When It Comes to Pediatric Retinal Surgery, Less is More
When performing retinal surgery on children, it is important to consider the age of the patient and know the anatomical changes that determine sclerotomy placement, noted Yoshi Yonekawa, MD, assistant professor of ophthalmology at Harvard Medical School in Boston, in a recent article. Dr. Yonekawa’s approach involves the following:
- Rule out retinoblastoma, using B-scan ultrasonography if necessary.
- Examine both eyes, since many eye issues are bilateral in children.
- Examine parents and siblings to look for a possible familial diagnosis.
- Use widefield and oral fluorescein angiography, as well as optical coherence tomography, if necessary.
- Remember that pediatric rhegmatogenous retinal detachment is usually best repaired with scleral buckling.
- Staged surgery is usually the best option for traction retinal detachments.
- The best surgeries achieve anatomic goals and do not go too far, lest iatrogenic complications arise.
In other words, less is more.
You can read more here.
Yonekawa Y. Practical pearls in pediatric vitreoretinal surgery. Ophthalmic Surgery, Lasers and Imaging Retina August 2018.