Vitreoretinal Surgery in Pediatrics

Pediatric vitreoretinal surgery necessitates distinct considerations due to anatomical disparities from adult retina surgery, unique complications, and the need for meticulous surgical planning. Surgeons must acquire proficiency in adults before transitioning to pediatric vitreoretinal cases. Anatomically, pediatric eyes pose challenges with limited space, small globes, and strong vitreoretinal adhesions. Philosophical differences involve avoiding iatrogenic retinal breaks, addressing aggressive proliferative vitreoretinopathy, and acknowledging amblyopia concerns. Surgical approaches demand careful limbal or pars plana considerations, adapted trocar insertion, and judicious lensectomy. Vitreous tamponade choices, like air or gas, require tailored selection based on pathology. The chapters discuss surgery of important pediatric retinal disease including retinopathy of prematurity stage 4 and 5, Coats disease, and familial exudative vitreoretinopathy.