25-Gauge vitrectomy for paediatric vitreoretinal conditions

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Retinal Surgery

Background:

• Pediatric vitreoretinal surgery presents unique challenges due to the small size of the eye.
• Minimally invasive techniques are desirable to reduce complications in pediatric patients.

Purpose of the Study:

• To assess the feasibility and safety of 25-gauge vitrectomy in children for various vitreoretinal conditions.
• To compare outcomes between standard and modified surgical approaches in different age groups.

Main Methods:

• Retrospective analysis of 56 eyes from 49 children (≤18 years) undergoing 25-gauge vitrectomy over 5 years.
• Two techniques were employed: a modified sutured approach for infants (<1 year) and a transconjunctival approach for older children.
• Data on intraoperative and postoperative complications were collected and analyzed.

Main Results:

• No cases of endophthalmitis, wound leaks, or hypotony requiring treatment were reported.
• Minor intraoperative events included conversions to 20-gauge and bleeding.
• Postoperative complications included cataract, retinal detachment, and vitreous hemorrhage, often in eyes with complex pathology.

Conclusions:

• 25-gauge vitrectomy is a viable and safe technique for pediatric vitreoretinal surgery, offering good access to small ocular spaces.
• A modified sutured technique is recommended for infants to mitigate the risk of postoperative hypotony.