Our Summary

This research paper discusses the case of a 10-month-old boy with a complex form of an eye condition called congenital retinoschisis. This condition caused his retinas to split, leading to decreased vision and retinal detachments in both eyes.

His condition was monitored, and it was found that the upper part of his retinas were being pulled and that there was a lack of blood supply to the outer parts of his eyes. Nine months after first being seen, his right eye developed a more severe form of retinal detachment, which was treated with a surgical technique known as scleral buckling.

Later, the left eye experienced a condition called vitreous hemorrhage (bleeding within the eye), which did not clear up on its own. It also developed a severe retinal detachment. Both conditions were treated with surgeries to remove the vitreous (a gel-like substance in the eye) and the lens, and a silicone oil was used.

After six years of follow-up, both of the boy’s retinas were back in place and the splitting of the retinas had resolved.

The paper concludes that severe complications of congenital retinoschisis, like retinal detachment and bleeding in the eye, can be prevented from progressing and causing further vision loss through surgeries like vitrectomy (removal of the vitreous) and scleral buckling.

FAQs

  1. What is scleral buckle surgery and how does it help with retinal detachment?
  2. What are some of the complications of congenital retinoschisis?
  3. How effective is the combination of vitrectomy and scleral buckling in treating congenital retinoschisis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including keeping the eye clean and avoiding strenuous activities that could put strain on the eye. It is also important to attend all follow-up appointments to ensure proper healing and monitor for any complications.

Suitable For

Patients with complicated congenital retinoschisis, such as those presenting with tractional retinal detachments and foveal schisis, may be recommended for scleral buckle surgery. This type of surgery can help prevent progression of vision loss, promote resolution of schisis, and ultimately lead to improved visual outcomes. It is important for patients with congenital retinoschisis to undergo regular ophthalmologic examinations to monitor for any potential complications and to determine the most appropriate treatment plan.

Timeline

  • Patient presents with decreased vision and foveal schisis in both eyes at 10 months of age
  • Tractional retinal detachments involving the macula are observed in both eyes
  • Follow-up examinations reveal retinal dragging and peripheral ischemia
  • Nine months after presentation, combined rhegmatogenous and tractional retinal detachment develops in the right eye and is treated with scleral buckle surgery
  • Vitrectomy is performed for nonclearing vitreous hemorrhage in the left eye, followed by development of combined rhegmatogenous and tractional retinal detachment
  • Vitrectomy and lensectomy with silicone oil are performed in the left eye
  • At 6 years of follow-up, both retinas are attached and foveal schisis has resolved

What to Ask Your Doctor

Some questions a patient should ask their doctor about scleral buckle surgery include:

  • What is scleral buckle surgery and how does it work?
  • Are there any alternative treatments to scleral buckle surgery for my condition?
  • What are the potential risks and complications associated with scleral buckle surgery?
  • What is the success rate of scleral buckle surgery for treating retinal detachment?
  • What is the recovery process like after scleral buckle surgery?
  • Will I need to follow any specific post-operative care instructions?
  • How long will it take for my vision to improve after the surgery?
  • Will I need any additional procedures or treatments after the scleral buckle surgery?
  • What is the long-term prognosis for my vision after undergoing scleral buckle surgery?
  • Are there any lifestyle changes I should make to improve the outcome of the surgery?

Reference

Authors: Savoie BT, Ferrone PJ. Journal: Retin Cases Brief Rep. 2017 Winter;11 Suppl 1:S202-S210. doi: 10.1097/ICB.0000000000000444. PMID: 27680778