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Comparison Between Pars Plana Vitrectomy with and without Encircling Band in the Treatment of Pediatric Traumatic
Hammouda Hamdy Ghoraba1,2, Hosam Othman Mansour1,3, Mohamed Ahmed Abdelhafez1
1Magrabi Eye Hospital, Tanta, Egypt.
Insights
Pars plana vitrectomy (PPV) with or without an encircling band showed similar outcomes for pediatric traumatic retinal detachment. However, an encircling band may benefit severe trauma cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pediatric Ophthalmology
Background:
- Pediatric traumatic rhegmatogenous retinal detachment (RD) presents unique management challenges.
- Surgical outcomes can be variable, necessitating evaluation of different surgical approaches.
Purpose of the Study:
- To compare the anatomical and visual results of pars plana vitrectomy (PPV) with versus without an encircling band.
- To evaluate the efficacy of adjunctive encircling bands in pediatric traumatic RD management.
Main Methods:
- Retrospective review of pediatric patients with traumatic RD.
- Comparison of outcomes between PPV with an encircling band and PPV alone.
- Minimum 18-month follow-up for all patients.
Main Results:
- Both groups achieved similar retinal reattachment rates (61% in both).
- Recurrent RD rates were comparable (38.9% with band vs. 38.8% without).
- Final visual acuity outcomes showed no statistically significant difference between the groups.
Conclusions:
- Pars plana vitrectomy (PPV) with or without an encircling band yields comparable results for pediatric traumatic RD.
- Consideration of an encircling band may be beneficial in cases of severe trauma.
Background And Objectives:
To compare anatomical and visual results of pars plana vitrectomy (PPV) with or without additional encircling band in the management of pediatric traumatic rhegmatogenous retinal detachment (RD) in a tertiary referral center.
Methods:
A retrospective review of children diagnosed with traumatic rhegmatogenous retinal detachment treated by pars plana vitrectomy with or without encircling band.
Results:
One hundred thirty-nine eyes of 139 children diagnosed with traumatic rhegmatogenous retinal detachment. Surgeries were performed between May 2011 and November 2016. Patients were followed up for at least 18 months after last intervention. The included eyes were categorized into two groups. Group A (vitrectomy with additional encircling band) included 72 eyes of 72 children; 58 boys and 14 girls. Group B (vitrectomy without encircling band) included 67 eyes of 67 children; 58 boys and 9 girls. In group A, the mean age was 9.21±3.24. Attached retina was achieved in 61% (44 out of 72 eyes), of which 34 eyes remained attached after silicon oil removal, and 10 eyes remained attached under silicon oil tamponade. Recurrent RD under oil was present in 28 eyes (38.9%). In group B, the mean age was 11.06±3.64. Attached retina was present in 61.2% (41 out of 67 eyes), of which 30 eyes remained attached after oil removal, and 11 eyes remained attached under silicon oil tamponade. Recurrent RD was present in 26 eyes (38.8%). In group A, the final visual acuity (VA) ranged from NLP to 0.5; 58.7% of patients achieved VA more than counting fingers at 1 meter, and 34.6% of patients achieved VA of 0.05 or more. In group B, the final postoperative VA ranged from NLP to 0.9; 16% of patients achieved VA from counting fingers at 1 meter to 0.05, and 29.2% achieved VA of 0.05 or more.
Conclusion:
Although no statistically significant difference between the two groups (combined vitrectomy and encircling band versus vitrectomy alone in pediatric traumatic retinal detachment), it is wise to consider adding encircling band in severe trauma cases.
