Pars Plana Vitrectomy in the Pediatric Population: Indications and Long-term Results

Purpose: To establish the indications and the long-term results of pars plana vitrectomy (PPV) in the pediatric population.

Methods: PPV was performed in 60 eyes of 57 children, 45 boys and 12 girls, aged from 6 to 15 years. Twenty-nine eyes (48%) suffered from complicated rhegmatogenous or traction retinal detachment (RD) with advanced proliferative vitreoretinopathy (PVR), 19 eyes (32%) had RD due to an idiopathic or traumatic giant tear (GT), 7 eyes (11%) had an intraocular foreign body (IOFB), and 5 eyes (9%) had hemorrhage or exudation into the vitreous. In 43 eyes (65%) silicone oil implantation (SOI) was indicated, in 39 eyes (91%) a primary SOI, and in 4 eyes (9%) a secondary SOI. The patients were followed up for 6-72 months, mean 42 months.

Results: At the end of follow-up, anatomical success with a flat macula was achieved in 77% of the eyes, and functional success with visual acuity of 0.02 and better in 72%. The results were best in IOFB and traction RD after penetrating injury (success in 100% and 91%); the worst results were in RD after regressed retinopathy of prematurity and RD due to idiopathic GT (success in 50% and 54%). After SOI silicone oil was removed in 27 out of 43 eyes (63%), and the retina remained attached in 23 of these eyes (85%).

Conclusions: Indications and the long-term results of PPV in children were comparable with those in the adult. By far the most frequent indications were injuries and their complications. In complicated RD, a radical approach with primary SOI and later silicone oil removal proved useful. In children, with their long life expectancy, timely removal of silicone oil is vital for maintaining the function of the eye.