Pars plana vitrectomy for pediatric posterior segment trauma: Outcomes and prognostic factors

Abstract

Purpose

To evaluate anatomical and visual outcomes and to identify prognostic factors in pediatric patients undergoing pars plana vitrectomy (PPV) following ocular trauma.

Methods

This retrospective study included medical records of pediatric patients who underwent PPV for posterior segment trauma at a tertiary referral center over 13 years. Demographic characteristics, injury patterns, ocular trauma classifications, surgical details, and postoperative outcomes were analysed to identify factors associated with anatomical success and visual prognosis.

Results

Among 208 pediatric patients who underwent surgery for ocular trauma, 47 patients requiring pars plana vitrectomy (PPV) were included in the present study. The mean age was 9.7 ± 4.2 years, and the median follow-up duration was 28 months (range, 3–118 months). Traumatic retinal detachment was the most frequent indication for PPV, observed in 37 eyes (78.7%). A statistically significant improvement in mean best-corrected visual acuity was observed from baseline to final follow-up (p = 0.003). Final anatomical success was achieved in 24 eyes (52.2%), and final functional success was observed in 11 eyes (23.3%). While the presence of proliferative vitreoretinopathy (PVR) was the only prognostic factor significantly associated with anatomical failure (p = 0.004), corneal injury (p = 0.010) and an increased number of PPV procedures (p = 0.028) were significantly associated with poor functional outcomes.

Conclusion

Pediatric posterior segment trauma requiring surgery remains challenging, with anatomical success achieved in only about half of patients and visual improvement being more limited. PVR, corneal injury, and the need for multiple surgical interventions were associated with less favorable outcomes.