Our Summary

This research paper reviews existing studies on combined cataract surgery and vitrectomy (removal of the eye’s vitreous gel) in children. The review focuses on when and why these procedures are performed, how they’re done, their results, and any complications that could occur. The conditions discussed include congenital cataracts, dislocated lens, retinopathy of prematurity (a potentially blinding eye disorder that primarily affects premature infants), retinal detachment, and persistent fetal vasculature (a developmental disorder where the eye’s blood vessels don’t develop properly).

The review found that while many doctors prefer to leave the lens in place during vitrectomy, in more severe or complex cases, it’s often necessary to remove it. The studies showed that combined surgery can lead to good physical results, but how well the child can see afterwards can vary. This depends on factors like the child’s age, the structure of their eye, and how severe their condition was. Complications like glaucoma, clouding of the lens, and lens dislocation are more common with combined procedures and need long-term monitoring and treatment.

The researchers concluded that combined cataract surgery and vitrectomy can be a helpful approach to managing complex eye conditions in children. The type of surgery should be tailored to the child’s specific needs to get the best results. More research is needed to develop guidelines for deciding on the best surgical approach for each child.

FAQs

  1. What conditions may necessitate combined cataract surgery and vitrectomy in children?
  2. What factors influence the visual results after combined cataract surgery and vitrectomy in children?
  3. What complications might occur after combined cataract surgery and vitrectomy, and how are they managed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vitrectomy is to follow all post-operative instructions carefully to promote healing and reduce the risk of complications. This may include using prescribed eye drops, avoiding strenuous activities, and attending follow-up appointments as scheduled. It’s important to communicate any concerns or changes in vision to your doctor promptly. Additionally, maintaining a healthy lifestyle with regular eye exams can help monitor and manage any long-term effects of the surgery.

Suitable For

Patients who are typically recommended vitrectomy include those with complex eye conditions such as congenital cataracts, dislocated lens, retinopathy of prematurity, retinal detachment, and persistent fetal vasculature. These conditions may require vitrectomy either alone or in combination with cataract surgery to improve vision and prevent further complications. It is important for doctors to carefully assess each patient’s individual case to determine the most appropriate treatment plan for optimal outcomes.

Timeline

  • Before vitrectomy: The patient undergoes a comprehensive eye exam to determine the need for vitrectomy, which may be recommended for conditions such as retinal detachment, diabetic retinopathy, macular hole, or vitreous hemorrhage. The patient will also undergo pre-operative testing to assess their overall health and ensure they are a suitable candidate for surgery.

  • Day of vitrectomy: The patient arrives at the surgical center, where they will receive anesthesia to ensure they are comfortable during the procedure. The surgery typically takes 1-2 hours, during which the vitreous gel is removed and any necessary repairs to the retina are made. After the surgery, the patient will be monitored in the recovery area before being discharged home.

  • Post-operative period: In the days and weeks following surgery, the patient may experience some discomfort, redness, and blurred vision. It is important to follow the post-operative care instructions provided by the surgeon, which may include using eye drops, wearing an eye patch, and avoiding strenuous activities. Follow-up appointments will be scheduled to monitor the eye’s healing progress and address any concerns or complications that may arise.

  • Long-term outcomes: The patient’s vision may gradually improve over time as the eye heals, although some patients may experience permanent changes in vision. It is important to attend all scheduled follow-up appointments to ensure the eye is healing properly and to address any complications that may arise. In some cases, additional procedures or treatments may be necessary to achieve the best possible outcome.

What to Ask Your Doctor

  1. Why do I need a vitrectomy?
  2. What are the potential risks and complications of the surgery?
  3. How long is the recovery period after a vitrectomy?
  4. Will I need any follow-up appointments or additional treatments after the surgery?
  5. How will the surgery affect my vision in the long term?
  6. Are there any alternative treatments to a vitrectomy that I should consider?
  7. What is the success rate of vitrectomy for my specific condition?
  8. Will I need to make any lifestyle changes or take any medications after the surgery?
  9. How experienced are you in performing vitrectomy surgeries?
  10. Can you provide me with any resources or additional information about vitrectomy and my specific condition?

Reference

Authors: Ruiz-Justiz AJ, Cruz-Villegas V, Schwartz SG, Villegas VM, Murray TG. Journal: Medicina (Kaunas). 2025 Jun 29;61(7):1176. doi: 10.3390/medicina61071176. PMID: 40731806