Lens-sparing vitrectomy for shaken baby syndrome

Abstract

AIM: To document the ophthalmological findings and visual outcomes for shaken baby syndrome(SBS)patients who had lens-sparing vitrectomy(LSV)for non-resolving premacular and vitreous hemorrhages obscuring the macula.METHODS: A retrospective review and statistical analysis of ophthalmological and demographic data of patients admitted with SBS from 2010 to 2012 was done. Patients with premacular and vitreous hemorrhage obscuring the macula who underwent LSV were included as subjects. Paired samples t-test was used to compare means, categorical data was analysed using Fisher's exact test and Pearson Chi-squared test. P value of less than 0.05 was considered as statistically significant.RESULTS: Thirty two subjects were recruited with a mean age of 5.09±1.96mo. Twenty one(65.6%)subjects had visual acuity of no light perception at presentation. Subjects with poorer initial visual acuity had larger pupil sizes(P=0.021)and most of them had neurosurgical intervention(P=0.027). The mean duration to perform LSV was 28.56±20.83d. Our vitrectomy complication rate was 4.26%. Post-operatively, 26(80%)subjects had vision of light perception or better, the spherical equivalent was significantly more myopic(P=0.001).CONCLUSION: Prompt ophthalmological assessment is vital to ensure optimum visual rehabilitation in SBS patients. With low complication rates, early surgical intervention with LSV represents a promising option for non-resolving intraocular hemorrhages obscuring the macula in SBS.

Keywords

• vitrectomy
• shaken baby syndrome
• macula hemorrhage
• vitreous hemorrhage