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AIM:To evaluate the underlying aetiology and clinical characteristics of retinal detachment(RD)in school-age pediatric monocular RD.METHODS:Patients with RD and contralateral blind(monocular RD)aged 7-14 years, from November 2015 to May 2021 in our hospital were retrospectively reviewed. Demographic characteristics and etiology of RD, clinical type, surgical modality, type of intraocular tamponade, pre-and postoperative visual and anatomical outcomes were recorded and evaluated.RESULTS: There were 27 children(27 eyes)with monocular RD at least 6mo follow-up. The average age at presentation was 10.63±2.30 years. Familial exudative vitreoretinopathy(FEVR)(11/27, 41%), postoperative congenital glaucoma(6/27, 22%)and Stickler syndrome(3/27, 11%)were main underlying etiologies. Among them, rhegmatogenous retinal detachment(RRD)comprised 78%(21/27)of the patients, of which 81% patients(17/21)had proliferative vitreoretinopathy(PVR)C3 or worse. Pars plana vitrectomy(PPV)was done in 85%(23/27)of the patients, of which 83%(19/23)received silicone oil tamponade. Best corrected visual acuity(BCVA, LogMAR)worse than 1.7 was seen in 78%(21/27)of the patients at final visit, and 82%(22/27)had reattached retina, but 41%(11/27)of the patients remained status of silicone oil tamponade at last visit.CONCLUSION:School-age pediatric monocular RD is often associated with underlying congenital or hereditary conditions, and often presented with severe RD and severe PVR reaction which needed vitrectomy combined with silicon oil tamponade, and with poor visual and anatomical short-term prognosis.
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Objective To investigate the clinical efficacy of 25G minimally invasive vitrectomy for the removal of foreign bodies in the posterior segment of the ball.Methods The clinical data of 21 patients (21 eyes) with intraocular foreign bodies who underwent 25G minimally invasive vitrectomy combined with intrabulbar foreign body removal were retrospectively analyzed,including magnetic foreign bodies in 17 patients and non-magnetic foreign bodies in 4 patients.All the patients had cataract and vitreous hemorrhage,with 3 patients (3 eyes) suffering secondary endophthalmitis,and 12 patients (12 eyes) suffering secondary retinal detachment.Cataract extraction,retinal reattachment and silicone oil tamponade were combined according to different conditions,and the complications and surgical outcomes were analyzed for 6-month followup.Results All patients received preoperative examinations,immediately following implementation of 25G minimally invasive vitrectomy and intrabulbar foreign body removal procedures.The removal rate of foreign bodies in phase Ⅰ was 100％.All the endophthalmitis and retinal detachment were cured before operation.The turbid lens was removed during operation from the corneal incision in 20 patients (20 eyes),and from a scleral incision in 1 patient after cataract extraction.A total of 19 eyes had better postoperative visual acuity than preoperative vision,14 eyes underwent phase Ⅱ intraocular lens implantation,and silicone oil was retained in 2 eyes.No postoperative complications related to minimally invasive surgery occurred.Conclusion 25G minimally invasive vitrectomy has good clinical outcomes in the removal of intraocular foreign bodies in the posterior segment of the eye,with minimal surgical trauma,rapid visual function recovery,and fewer complications,but great attention should be paid to its indications.