Advances result in higher pediatric retinal reattachment rates

PARIS — Recent advances in surgical techniques have allowed surgeons to achieve remarkably better anatomical and functional results in pediatric retinal detachment surgery, a group of experts said here during the French Society of Ophthalmology meeting.

Baptiste Dufay, MD, told attendees about his retrospective study of 99 eyes of 88 patients who were treated for retinal detachment. All the patients were between 2 and 16 years old, and were treated between January 2000 and September 2005. The children all had a high rate of success, Dr. Dufay said.

“Final success, after one or more operations, was obtained in 81% of the cases. Visual acuity was better than 1/20 in 55% of the cases,” Dr. Dufay said.

In his case series, the main cause of retinal detachment was trauma (48%), followed by myopia (21%). Patients were predominantly boys (68%), and in two-thirds of the cases the diagnosis was delayed by more than 1 month.

“Delayed diagnosis and vitreoretinal proliferation still account for a number of failures in the treatment of this pathology in young patients,” Dr. Dufay said.

M. Djabour, MD, presented results from a shorter series. In his study, 24 eyes of 22 patients were treated for retinal detachment between January 2004 and May 2005. At baseline, the mean patient age was 9 years old. A wider variety of causes were reported among these patients, including trauma (33.3%), retinoblastoma (16.6%), myopia (8.3%), aphakia (8.3%), retinopathy of prematurity (4%) and other causes, he said.

Reattachment was obtained in 11 cases, and visual acuity ranged from finger count to 3/10 (1 eye).

“The progresses of vitreoretinal surgery in these years gives us the opportunity to save eyes that would have been lost in the past,” Dr. Djabour said.