PURPOSE To describe presenting clinical features and surgical techniques that are associated with successful surgical repair of pediatric rhegmatogenous retinal detachment (RRD). DESIGN Retrospective interventional case series. PARTICIPANTS Two hundred twelve eyes of 191 patients 0 to 18 years of age undergoing surgical repair for RRD between 2001 and 2015 with a minimum follow-up of 3 months. METHODS Patients were divided into 3 age groups (0-6 years, 7-12 years, and 13-18 years) and comparisons were made using bivariate and multivariate generalized estimating equation models. A mixed means model was used to examine visual acuity in each age group over time. MAIN OUTCOME MEASURES Complete reattachment of the retina at final follow-up. RESULTS Of 212 eyes, 166 (78%) achieved total reattachment at final follow-up. Mean follow-up was 36.3 months. Rhegmatogenous retinal detachment associated with Stickler syndrome was more likely to occur in the younger cohorts (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.22-0.91), whereas RRD associated with blunt trauma was more likely to occur in the oldest cohort (OR, 2.3; 95% CI, 1.2-4.4). Subtotal RRD was more likely to be repaired successfully than total RRD (OR, 3.6; 95% CI, 1.5-8.4; P = 0.0100), and eyes with previous vitreoretinal surgery were less likely to undergo successful repair (OR, 0.30; 95% CI, 0.12-0.78; P = 0.0258). There was no significant difference between age groups in the rate of surgical success (P = 0.55). There was a significantly higher success rate with primary scleral buckle (SB; 63%; OR, 2.2; 95% CI, 1.1-4.5) and combined SB plus pars plana vitrectomy (PPV; 68%; OR, 2.3; 95% CI, 1.1-5.1) compared with PPV alone (51%). CONCLUSIONS Most pediatric patients with RRD achieved complete reattachment with surgery. Success was more common in patients with a subtotal RRD at presentation. Previous vitreoretinal surgery was a risk factor for failure. Younger patients were more likely to demonstrate RRD involving the macula, but there was no difference between age groups in successful reattachment at final follow-up. Primary PPV showed a lower rate of success than SB or combined SB plus PPV.

中文翻译：

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小儿类风湿性视网膜脱离：预测成功手术修复的临床因素。

目的描述与成功的儿科血源性视网膜脱离（RRD）手术修复相关的临床特征和手术技术。设计回顾性介入病例系列。参与者2001年至2015年之间，对191例0至18岁的患者的212眼进行了RRD手术修复，至少随访3个月。方法将患者分为3个年龄段（0-6岁，7-12岁和13-18岁），并使用双变量和多变量广义估计方程模型进行比较。使用混合均值模型来检查每个年龄组随时间的视敏度。主要观察指标在最后的随访中将视网膜完全复位。结果212眼中，有166眼（78％）在最终随访时完全重新附着。平均随访36次。3个月。在年轻的人群中，更容易发生与Stickler综合征相关的流源性视网膜脱离（优势比[OR]为0.45； 95％置信区间[CI]为0.22-0.91），而RRD与钝性创伤相关的可能性更高年龄最大的队列（OR，2.3； 95％CI，1.2-4.4）。与总RRD相比，次全RRD修复成功的可能性更高（OR，3.6； 95％CI，1.5-8.4； P = 0.0100），以前进行过玻璃体视网膜手术的眼睛修复成功的可能性较小（OR，0.30； 95％ CI，0.12-0.78； P ＝ 0.0258）。年龄组之间的手术成功率没有显着差异（P = 0.55）。原发性巩膜扣术（SB; 63％; OR，2.2; 95％CI，1.1-4.5）和SB + pars平板玻璃体切除术联合治疗（PPV; 68％; OR，2.3; 95％CI， 1.1-5。1）与单独的PPV相比（51％）。结论大多数RRD的儿科患者已通过手术完全复位。在呈现RRD小计的患者中，成功更为常见。先前的玻璃体视网膜手术是失败的危险因素。年轻的患者更有可能表现出累及黄斑的RRD，但在最终的随访中，成功重新置入年龄组之间没有差异。原发性PPV的成功率低于SB或SB加PPV的成功率。但是，在最终随访中，成功重新连接的年龄组之间没有差异。原发性PPV的成功率低于SB或SB加PPV的成功率。但是，在最终随访中，成功重新连接的年龄组之间没有差异。原发性PPV的成功率低于SB或SB加PPV的成功率。