PDF(Pubmed)
Abstract：
Purpose: To describe the predisposing factors, clinical course, and surgical methods of pediatric rhegmatogenous retinal detachment (RRD) and determine which factors affect anatomic success. Methods: Data of patients 18 years or younger who had surgical repair for RRD from January 1, 2004, to June 31, 2020, with a minimum of 6 months of follow-up were retrospectively analyzed. Results: The study evaluated 101 eyes of 94 patients. Of the eyes, 90% had at least 1 predisposing factor to pediatric RRD, including trauma (46%), myopia (41%), prior intraocular surgery (26%), and congenital anomaly (23%); 81% had macula-off detachments and 34% had proliferative vitreoretinopathy (PVR) grade C or worse at presentation. The presence of PVR grade C or worse (P = .0002), total RRD (P = .014), and vitrectomy alone at first surgery (P = .0093) were associated with worse outcomes. Patients who had scleral buckle (SB) alone at the first surgery had statistically higher rates of anatomic success than those who had vitrectomy alone or combined with SB (P = .0002). After the final surgery, 74% of patients achieved anatomic success. Discussion: The majority of cases in this study were associated with 1 of the 4 risk factors predisposing to pediatric RRD. These patients often present late with macula-off detachments and PVR grade C or worse. The majority of patients achieved anatomic success after surgical repair using SB, vitrectomy, or a combination.
摘要：
目的：描述诱发因素，临床课程，以及小儿孔源性视网膜脱离（RRD）的手术方法，并确定影响解剖成功的因素。方法：回顾性分析2004年1月1日至2020年6月31日因RRD进行手术修复的18岁以下患者的资料，并随访至少6个月。结果：该研究评估了94例患者的101只眼。眼睛，90%至少有1个儿科RRD的诱发因素，包括创伤（46%），近视(41%)，既往眼内手术（26%），和先天性异常（23％）；81％的患者出现黄斑脱落，34％的患者出现增生性玻璃体视网膜病变（PVR）C级或更严重。PVRC级或更差的存在（P=.0002），总RRD（P=.014），首次手术时仅进行玻璃体切除术（P=.0093）与较差的预后相关。在第一次手术中单独使用巩膜扣（SB）的患者的解剖成功率高于单独使用或联合使用SB进行玻璃体切除术的患者（P=0.0002）。在最后一次手术之后,74%的患者实现了解剖成功。讨论：本研究中的大多数病例与4个易患小儿RRD的危险因素中的1个相关。这些患者通常表现为黄斑脱落和PVRC级或更差。大多数患者在使用SB进行手术修复后获得了解剖成功，玻璃体切除术,或组合。
