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Extended Internal Limiting Membrane Peeling in Complex Pediatric Rhegmatogenous Retinal Detachment
Abdussalam M Abdullatif1, Tamer A Macky1, Hassan A Mortada1
1Department of Ophthalmology, Kasr El Aini Hospital, Cairo University, El-Manial, Cairo, Egypt.
Summary
Extended internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) is feasible for pediatric rhegmatogenous retinal detachment (RRD). This procedure shows promising anatomical success rates in complex cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Pediatric rhegmatogenous retinal detachment (RRD) can be challenging to manage.
- Severe proliferative vitreoretinopathy (PVR) complicates RRD treatment in children.
Purpose of the Study:
- To evaluate the feasibility of extended internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV).
- To assess anatomical and functional outcomes of this technique in pediatric RRD with severe PVR.
- To investigate the impact on epiretinal proliferation.
Main Methods:
- Retrospective interventional case series.
- Inclusion of children (≤18 years) with RRD and PVR grade C.
- Performance of PPV with ILM peeling up to 2-disk diameter beyond vascular arcades.
Main Results:
- ILM peeling in pediatric eyes was comparable in difficulty to adult eyes.
- Final anatomical success rate of 86.2% after a mean follow-up of 18 months.
- Corrected-distance visual acuity (CDVA) better than 20/200 achieved in 37.9% of patients.
Conclusions:
- Vitrectomy with ILM peeling is technically feasible for complex pediatric RRD.
- The procedure demonstrates favorable anatomical outcomes and limits epiretinal proliferation.
- Further research is needed to understand the long-term effects of ILM peeling in this population.
