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Sidath Liyanage, Marie-Hélène Errera, Rene Moya, S. Chien Wong, Eric Ezra; Pediatric Rhegmatogenous Retinal Detachment Surgery by Segmental Scleral Bucking: Risk Factors and Anatomical Outcomes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4957.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomical outcomes of segmental scleral buckling procedures as a primary intervention in pediatric rhegmatogenous retinal detachments.
A retrospective case note review of all children aged 18 years or younger who underwent segmental scleral buckling (scleral buckling using segmental episcleral explants in combination with retinal cryopexy) as an initial procedure for rhegmatogenous retinal detachment at Moorfields Eye Hospital, London, United Kingdom. This review included consecutive cases presenting over a 13 year period, from October 1998 to September 2011. Data collected included demographics, etiology, presenting clinical examination findings, prior ocular surgery, predisposing factors and outcome. The primary outcome was anatomic success defined as retinal reattachment. Secondary outcomes included the number of subsequent surgeries and the requirement of silicone oil to maintain retinal attachment.
We identified 103 eyes in 98 children who underwent segmental scleral buckling as an initial procedure for rhegmatogenous retinal detachment. The mean age was 12 years (standard deviation ±3.22; range 1 to 18 years) with 79.5% of patients being male. The mean follow-up interval was 25 months, with follow up ranging from 3 months to 13 years. Retinal reattachment was achieved with one operation in 71.8% (74 out of 103 eyes) and the final success rate was 95% (98 out of 103 eyes). Factors associated with an increased risk of failure included: more than one break; 3 or more quadrants of detachment; horse shoe tears; no breaks seen on pre-operative examination; congenital and developmental abnormalities.
The anatomic success rate for segmental scleral buckling in this study compares favorably with other studies and modalities and supports its use as a primary intervention in pediatric rhegmatogenous retinal detachments.
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