Anatomical Outcome of Retinal Detachment Surgery in Children with Intravitreal Carbamide Prior to

Abstract

Abstract: : Purpose: To evaluate safety and advantages of intravitreal injection of carbamide as an adjuvant of vitrectomy in pediatric patients. From our report last year, we present a longer follow up in a larger group of patients. Methods: Prospective, longitudinal and interventional study, partially reported last year. 10 eyes of 10 children with retinal detachment were included. Modifications to the previous report methods were made as follows: Intravitreal injection of 3.0mg/50mL of carbamide was performed 72 hours prior to pars plana vitrectomy (instead of 24 hours). Follow–up period was one year (instead of 3 and 6 months). Results: Ten eyes of ten patients, mean age 12.1 years (range 6–18) were included. Follow–up period was 1 year. 3 cases associated with Stickler syndrome, 5 with high myopia and 2 with trauma. Complete hyaloid removal was possible in all cases. Retinal reattachment was achieved in all patients, and retina remained attached in 90% (9/10) at 3 months and 70% (7/10) at 6 months. Silicone oil was used as tamponade in 80% (8/10) and C3F8 in 20% (2/10). Visual improvement occurred in 80% (8/10). No changes were observed on 1 year follow–up. No other complications were observed. Prolonging exposure to carbamide increased effectiveness. Conclusions:Intravitreal injection of carbamide as an adjuvant of pars plana vitrectomy in pediatric patients with retinal detachment is a safe technique that offers advantages, such as: facilitated removal of vitreous gel end improvement of anatomical outcome. Applying medication 72 hour prior to surgery seems to be better compared to previously described period. More extensive, controlled studies are necessary to define carbamide’s role on retinal surgery of pediatric population.

Keywords: retinal detachment • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: outcomes/complications