儿童视网膜脱离玻璃体视网膜手术后的解剖和视力结果

Chanchal Meena, Sanjeev K Nainiwal, Ram Swaroop Harsolia
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摘要

儿童玻璃体视网膜手术(PVRS)与成人手术相比具有独特的挑战。了解眼部生长发育是PVRS的重要考虑因素。睫状体尺寸随年龄的变化可能会影响巩膜切开术的放置方式,从而避免医源性损伤周围视网膜。目的探讨儿童年龄层视网膜脱离后玻璃体视网膜手术的视觉和解剖效果。在这项前瞻性介入研究中,连续20例年龄在18岁或以下的患者接受玻璃体视网膜手术治疗视网膜脱离。所有患者详细记录眼部和全身病史。收集术前和术后数据。随访3个月。手术结果以视力和视网膜状态的改善来衡量。20例患者20只眼,男性优势(75%),平均年龄16.4±2.01岁。最常见的病因是外伤(65%),其次是近视(30%)。50%的患者行玻璃体切除(PPV), 15%的患者行晶状体切除合并玻璃体切除,25%的患者行巩膜扣(SB)手术,10%的患者行PPV-SB手术。85%的患者视力得到改善。80%的病例获得初步解剖成功。由于RD的复杂性,PPV是我们研究的主要手术方式。术后视力康复也尽可能地治疗弱视。
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Anatomical and visual outcomes after vitreoretinal surgery in paediatric retinal detachment
Paediatric vitreoretinal surgery (PVRS) has unique set of challenges compared to surgery in adult eyes. An understanding of ocular growth and development is an important consideration in PVRS. Changes in ciliary body dimensions with age may affect how sclerotomies are placed, so as to avoid iatrogenic damage to the peripheral retina. To study the visual and anatomical outcomes after vitreoretinal surgery in paediatric age group after retinal detachment. In this prospective interventional study, 20 consecutive patients aged 18 years or younger undergoing vitreoretinal surgery for retinal detachment were included. A detailed ocular and systemic history was recorded from all patients. Pre and postoperative data were collected. All the evaluated eyes were followed up to 3 months. Outcome of surgery was measured in terms of improvement in visual acuity and retinal status. Twenty eyes of 20 patients were evaluated with male predominance (75%) and mean age of the patient was 16.4±2.01. Most common etiology was found to be trauma (65%) followed by myopia (30%). Pars plana vitrectomy (PPV) was done in 50% patients, lensectomy with vitrectomy was done in 15%, scleral buckle (SB) surgery was done in 25% cases, where as PPV-SB was done in 10% cases. Improvement in visual acuity was noted in 85% cases. Primary anatomical success was achieved in 80% cases. PPV was the major surgical procedure in our study due to complexity of RD. Postoperative visual rehabilitation was also done to fight amblyopia as far as possible.
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