@article {726231,
	title = {Immediate Sequential Bilateral Pediatric Vitreoretinal Surgery: An International Multicenter Study.},
	journal = {Ophthalmology},
	volume = {123},
	number = {8},
	year = {2016},
	month = {2016 Aug},
	pages = {1802-8},
	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{\textpm}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 \&lt; 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{\textpm}59 minutes for both eyes. Higher ROP stage correlated with longer surgical time (P\&nbsp;= 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{\textpm}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.},
	issn = {1549-4713},
	doi = {10.1016/j.ophtha.2016.04.033},
	author = {Yonekawa, Yoshihiro and Wu, Wei-Chi and Kusaka, Shunji and Robinson, Joshua and Tsujioka, Daishi and Kang, Kai B and Shapiro, Michael J and Padhi, Tapas R and Jain, Lubhani and Sears, Jonathan E and Kuriyan, Ajay E and Berrocal, Audina M 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 Spencer, Rand 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 Mukai, Shizuo and Murray, Timothy G and Thomas, Benjamin J and Meza, P Anthony and Drenser, Kimberly A and Trese, Michael T and Capone, Antonio}
}
