Surgical treatment in pediatric rhegmatogenous retinal detachment: pars plana vitrectomy versus scleral buckling, versus combined method

Objective: To analyze and report the results of patients who underwent vitreoretinal surgeries for pediatric rhegmatogenous retinal detachment (RRD).Method: The study was a non-blinded/non-randomized controlled study.Between July 2020 and July 2021, children < 16 years with pediatric RRD were enrolled and assigned to one of the following treatment cohorts depending on the type of surgery: scleral buckling (SB), pars plana vitrectomy (PPV), and PPV combined with SB (Groups I, II, and III, respectively).The follow-up period was up to 6 months.Results: 68 children (68 eyes) with pediatric RRD were enrolled in the study: Group I -28 eyes (41.2%);Group II -24 eyes (35.4%);Group III -16 eyes (23.5%).The patients' age range was from 8 to 16 years and the mean ± standard deviation was 11.2 ± 3.9 years: female 29.4% (n = 20) and male 70.6% (n = 48).Of those patients, 34 (50.0%)cases of pediatric RRD were after closed globe trauma, 22 (32.3%)cases were associated with high myopia, 10 (12.2%) cases were idiopathic, and 2 (2.4%) occurred after previous ocular surgery.In the 6 months of the follow-up period, complete retinal attachment was achieved in 78.6%, 70.8%, and 100% of cases in Groups I, II, and III.Best-corrected visual acuity ≥ 1.0 (LogMAR) was achieved in 85.7%, 66.7%, and 62.5% of cases in Groups I, II, and III, respectively.Conclusion: Favorable results may be achieved in all types of pediatric RRD surgery, including PPV, SB, and its combination.Treatment of pediatric RRD is still challenging due to the high rate of proliferative vitreoretinopathy and macula off detachment, which could be resulted in unsuccessful surgery.