Rhegmatogenous Retinal Detachment in Childhood.

Aims:  To retrospectively evaluate the anatomical and functional success of surgical treatment for rhegmatogenous retinal detachment (RRD) in pediatric patients aged 18 years and younger.

Material and methods:  The study includes 14 eyes of 14 patients, 9 (64%) of whom were males, with an average age of 12 years. All patients underwent surgery for rhegmatogenous retinal detachment (RRD) performed by a single surgeon at the Department of Ophthalmology, University Hospital Brno, and Masaryk University, from July 1, 2019, to June 30, 2024. The surgical techniques used included cryosurgery and 25G+ pars plana vitrectomy (PPV). In 3 patients a 25G+ PPV was combined with pre-equatorial scleral buckling. A history of blunt ocular trauma was permissible. The cause of RRD was retinal tear(s), regardless of their number or location. The transparency of the anterior segment enabled reliable visualization of the posterior segment. Preoperative proliferative vitreoretinopathy (PVR) grades A-D2 were acceptable. Patients with a history of penetrating ocular trauma were excluded. Anatomical success was defined as complete retinal reattachment. Each patient's final visual acuity (VA) was assessed using a Snellen chart. Numerical outcomes were expressed as arithmetic means and percentages. Since no comparative analysis was conducted between different groups, statistical tests were not required.

Results:  In 13 patients (93%), complete retinal reattachment was achieved. In 1 patient (7%), the retina became detached again after silicone oil removal, with rapid progression of PVR, leading to anatomical treatment failure due to inoperability. A total of 11 patients (78%) achieved visual acuity (VA) of ≥ 4/40.

Conclusion:  We consider cryosurgical techniques utilizing episclerally fixed encircling bands and buckles, 25G+ PPV, and potentially a combination thereof as appropriate methods for managing RRD in children.