Abstract
PURPOSE: To look at the outcomes of various interventions in treatment-naive pediatric rhegmatogenous retinal detachment (RRD). METHODS: This study was conducted at a tertiary care hospital in North India. Children below 16 years with treatment-naive RRD with a minimum 6-month follow-up were enrolled retrospectively from July 2012 to June 2021 and prospectively from July 2021 to June 2022. Patient demographics at presentation, risk factors, preoperative ophthalmic findings including best-corrected visual acuity (BCVA), the choice of surgery and tamponade, and postoperative assessment parameters were recorded. The primary outcome measure was anatomical success after surgery. Secondary outcome measures included functional success, that is, postoperative BCVA at last follow-up, improvement in vision, number of surgeries required to achieve final anatomical success, and correlation of factors such as age and etiology with outcomes. Functional success was taken as postoperative BCVA ≥ logMAR 1.3. RESULTS: Among the 333 pediatric patients (348 eyes), the most common etiology was trauma (44.8%), followed by high myopia (17%) and idiopathic causes (15.5%). Primary anatomical success was achieved in 66.9% of cases, improving to 88.5% with additional surgeries. Functional success was recorded in 46.3% of cases. Combined scleral buckling (SB) and pars plana vitrectomy (PPV) provided the best anatomical (66.01%) and functional (48.32%) outcomes. CONCLUSION: Pediatric RRD presents significant management challenges. Combined SB + PPV yielded superior outcomes. Functional recovery remains limited, emphasizing the need for early detection, improved surgical strategies, and long-term follow-up for optimal visual rehabilitation.