Characteristics and outcomes of pediatric retinal detachment surgery at a tertiary referral center.

Purpose: To report the clinical features, and anatomic and visual outcomes of pediatric retinal detachment (RD) surgery at a tertiary referral center in Southern Iran.

Methods: In this retrospective, non-comparative, interventional case series, we reviewed the records of 77 patients less than 18 years of age who had undergone primary RD surgery at Khalili Hospital, Shiraz, Iran from 2005 to 2010. All patients had follow-up duration more than 12 months.

Results: Seventy-seven eyes of 77 patients with mean age of 12.5±5 (range, 2-18) years including 56 (73%) male subjects were included. The most common etiologies of RD included trauma (90%) and myopia (6%). Different types of breaks and proliferative viteroretinopathy were present in 75% and 13% of eyes, respectively. The most common primary surgery was deep viterectomy (78%) followed by scleral buckling (19.5%). Single-operation reattachment was accomplished in 55% of cases. At final follow up, functional visual loss [best corrected visual acuity (BCVA) <5/200] occurred in 66.7%, while the rate of anatomical success was 62.3%. Significant predictors of better final BCVA were higher initial BCVA (P=0.015), absence of relative afferent pupillary defect (P=0.002), less extensive RD (P=0.031), and primary RD surgery (P=0.056). Anatomical success was associated with a lower number of procedures (P<0.001) and marginally with phakic lens status (P=0.079).

Conclusions: Trauma was the most prevalent predisposing factor for pediatric RD in our study. The high rates of functional visual loss and low anatomical success may be due to a large proportion of trauma and the complex nature of RD.