Vitreoretinal surgery after childhood ocular trauma

Abstract

Aim In adults modern vitreoretinal surgery allows many traumatised eyes to be salvaged. However, one third of serious eye injuries occur in the paediatric age group and trauma is a leading cause of monocular blindness in childhood. This study aims to report the indications, complications and outcomes for vitreoretinal surgical intervention after childhood ocular trauma. Methods Retrospective case note review of 61 children (age 16 years or less) undergoing vitreoretinal surgical procedures following ocular trauma at a tertiary referral centre. Results Twenty-eight children (45.9%) had open globe injuries (OGI) and 33 closed globe injuries (CGI, 54.1%). The mean age of children with OGI was 9.5 years and with CGI 12.3 years (P ¼ 0.0068). Forty-seven children had traumatic retinal detachments (77.1%), which in 17 cases were treated with conventional scleral buckling surgery and in 30 by vitrectomy. Retinal re-attachment was achieved after one procedure in 70.6% with scleral buckling and 46.7% with vitrectomy.

Pediatric open-globe injuries: clinical characteristics and factors associated with poor visual and anatomical success

“…In the present study, despite the high anatomical success due to improved surgical techniques, the visual outcome was low, similar to previous studies [21,24,25]. Delayed diagnosis is a significant feature of RD.…”

Determination of visual prognosis in children with open globe injuries

“…Many studies have confirmed the association between RD and poor prognostic features. 1,9,11,12 Photoreceptor cells are seriously injured when RD occurs, and proliferative vitreoretinopathy after RD is another factor that may cause limited postoperative vision.…”

Anatomical and functional outcomes in contusion injuries of posterior segment

“…14,19,23,24 We found a strong positive correlation (Po0.001) between initial and final visual acuities. Presenting visual acuity of 20/400 or less was predictive of poor visual outcome, especially in the surgical treatment group (Po0.001 and P ¼ 0.042 for surgical treatment and medical treatment groups, respectively).…”