Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.
CNLDO could have a genetic predisposition and maternal infection is a possible risk factor for developing CNLDO. Surgical management awareness should be emphasized to relieve children from this relatively common and benign condition.
Objective: To evaluate the corneal re-epithelialization and patient-perceived pain after bandage contact lens (BCL) exchange on day one, after photorefractive keratectomy (PRK). Methods: A randomized controlled trial, of all patients who underwent bilateral transepithelial-PRK (trans-PRK) or bilateral alcohol debridement and PRK (A-PRK), between March and October 2019. One eye of each patient was randomly assigned to BCL exchange on the first postoperative day (exchange group) and the BCL was not exchanged in the fellow eye (control group). Patients were evaluated daily until healing was complete. At each visit, the corneal epithelial defect was measured, and a questionnaire was used to assess pain, photophobia, and excessive tearing. P<0.05 was statistically significant. Results: The study sample was comprised of 56 patients (mean age 27.2±5.7 years). Trans-PRK was performed in 20 (34.5%) and A-PRK in 36 (64.3%) patients. At day 3, 40 (71.4%) eyes of the exchange group healed completely compared with 38 (67.9%) eyes of the control group (P=0.5). At day-1 follow-up, the pain score was 1.87±1.4 in the exchange group and 2.29±1.3 in the control group (P=0.009). The mean pain score was 1.58±1.4 among patients who underwent A-PRK and 2.35±1.2 among patients operated by trans-PRK (P=0.04). Conclusion: The epithelial healing did not vary when BCL was exchanged one day after refractive surgery. However, postoperative pain score after PRK was lower at day 1, when the BCL was exchanged. Compared with A-PRK, trans-PRK group demonstrated a higher pain score in the early postoperative phase.
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