July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Visual and Anatomic Outcomes of Pediatric Endoscopic Vitrectomy in 210 Consecutive Cases
Author Affiliations & Notes
  • Unikora Yang
    Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, United States
  • Aaron Nagiel
    Ophthlamology, The Vision Center, Children's Hospital Los Angeles, Los Angeles, California, United States
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Sui Chien Wong
    Ophthlamology, The Vision Center, Children's Hospital Los Angeles, Los Angeles, California, United States
    Ophthalmology, Moorfields Eye Hospital, Great Ormond Street Hospital for Children, Royal Free Hospital, London, United Kingdom
  • Emil Anthony Say
    Ophthlamology, The Vision Center, Children's Hospital Los Angeles, Los Angeles, California, United States
    Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, United States
  • Thomas C Lee
    Ophthlamology, The Vision Center, Children's Hospital Los Angeles, Los Angeles, California, United States
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Unikora Yang, None; Aaron Nagiel, None; Sui Chien Wong, None; Emil Say, None; Thomas Lee, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 844. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Unikora Yang, Aaron Nagiel, Sui Chien Wong, Emil Anthony Say, Thomas C Lee; Visual and Anatomic Outcomes of Pediatric Endoscopic Vitrectomy in 210 Consecutive Cases. Invest. Ophthalmol. Vis. Sci. 2018;59(9):844.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To report on the indications, outcomes, and complications of endoscopic vitrectomy (EV) in a large cohort of pediatric vitreoretinal patients. Prior case series have described endoscopic vitreoretinal surgery predominantly in adult patients with a limited range of indications. Here we describe our experience with EV in a diverse group of patients and pathologies, including those without anterior segment comorbidities.

Methods : Retrospective review of all patients who underwent posterior vitrectomy at Children’s Hospital Los Angeles (CHLA) from 2012-2017. 154 eyes of 125 patients underwent 210 endoscopic vitrectomies using 23-gauge vitrectomy and 19-gauge endoscopy, of which 209 were via the pars plicata/pars plana and 1 was clear corneal. Data collected included demographics, prior ocular histories, pre-operative and post-operative eye exams, and intraoperative techniques. The study was approved by the Institutional Review Board of CHLA (IRB#16-00103).

Results : Out of 210 surgeries on 154 eyes, the most common pre-operative diagnoses were trauma (24%), retinopathy of prematurity (20%), and pars planitis (7%). At presentation, 68% of eyes had no prior surgery (105/154), 23% had 1 prior surgery (36/154), and 8.4% had 2-11 prior surgeries (13/154). Common indications were tractional (107/210; 51%) and rhegmatogenous (60/210; 29%) retinal detachments. Concurrent procedures included silicone oil placement (95/210; 45%), lensectomy (65/210; 25%), and scleral buckling (25/210; 12%). The mean number of surgeries per eye performed at our center was 3.2 (range: 1-11) with a median follow up since last surgery of 4 months (range: 1 month-6 years). Of 103 eyes with pre-operative retinal detachment, including previously operated eyes, anatomic success as defined by retinal attachment with intraocular pressure > 6 mmHg at last follow up was achieved in 63.1% (65/103). The most common postoperative complications were band keratopathy (19/154; 12%) and cataract (14/154; 9%).

Conclusions : In this large series of pediatric endoscopic vitreoretinal surgeries, there were good anatomic outcomes and complication rates comparable to previous studies. The endoscope is a valuable surgical visualization instrument with wide applicability especially in pediatric eyes with complex retinal pathology.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Image from 20-gauge endoscope showing cutter tip addressing vitreous traction adjacent to lens in eye with ROP stage 4A detachment.

Image from 20-gauge endoscope showing cutter tip addressing vitreous traction adjacent to lens in eye with ROP stage 4A detachment.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×