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Long-term surgical outcomes of pediatric retinal detachment associated with primary congenital glaucoma
O Artunay1, M Ozbek1, S Ozcaliskan1
1Ophthalmology Department, Eye Training and Research Hospital, Istanbul, Turkey.
Insights
This study on pediatric retinal detachment (RD) in primary congenital glaucoma (PCG) found that while visual outcomes are often poor, globe preservation is achievable. This offers significant benefits for patients
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Surgery
Background:
- Primary congenital glaucoma (PCG) is a rare condition affecting 1 in 10,000 live births.
- Increased axial length in PCG leads to retinal thinning and detachment (RD).
Purpose of the Study:
- To evaluate the long-term surgical outcomes of pediatric retinal detachment (RD) in eyes with primary congenital glaucoma (PCG).
Main Methods:
- Retrospective analysis of pediatric patients undergoing vitrectomy with silicone oil injection for RD associated with PCG.
- Assessment of anatomical and functional outcomes through ocular examination reports and surgical findings.
Main Results:
- The study included 20 eyes; mean age 10.35 years, mean axial length 26.10 mm.
- Visual acuity remained stable in 45% and improved in 35% of patients. Globe preservation was achieved in all eyes after silicone oil removal.
- Recurrent RD occurred in 30% of cases, with one instance of phthisis bulbi.
Conclusions:
- Ocular comorbidities significantly impact final visual outcomes in PCG-associated RD.
- Despite a generally poor visual prognosis, globe preservation is attainable and crucial for patient quality of life.
- Ambulatory vision can be maintained in the majority of affected eyes.
Purpose:
Primary congenital glaucoma (PCG) is an extremely rare disease with an incidence of one in 10,000 live births. Increasing axial length due to PCG predisposes to retinal thinning and retinal detachment (RD). The present study aims to determine the long-term surgical outcomes of pediatric RD associated with PCG.
Methods:
This was a retrospective study including pediatric patients who underwent vitrectomy with silicone oil injection for RD associated with PCG. Ocular examination reports and surgical findings of patients were analyzed to assess the anatomical and functional outcomes of the surgery.
Results:
The study included 20 eyes of 20 children. Mean age was 10.35±3.73 years, range 5-16 years. The mean axial length was 26.10±2.19mm (range, 20.31-28.91mm). In 11 eyes, the intraocular pressure was<6mmHg at the time of RD diagnosis. Visual acuity remained stable in 9 patients (45%), and 7 patients (35%) showed improvement at the final visit. The mean follow-up period was 24.55±10.01 months, range 12-48 months. During the follow-up period, 6 patients (30%) underwent surgical revision due to recurrent RD. All 14 eyes that underwent silicone oil removal demonstrated maintenance of postoperative globe preservation. In five patients, the silicone oil remained in the eye throughout the follow-up period without the need for enucleation. One patient developed phthisis bulbi.
Conclusion:
Ocular comorbidities play a significant role in limiting final visual outcomes. Despite the poor visual prognosis of surgery, globe preservation can be achieved in such cases. Globe preservation has an important impact on patients' quality of life and psychological and social functioning. Moreover, ambulatory vision can be preserved in most eyes.
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