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Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery: An International Multicenter Study.

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Immediate sequential bilateral vitreoretinal surgery (ISBVS) is a safe and feasible option for pediatric patients with bilateral eye conditions. This approach minimizes anesthesia risks and is effective for various retinal diseases.

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Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Retinal Diseases

Background:

  • Bilateral vitreoretinal diseases in children often require surgical intervention.
  • Repeated general anesthesia in pediatric patients poses significant risks.
  • Immediate sequential bilateral vitreoretinal surgery (ISBVS) offers a potential solution to minimize anesthesia exposure.

Purpose of the Study:

  • To evaluate the feasibility and safety of performing bilateral simultaneous vitreoretinal surgery in pediatric patients.
  • To assess the incidence of ocular and systemic adverse events associated with ISBVS.

Main Methods:

  • A retrospective, international, multicenter case series.
  • Review of clinical history, surgical details, and adverse events in pediatric patients (≤17 years) undergoing ISBVS.
  • Data collected included indications, surgical time, anesthesia time, and postoperative outcomes.

Main Results:

  • 172 ISBVS procedures in 167 pediatric patients were analyzed.
  • Common indications included retinopathy of prematurity (ROP), abusive head trauma, and familial exudative vitreoretinopathy.
  • No intraoperative ocular complications were reported; low rates of postoperative vitreous hemorrhage (0.6%) and no endophthalmitis.
  • Anesthesia-related adverse events were minimal, with low rates of reintubation (0.6%) and oxygen desaturation (0.6%).
  • High anatomic success (89.8%) and globe salvage (98.0%) rates were achieved.

Conclusions:

  • ISBVS is a feasible and safe surgical approach for pediatric patients with bilateral vitreoretinal conditions.
  • This technique is particularly beneficial when repeated general anesthesia is undesirable or impractical.
  • ISBVS demonstrates favorable safety profiles and successful outcomes in a pediatric cohort.