VITREORETINAL SURGERY FOR COMPLICATIONS OF CONGENITAL RETINOSCHISIS

PURPOSE: To report the results of vitreoretinal surgery for the manage ment of complications associated with congenital retinoschisis in chil dren. METHODS: We conducted a review of consecutive children with comp lications of congenital retinoschisis created with advanced vitreoreti nal techniques, Nine eyes of seven patients with congenital retinoschi sis had vitreoretinal surgery for one of the following complications o f congenital retinoschisis: hemorrhage within a large schisis cavity w ith a dense vitreous hemorrhage; rapid progression of schisis threaten ing the macula; obscuration of the macula by the overhanging inner wal l of a schisis cavity; a combined schisis-traction retinal detachment; or a combined schisis-rhegmatogenous retinal detachment. Vitreo-retin al surgery consisted of vitrectomy, inner schisis wall retinectomy, fl uid-gas exchange, endo-laser laser treatment, and perfluoropropane gas injection. After vitreoretinal surgery, patients were followed up for a mean of 26 months (range, 9 to 67 months). Retinal reattachment, vi sual acuity, and visual fields were used as outcome measures. RESULTS: Eight of nine eyes had successful retinal reattachment, Six eyes post operatively had improved visual acuity or visual field, or both. One e ye had stabilization of visual acuity, and two eyes had a decrease in visual acuity. CONCLUSION: In children with complications of congenita l retinoschisis, vitreoretinal surgery with excision of the inner wall of the peripheral schisis cavity may be effective in achieving retina l reattachment, thereby improving visual acuity or visual field size.