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Practical pearls in pediatric vitreoretinal surgery
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Pediatric retina surgery is not for the faint of heart. The stakes could not be higher for the youngest of our patients, and the margin between success and failure is razor thin. In surgery, as in medicine, small innovations and stepwise refinements to technique can, over time, cumulatively create tremendous progress.
In this edition of Practical Retina, Yoshi Yonekawa, MD, provides a comprehensive approach to the pediatric retinal surgical patient: from differential diagnosis, through diagnostic imaging, and ultimately to surgical decision-making with a compendium of surgical pearls.
There is an adage among pediatricians that children are not small adults. Dr. Yonekawa discusses the importance of stratifying pediatric patients by age and stresses the anatomical changes that dictate sclerotomy placement as the eye grows. The impact of technologic advances has translated well to pediatric retina, from widefield fluorescein angiography to small gauge instrumentation. The classic debate of scleral buckle versus vitrectomy surgery is addressed. Appropriate goal setting is important in pediatric retinal surgery to achieve the surgical objective while minimizing risk. Read more.
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Excerpted from Yoshihiro Yonekawa, MD; Howard F. Fine. Ophthalmic Surg Lasers Imaging Retina. 2018;doi:10.3928/23258160-20180803-02.
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