V 801Pars plana vitrectomy in children - indications and results
C. Jandeck, U. Kellner
Purpose: To investigate the indications and results of pars plana vitrectomy (ppV) in pediatric patients.
Patients & Methods: In a consecutive series from 1991-2000 ppV was performed in 70 eyes of 65 children aged from 1 month to 16 years.
Results: 49 boys and 16 girls were operated on. Indications for ppV were the following: 22 eyes had a penetrating injury and 6 eyes had a retinal detachment due to a traumatic tear. 10 eyes suffered from complicated retinal detachment due to high myopia (3 of them were former premature children), 9 eyes presented an uveitis and 3 eyes had a Coats disease. Other reasons were a macular hole due to trauma (n=3), macular pucker (n=2), others (n=10). In 18 eyes silicone oil implantation was necessary during the first or additional operation. In 39 eyes at least a second retinal operation was performed. All patients were followed for 1 month to 6.6 years (mean: 21 months). At the end of follow-up, the retina was completly attached in 60 eyes (86%), with macular attachment in 63 eyes (90%). Subretinal strands occurred in 7 eyes and central subretinal exsudates in 2 eyes with Coats` disease. Functional success with a visual acuity of 0,02 and better was achieved in 82% and 0,1 or better in 67%.
Conclusion: Trauma with a complicated retinal detachment was the most common cause (47%) for vitrectomy in children. As in adult patients, silicone oil should be an option within the standard of care for the treatment of complex retinal detachments.
Augenklinik, Universitätsklinikum Benjamin Franklin, FU Berlin, D-12200 Berlin