Retinal Push During Vitrectomy for Primary Retinal Detachment in Children



Posterior Hyaloid poses a serious challenge to surgeons during vitrectomy for primary pediatric Retinal Detachment. It’s toughly adherent to the underlying Retina. PVR and Recurrent RD are inevitable, if posterior Hyaloid isn’t properly removed.


To report anatomical and functional outcome of Retinal push technique in patients for whom primary vitrectomy was performed for retinal detachment.


Retrospective consecutive case series. Twenty-six eyes of twenty-six children, for whom vitrectomy had been performed for primary retinal detachment, were identified. Bimanual peeling of the posterior hyaloid had been performed using a Tano scraper or cutting probe in one hand, and forceps in the other hand. Retina had been pushed by the blunt scraper or probe instead of pulling endlessly by a probe or forceps. Outcome measures: anatomical reattachment, and iatrogenic retinal breaks.


Primary reattachment occurred in 23 / 26 eyes, secondary reattachment occurred in all the 26 eyes. Iatrogenic retinal breaks were induced in 2 cases (one break in each).


Retinal Push enables complete detachment of the posterior hyaloid as far as the vitreous base, which is in turn crucial for sustainable reattachment in primary pediatric retinal detachment.



Wael Ewais
Cairo, Egypt
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