Pediatric open-globe injury in a university-based tertiary hospital

Abstract

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.

Pediatric Open Globe Injury in Tertiary Hospitals of Khobar and Dhahran

“…Most of the cases in the study were males, which is similar to previous studies [7][8][9]. This implies that males tend to be more engaged in risky behaviors.…”

Pediatric Open Globe Injury in Central China

“…The male-female ratio was 2.43 in our study. The male-female ratio was 1.44–5.13 in other previous studies ( 11 – 13 , 16 – 22 ). The differences of male-female ratio among different regions or countries could be related to many factors.…”

“…In the study of Lesniak et al ( 8 ), there was no one who developed endophthalmitis of all the pediatric 89 patients. In another study, of all the 213 patients, eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis ( 16 ). While in the study of Choovuthayakorn et al ( 12 ), endophthalmitis occurred in 15 of the 49 patients (30.6 %).…”

Clinical and Microbiological Features of Pediatric Endopthalmitis After Open Globe Injury in the North of VietNam

“…Alfaro (1995) reported an average time from injury to the primary repair higher than our study of 4 days and this time in the report of Sheng (2017) was 9.3 days [9], [11]. In a series of other authors about the pediatric open-globe injury, there was also a high rate of patients who had primary repair late after 24 hours and who got endophthalmitis [16], [17], [18].…”