LAUSR

Purpose: To assess the feasibility and investigate the anatomical and functional outcomes of extended internal limiting membrane (ILM) peeling with pars plana vitrectomy (PPV) for complex pediatric rhegmatogenous retinal detachment (RRD). Methods: This was a retrospective interventional case series where children (≤18 years) with RRD and severe PVR (grade C) were included. All eyes underwent PPV with ILM peeling up to 2-disk diameter beyond the vascular arcades. The main outcome measures were assessment of feasibility of ILM peeling in the pediatric RRD and evaluation of the rate of complete retinal reattachment and corrected-distance visual acuity (CDVA) at the final follow-up. Results: A total of 29 eyes (25 patients) were enrolled in this study. ILM peeling performed on these children was not more difficult than in adult eyes. After a mean follow-up of 18 months, the patients achieved final CDVA better than 20/200 in 37.9%. The initial retinal reattachment was 55.2% while the final anatomical success was 86.2%. Conclusion: Vitrectomy with ILM peeling is technically feasible in pediatric RRD, limiting epiretinal proliferation and achieving favorable anatomical outcomes in cases of complex pediatric RRD. The long-term effects of ILM peeling need further investigation.