Take care to avoid iatrogenic breaks when addressing tractional detachments in children
KOLOA, Hawaii — In cases of tractional detachments in pediatric patients, retinal surgeons need to be careful not to make iatrogenic breaks, a speaker here said.
“It's a little different than in diabetic patients in adults, where if you end up making a break, you can usually just flatten the retina by peeling more or doing a retinectomy, whatever you can to force the retina down, but you cannot do that in these severe detachments in kids,” Yoshihiro Yonekawa, MD, said at Retina 2023.
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If there is an iatrogenic break in a pediatric patient, then the eye can quickly become inoperable, he said.
To address these cases, Yonekawa said, “You go in, you try to release the traction, and then you come out. Usually, it’s relatively quick surgery because you’re not trying to do a complete job. You just visualize which tractional vectors you have to cut and then get out of the eye before you cause any trouble.”
Once the traction is released, he said, over the ensuing few weeks, the retinal pigment epithelium pumps out the fluid and the retina gradually attaches.
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Yonekawa Y. Pediatric retina surgery: Tips and tricks. Presented at: Retina 2023; Jan. 15-20, 2023; Koloa, Hawaii.