Our Summary

The researchers reviewed medical records of children who had eye surgery between 2013 and 2021. They wanted to identify risk factors that might lead to these children requiring two specific types of eye surgeries: a glaucoma drainage device (GDD) and a scleral buckle (SB). GDD is a device to help drain excess fluid from the eye to lower eye pressure in glaucoma patients, and SB is a technique used to repair a detached retina.

They divided the patients into two groups. The first group had an SB surgery first without any previous GDD and the second group had a GDD surgery first without any previous SB. In the SB-first group, the most common reasons for surgery were retinal detachment linked to a syndrome or disease, injury from a blunt force, or pathologic myopia (extreme nearsightedness) without any known syndrome or disease. About 9% of these patients later needed a GDD, usually around 20 months after the first surgery. Patients who had eye injuries were five times more likely to need the second surgery, and each additional glaucoma medication before the first surgery also increased the risk.

In the GDD-first group, only 3% later needed an SB surgery, usually around 17 months after the first surgery. The only significant risk factor in this group was eye injury.

So, the study suggests that children who have a history of eye injury or multiple glaucoma medications are more likely to need both types of surgeries.

FAQs

  1. What are the common indications for a scleral buckle placement in pediatric patients?
  2. What factors increase the risk of requiring a Glaucoma Drainage Device after a Scleral Buckle surgery?
  3. What is the average time to reoperation for patients undergoing Glaucoma Drainage Device implantation after a Scleral Buckle procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scleral buckle surgery is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities to ensure proper healing and reduce the risk of complications.

Suitable For

Pediatric patients who are at a high risk of requiring both scleral buckle surgery and a glaucoma drainage device are those with retinal detachment associated with a syndrome/disease, blunt trauma, non-syndromic pathologic myopia, a history of trauma, and/or multiple glaucoma medications before intervention. These patients may benefit from close monitoring and consideration of both surgical interventions to address their eye conditions effectively.

Timeline

  • Before scleral buckle surgery:
  1. Patient presents with symptoms such as floaters, flashes of light, or a sudden decrease in vision.
  2. Eye examination and diagnostic tests are performed to confirm a retinal detachment.
  3. Surgery is recommended to repair the detached retina, and the patient is informed about the procedure.
  4. Preoperative evaluations and preparations are done, including obtaining medical history and consent, and discussing anesthesia options.
  • After scleral buckle surgery:
  1. The patient undergoes the surgical procedure, which involves placing a silicone band around the eye to support the retina.
  2. Postoperative care includes monitoring for complications such as infection or increased eye pressure.
  3. The patient may experience discomfort, redness, and swelling in the eye following surgery.
  4. Follow-up appointments are scheduled to monitor the healing process and ensure the retina remains attached.
  5. Visual recovery may take several weeks to months, and the patient may need to avoid certain activities during the recovery period.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scleral buckle surgery in pediatric patients?
  2. How long is the recovery period after scleral buckle surgery and what can be expected during this time?
  3. Will my child need to undergo any additional procedures or surgeries in the future following scleral buckle surgery?
  4. How successful is scleral buckle surgery in treating retinal detachment in pediatric patients?
  5. What type of anesthesia will be used during the surgery and are there any risks associated with it in pediatric patients?
  6. What is the long-term prognosis for my child’s vision following scleral buckle surgery?
  7. How often will my child need to follow up with the doctor after scleral buckle surgery?
  8. Are there any specific post-operative care instructions or restrictions that my child will need to follow after the surgery?
  9. Is there a possibility of the retinal detachment recurring after scleral buckle surgery and if so, what can be done to prevent it?
  10. Are there any alternative treatment options to scleral buckle surgery that may be more suitable for my child’s condition?

Reference

Authors: Karam MA, Sharma A, Lopez-Canizares A, Carletti P, Vanner EA, Berrocal AM, Chang TC. Journal: Sci Rep. 2024 Oct 25;14(1):25300. doi: 10.1038/s41598-024-76352-7. PMID: 39455806