Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study

Yoshihiro Yonekawa, Wei Chi Wu, Shunji Kusaka, Joshua Robinson, Daishi Tsujioka, Kai B. Kang, Michael J. Shapiro, Tapas R. Padhi, Lubhani Jain, Jonathan E. Sears, Ajay Kuriyan, Audina Berrocal, Polly A. Quiram, Amanda E. Gerber, R. V. Paul Chan, Karyn E. Jonas, Sui Chien Wong, C. K. Patel, Ashkan M. Abbey, Rand SpencerMichael P. Blair, Emmanuel Y. Chang, Thanos D. Papakostas, Demetrios G. Vavvas, Robert A. Sisk, Philip J. Ferrone, Robert H. Henderson, Karl R. Olsen, M. Elizabeth Hartnett, Felix Y. Chau, Shizuo Mukai, Timothy G. Murray, Benjamin J. Thomas, P. Anthony Meza, Kimberly A. Drenser, Michael T. Trese, Antonio Capone

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design: International, multicenter, interventional, retrospective case series. Participants: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session. Methods: Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures: Ocular and systemic adverse events. Results: A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6%), systemic morbidity placing the child at high anesthesia risk (76.0%), and residence remote from surgery location (30.2%). The most common diagnoses were retinopathy of prematurity (ROP; 72.7% [. P < 0.01]; stage 3, 4.8%; stage 4A, 44.4%; stage 4B, 22.4%; stage 5, 26.4%), familial exudative vitreoretinopathy (7.0%), abusive head trauma (4.1%), persistent fetal vasculature (3.5%), congenital cataract (1.7%), posterior capsular opacification (1.7%), rhegmatogenous retinal detachment (1.7%), congenital X-linked retinoschisis (1.2%), Norrie disease (2.3%), and viral retinitis (1.2%). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P = 0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous hemorrhage (0.6%). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6%) and 1 case of prolonged oxygen desaturation (0.6%). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8% and 98.0%, respectively. Conclusions: This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical.

Original languageEnglish (US)
JournalOphthalmology
DOIs
StateAccepted/In press - Mar 4 2016

Fingerprint

Vitreoretinal Surgery
Multicenter Studies
Pediatrics
Anesthesia
Operative Time
Choroid Hemorrhage
Retinoschisis
Retinitis
Vitreous Hemorrhage
Malignant Hyperthermia
Retinopathy of Prematurity
Endophthalmitis
Vitrectomy
Intraoperative Complications
Anaphylaxis
Retinal Detachment
Craniocerebral Trauma
Postoperative Period
Cataract
General Anesthesia

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology

Cite this

Yonekawa, Y., Wu, W. C., Kusaka, S., Robinson, J., Tsujioka, D., Kang, K. B., ... Capone, A. (Accepted/In press). Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study. Ophthalmology. https://doi.org/10.1016/j.ophtha.2016.04.033

Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study. / Yonekawa, Yoshihiro; Wu, Wei Chi; Kusaka, Shunji; Robinson, Joshua; Tsujioka, Daishi; Kang, Kai B.; Shapiro, Michael J.; Padhi, Tapas R.; Jain, Lubhani; Sears, Jonathan E.; Kuriyan, Ajay; Berrocal, Audina; Quiram, Polly A.; Gerber, Amanda E.; Paul Chan, R. V.; Jonas, Karyn E.; Wong, Sui Chien; Patel, C. K.; Abbey, Ashkan M.; Spencer, Rand; Blair, Michael P.; Chang, Emmanuel Y.; Papakostas, Thanos D.; Vavvas, Demetrios G.; Sisk, Robert A.; Ferrone, Philip J.; Henderson, Robert H.; Olsen, Karl R.; Hartnett, M. Elizabeth; Chau, Felix Y.; Mukai, Shizuo; Murray, Timothy G.; Thomas, Benjamin J.; Meza, P. Anthony; Drenser, Kimberly A.; Trese, Michael T.; Capone, Antonio.

In: Ophthalmology, 04.03.2016.

Research output: Contribution to journalArticle

Yonekawa, Y, Wu, WC, Kusaka, S, Robinson, J, Tsujioka, D, Kang, KB, Shapiro, MJ, Padhi, TR, Jain, L, Sears, JE, Kuriyan, A, Berrocal, A, Quiram, PA, Gerber, AE, Paul Chan, RV, Jonas, KE, Wong, SC, Patel, CK, Abbey, AM, Spencer, R, Blair, MP, Chang, EY, Papakostas, TD, Vavvas, DG, Sisk, RA, Ferrone, PJ, Henderson, RH, Olsen, KR, Hartnett, ME, Chau, FY, Mukai, S, Murray, TG, Thomas, BJ, Meza, PA, Drenser, KA, Trese, MT & Capone, A 2016, 'Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study', Ophthalmology. https://doi.org/10.1016/j.ophtha.2016.04.033
Yonekawa, Yoshihiro ; Wu, Wei Chi ; Kusaka, Shunji ; Robinson, Joshua ; Tsujioka, Daishi ; Kang, Kai B. ; Shapiro, Michael J. ; Padhi, Tapas R. ; Jain, Lubhani ; Sears, Jonathan E. ; Kuriyan, Ajay ; Berrocal, Audina ; Quiram, Polly A. ; Gerber, Amanda E. ; Paul Chan, R. V. ; Jonas, Karyn E. ; Wong, Sui Chien ; Patel, C. K. ; Abbey, Ashkan M. ; Spencer, Rand ; Blair, Michael P. ; Chang, Emmanuel Y. ; Papakostas, Thanos D. ; Vavvas, Demetrios G. ; Sisk, Robert A. ; Ferrone, Philip J. ; Henderson, Robert H. ; Olsen, Karl R. ; Hartnett, M. Elizabeth ; Chau, Felix Y. ; Mukai, Shizuo ; Murray, Timothy G. ; Thomas, Benjamin J. ; Meza, P. Anthony ; Drenser, Kimberly A. ; Trese, Michael T. ; Capone, Antonio. / Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study. In: Ophthalmology. 2016.
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title = "Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study",
abstract = "Purpose: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design: International, multicenter, interventional, retrospective case series. Participants: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session. Methods: Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures: Ocular and systemic adverse events. Results: A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6{\%}), systemic morbidity placing the child at high anesthesia risk (76.0{\%}), and residence remote from surgery location (30.2{\%}). The most common diagnoses were retinopathy of prematurity (ROP; 72.7{\%} [. P < 0.01]; stage 3, 4.8{\%}; stage 4A, 44.4{\%}; stage 4B, 22.4{\%}; stage 5, 26.4{\%}), familial exudative vitreoretinopathy (7.0{\%}), abusive head trauma (4.1{\%}), persistent fetal vasculature (3.5{\%}), congenital cataract (1.7{\%}), posterior capsular opacification (1.7{\%}), rhegmatogenous retinal detachment (1.7{\%}), congenital X-linked retinoschisis (1.2{\%}), Norrie disease (2.3{\%}), and viral retinitis (1.2{\%}). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P = 0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous hemorrhage (0.6{\%}). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6{\%}) and 1 case of prolonged oxygen desaturation (0.6{\%}). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8{\%} and 98.0{\%}, respectively. Conclusions: This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical.",
author = "Yoshihiro Yonekawa and Wu, {Wei Chi} and Shunji Kusaka and Joshua Robinson and Daishi Tsujioka and Kang, {Kai B.} and Shapiro, {Michael J.} and Padhi, {Tapas R.} and Lubhani Jain and Sears, {Jonathan E.} and Ajay Kuriyan and Audina Berrocal and Quiram, {Polly A.} and Gerber, {Amanda E.} and {Paul Chan}, {R. V.} and Jonas, {Karyn E.} and Wong, {Sui Chien} and Patel, {C. K.} and Abbey, {Ashkan M.} and Rand Spencer and Blair, {Michael P.} and Chang, {Emmanuel Y.} and Papakostas, {Thanos D.} and Vavvas, {Demetrios G.} and Sisk, {Robert A.} and Ferrone, {Philip J.} and Henderson, {Robert H.} and Olsen, {Karl R.} and Hartnett, {M. Elizabeth} and Chau, {Felix Y.} and Shizuo Mukai and Murray, {Timothy G.} and Thomas, {Benjamin J.} and Meza, {P. Anthony} and Drenser, {Kimberly A.} and Trese, {Michael T.} and Antonio Capone",
year = "2016",
month = "3",
day = "4",
doi = "10.1016/j.ophtha.2016.04.033",
language = "English (US)",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery. An International Multicenter Study

AU - Yonekawa, Yoshihiro

AU - Wu, Wei Chi

AU - Kusaka, Shunji

AU - Robinson, Joshua

AU - Tsujioka, Daishi

AU - Kang, Kai B.

AU - Shapiro, Michael J.

AU - Padhi, Tapas R.

AU - Jain, Lubhani

AU - Sears, Jonathan E.

AU - Kuriyan, Ajay

AU - Berrocal, Audina

AU - Quiram, Polly A.

AU - Gerber, Amanda E.

AU - Paul Chan, R. V.

AU - Jonas, Karyn E.

AU - Wong, Sui Chien

AU - Patel, C. K.

AU - Abbey, Ashkan M.

AU - Spencer, Rand

AU - Blair, Michael P.

AU - Chang, Emmanuel Y.

AU - Papakostas, Thanos D.

AU - Vavvas, Demetrios G.

AU - Sisk, Robert A.

AU - Ferrone, Philip J.

AU - Henderson, Robert H.

AU - Olsen, Karl R.

AU - Hartnett, M. Elizabeth

AU - Chau, Felix Y.

AU - Mukai, Shizuo

AU - Murray, Timothy G.

AU - Thomas, Benjamin J.

AU - Meza, P. Anthony

AU - Drenser, Kimberly A.

AU - Trese, Michael T.

AU - Capone, Antonio

PY - 2016/3/4

Y1 - 2016/3/4

N2 - Purpose: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design: International, multicenter, interventional, retrospective case series. Participants: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session. Methods: Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures: Ocular and systemic adverse events. Results: A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6%), systemic morbidity placing the child at high anesthesia risk (76.0%), and residence remote from surgery location (30.2%). The most common diagnoses were retinopathy of prematurity (ROP; 72.7% [. P < 0.01]; stage 3, 4.8%; stage 4A, 44.4%; stage 4B, 22.4%; stage 5, 26.4%), familial exudative vitreoretinopathy (7.0%), abusive head trauma (4.1%), persistent fetal vasculature (3.5%), congenital cataract (1.7%), posterior capsular opacification (1.7%), rhegmatogenous retinal detachment (1.7%), congenital X-linked retinoschisis (1.2%), Norrie disease (2.3%), and viral retinitis (1.2%). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P = 0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous hemorrhage (0.6%). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6%) and 1 case of prolonged oxygen desaturation (0.6%). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8% and 98.0%, respectively. Conclusions: This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical.

AB - Purpose: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. Design: International, multicenter, interventional, retrospective case series. Participants: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session. Methods: Clinical history, surgical details and indications, time under anesthesia, and intraoperative and postoperative ophthalmic and systemic adverse events were reviewed. Main Outcome Measures: Ocular and systemic adverse events. Results: A total of 344 surgeries from 172 ISBVS procedures in 167 patients were included in the study. The mean age of the cohort was 1.3±2.6 years. Nonexclusive indications for ISBVS were rapidly progressive disease (74.6%), systemic morbidity placing the child at high anesthesia risk (76.0%), and residence remote from surgery location (30.2%). The most common diagnoses were retinopathy of prematurity (ROP; 72.7% [. P < 0.01]; stage 3, 4.8%; stage 4A, 44.4%; stage 4B, 22.4%; stage 5, 26.4%), familial exudative vitreoretinopathy (7.0%), abusive head trauma (4.1%), persistent fetal vasculature (3.5%), congenital cataract (1.7%), posterior capsular opacification (1.7%), rhegmatogenous retinal detachment (1.7%), congenital X-linked retinoschisis (1.2%), Norrie disease (2.3%), and viral retinitis (1.2%). Mean surgical time was 143±59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P = 0.02). There were no reported intraoperative ocular complications. During the immediate postoperative period, 2 eyes from different patients demonstrated unilateral vitreous hemorrhage (0.6%). No cases of endophthalmitis, choroidal hemorrhage, or hypotony occurred. Mean total anesthesia time was 203±87 minutes. There were no cases of anesthesia-related death, malignant hyperthermia, anaphylaxis, or cardiac event. There was 1 case of reintubation (0.6%) and 1 case of prolonged oxygen desaturation (0.6%). Mean follow-up after surgery was 103 weeks, and anatomic success and globe salvage rates were 89.8% and 98.0%, respectively. Conclusions: This study found ISBVS to be a feasible and safe treatment paradigm for pediatric patients with bilateral vitreoretinal pathologic features when repeated general anesthesia is undesirable or impractical.

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