Abstract

Aim: To compare the outcomes of different surgical approaches in cases of pediatric rhegmatogenous retinal detachment.

Method: A systematic review and meta-analysis were performed, and an electronic search identified all stud ies comparing the surgical outcomes of the different surgical approaches in cases of pediatric rhegmatoge nous retinal detachment. The outcome was anatomical success from single surgery.

Results: Our systematic review and meta-analysis included 8 studies with 909 operated pediatric rhegmat ogenous retinal detachment eyes with one of three procedures, pars plana vitrectomy (PPV), combined pars plana vitrectomy and scleral buckle (PPV & SB) and scleral buckle alone (SB). The pooled single surgery anatomical success rates of PPV, combined PPV & SB and SB are 63%, 66% and 81% respectively.

When considering studies that directly compared two interventions, five studies directly compared PPV with combined PPV & SB with no statistically significant difference between the two interventions with a slight advantage to combined PPV & SB. Three studies directly compared SB with PPV, and the results showed that scleral buckle has higher odds of achieving anatomical success from a single surgery. While two studies di rectly compared SB with combined PPV & SB and showed no significant difference in achieving anatomical success

Conclusion: Scleral buckle is considered the most successful of the three procedures in achieving single surgery anatomical success. Combined PPV and SB can be considered in more advanced cases of rhegmatog enous retinal detachment with lower success rate. PPV is the least successful of the three interventions. Fur ther details are required within the literature to establish an evidence-based algorithm in cases of pediatric rhegmatogenous retinal detachments to increase future success rates.

doi.org/10.63721/26JORT0108

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