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27-GAUGE PARS PLANA/PLICATA VITRECTOMY FOR PEDIATRIC VITREORETINAL SURGERY
Cindy Ung1, Yoshihiro Yonekawa2, Mina M Chung3
1South Coast Retina Center, Long Beach, California.
Insights
This study found that 27-gauge vitrectomy is a safe and feasible surgical option for pediatric patients with various vitreoretinopathies. The procedure demonstrated good anatomical success and improved visual acuity in young patients.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Pediatric vitreoretinopathy presents unique surgical challenges.
- Minimally invasive techniques are increasingly explored for pediatric eye surgery.
Purpose of the Study:
- To evaluate the feasibility and safety of 27-gauge vitrectomy in pediatric patients.
- To assess surgical outcomes, including complications and visual acuity, in this population.
Main Methods:
- An international, multicenter, retrospective case series involving 47 pediatric patients (56 eyes) aged 17 years or younger.
- Patients underwent 27-gauge vitrectomy for conditions such as retinopathy of prematurity, Terson's syndrome, and traumatic macular holes.
- Data on intraoperative events, postoperative complications, and visual acuity were collected and analyzed.
Main Results:
- No intraoperative complications or postoperative endophthalmitis were reported.
- Instrument bending occurred in 1.8% of cases; 7.1% required conversion to a larger gauge, and 5.3% developed postoperative hypotony.
- Mean visual acuity improved significantly (P=0.01), with 96.4% achieving anatomical success after one surgery.
Conclusions:
- Twenty-seven-gauge vitrectomy is a safe and feasible ultra-small gauge surgical option for selected pediatric vitreoretinopathies.
- Further research is needed to fully understand the indications and long-term outcomes of this technique in pediatric ophthalmology.
Purpose:
To report on the feasibility of 27-gauge (G) vitrectomy for pediatric patients.
Methods:
This study is an international, multicenter, retrospective, interventional case series. Participants were patients 17 years or younger who underwent 27-G vitrectomy for various indications.
Results:
The records of 56 eyes from 47 patients were reviewed. Mean age was 5.7 ± 5.2 years. Diagnoses included retinopathy of prematurity (Stages 3 with vitreous hemorrhage, 4A, 4B, and 5), Terson's syndrome, traumatic macular hole, posterior capsular opacification, endophthalmitis, and others. Instruments used were the 27-G infusion, 27-G vitreous cutter, 27-G light pipe, and 27-G internal limiting membrane forceps. Instrument bending was noted in one (1.8%) case. There were no cases with intraoperative complications, infusion issues, or postoperative endophthalmitis. There were 67/145 (46%) sclerotomies that required suturing, of which most (51/145) were sutured out of precaution. There were four cases (7.1%) that required conversion to a larger gauge and three cases (5.3%) that developed postoperative hypotony. Mean visual acuity improved from logarithm of the minimum angle of resolution 1.32 (20/420) to 0.72 (20/105), after a mean follow-up of 125.1 days (P = 0.01). Anatomic success was achieved in 96.4% of eyes after a single surgery.
Conclusion:
Twenty-seven-gauge vitrectomy was safe and feasible in selected pediatric vitreoretinopathies. Further studies are warranted to examine indications and outcomes.
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