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Paediatric giant retinal tears: management outcomes

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 18/09/2015 | 14:30-16:00

Paper Time: 15:18

Venue: Athena

First Author: : M.Bhende INDIA

Co Author(s): :    R. Muldiyar   P. Bhende   T. Sharma        

Abstract Details

PURPOSE:To report results of intervention for retinal detachment (RD) due to giant retinal tears (GRT) in patients aged ≤ 16 years of age

Setting:

Vitreoretinal service of a tertiary referral center in South India

Methods:

Observational case series of 36 eyes of 35 patients ≤ 16 years of age who underwent surgery for RD due to GRT , with a minimum followup of 12 months after the first surgery. Pre operative characteristics, surgery details, fellow eye status and postoperative course were noted.

Results:

Minimum age was 4 years. Male preponderance was noted. High myopia (44.4%), trauma (30.5%)and cataract surgery (13.8%) were the commonest risk factors. 52.7% had poor vision in the fellow eye . 80.6% had RD involving the macula. 75% eyes had GRT extending from 90-180 deg, 64% presented with PVR . 35 eyes underwent pars plana vitrectomy (28 with encirclage) , 1 eye had a scleral buckle. Silicone oil was used as tamponade in all eyes that underwent vitrectomy. Anatomical success was achieved in 91.6% at final follow up. 58.33% eyes had a final visual acuity of ≥ 6/60. Silicone oil emulsification (41.66%), glaucoma (19.44%)and recurrent RD (8.3%) were the common complications. Severe PVR and myopia ≥ 6 D limited the visual gain after surgery. 4 fellow eyes developed RD during follow up.

Conclusions:

GRT in the pediatric age group usually presents with PVR which limits the visual improvement, though anatomical success is good. High myopia and trauma are significant risk factors. Emulsification of silicone oil and glaucoma are common post operative complications. Poor vision in the fellow eye at presentation and development of similar findings in the fellow eye during the followup period signify the morbidity of this condition.

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