PFV), familial exudative vitreoretinopathy (FEVR) and penetrating ocular trauma. RRD in the adult usually associates with the posterior vitreous detachment (PVD), while as the RRD in pediatric age is often caused by trauma or congenital abnormalities. As pediatric retinal detachments (RD) usually present in late stages and pediatric ocular anatomy is featured, PVRS is more difficult and complex and has greater complication rates. The most common and devastating complication of PVRS is proliferative vitreoretinopathy (PVR). In particular, creating an iatrogenic retinal break (IRB) during PVRS can cause PVR in children because of the strong inflammatory and proliferative response.1−5