儿童玻璃体视网膜手术的建议

B. Turgut, T. Demir, O. Çatak
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引用次数: 1

摘要

与成人相比,儿童玻璃体视网膜手术(PVRS)具有重要的差异。PVRS的主要适应证包括外伤引起的孔源性视网膜脱离(RRD)、先天性视网膜裂、Marfan、Stickler或牵牛花综合征、周围性视网膜变性、眼底缺损、视网膜母细胞瘤、近视、既往眼部手术、早产儿视网膜病变(ROP)、持续性胎儿血管病变(PFV)、家族性渗出性玻璃体视网膜病变(FEVR)和穿透性眼外伤引起的牵引性视网膜脱离(TRD)。成人的RRD通常与玻璃体后脱离(PVD)有关,而儿童年龄的RRD通常由创伤或先天性异常引起。由于儿童视网膜脱离(RD)通常出现在晚期,且儿童眼部解剖特点,PVRS更为困难和复杂,并发症发生率更高。增生性玻璃体视网膜病变(PVR)是PVRS最常见和最具破坏性的并发症。特别是,在PVRS期间产生医源性视网膜破裂(IRB)可导致儿童PVR,因为强烈的炎症和增殖反应1−5
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The recommendations for pediatric vitreoretinal surgery
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
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