Clinical Analysis Of Vitrectomy In Children With Vitreoretinopathy

PURPOSETo observe the clinical characteristics of vitreoretinopathy in children undergoing pars plana vitrectomy and to evaluate the surgical outcome in traumatic group.METHODSRetrospective observational case series. 102 consecutive cases (aged<18 years) undergoing primary pars plana vitrectomy collected from Department of Ophthalmology, Xiangya 2nd Hospital from July 2003 to June 2008 were studied. The surgical process and prognosis were analysed in the both traumatic and primary rhegmatogenous retinal detachment groups. Several meaningful cases have been disscussed. RESULTS1) The traumatic group accounts for the most(65.7%), in which the ratio of the male patients equals to 80.6%. Cases in both pre-school stage and school stage are dominant, accounting for 52.2 %, while the occurrence in the adolescence increases gradually.2) The binomial Logistic regression analysis identified the significant factors for the retinal anatomical reattachment including: APVR,PVR,retinotomy or retinectomy,iatrogenic tear and severe subretinal proliferation(P<0.05).3) The rhegmatogenous retinal detachment have been dominant (54.3%) in the non-tramatic group, especially primary rhegmatogenous retinal detachment have been complicated with high myopia(53.8%), giant tears(38.5%), cataract(38.5%) and owning history of retinal detachment in the fellow eye(23.1%). The rest can be devided into congenital abnormalities and biological infections.4) Silicone oil tamponade was performed by 90.4% in the tramatic retinal detachment group while by 84. 6% in the primary rhegmatogenous retinal detachment group. The ultimate retinal reattachment ratio in the traumatic group has been 89.7%, with 17.6% of cases having silicone oil remained. The visual acuity postoperatively has increased in 42 eyes(67.7%), maintained in 14 eyes(22.6%) and decreased in 6 eyes(9.7%). The obvious increase in visual acuity has been present postoperatively(P<0.05).CONCLUSIONS1. Males are the most in all children with vitreoretinopathy undergoing vitrectomy. Trama is the main cause, in which cases in both pre-school stage and school stage are dominant, it is related to the special characters and the slack family custody. It is essential to emphasize the custody and scientific guidance in such period.2. The general surgical result of the pars plana vitrectomy needs to be raised further. PVR especially APVR has accounted for the recurrent retinal detachment because of the vitreous residue in the base area. The significant factors for the retinal anatomical reattachment including: APVR,PVR,retinotomy or retinectomy,iatrogenic tear and severe subretinal proliferation.3. Selecting surgical opportunity scientificly is desirable as well as lens extraction and retinotomy or retinectomy carefully. Appropriate removal of silicone oil tamponade is recommended.