Author: Ömer Özer (Turkey)
Co-authors: Özgün Oktay, Erdem Dinç, Özer Dursun, Mustafa Vatansever, Ufuk Adıgüzel
Purpose
The aim of this study is to determine the demographic characteristics of pediatric open globe injuries, to calculate the ocular trauma scores and to predict the visual outcomes.
Setting/Venue
All pediatric open globe trauma cases admitted to Department of Ophthalmology, Mersin University between January 2018 and December 2019 were included in this study.
Methods
Age, gender, type of injury, time of admission, time to surgery, ocular trauma scores (OTS) and pediatric ocular trauma scores (POTS) were calculated for each patient. The relation between these findings and final visual acuity after 12 months of follow-up was examined. The purpose of primary surgeries was to reconstruct globe integrity by repositioning or excision of the ocular contents and achieving the best visual outcome.
Results
Forty-two eyes of 41 patients were included in this study. Of these patients, 14 (34.1%) were female, 27 (65.9%) were male. The most common injuries observed were sharp objects such as knives (23.8%) and stones (23.8%). The initial visual acuity of the patients; LP-HM in 20 (47.6%), counting finger in 5 (11.9%), between 0.1 and 0.5 in 11 (26.2%), and between 0.6 and 1.0 in 6 (14,3%). At the time of admission, 15 (35,7%) of the patients were 0-5 years old, 21 (50%) patients were 6-10 years old, and 6 (14,3%) patients were 11-15 years old. The wound location were zone I in 36 patients (85,7%). Concomitant eye pathologies were iris prolapse in 37 (88,1%), hyphema in 29 (69,1%), organic/unclean injuries in 23 (54,7%), vitreous hemorrhage in 7 (16,7%), retinal detachment in 4 (%9,5), endophthalmitis in 3 (7,1%). Final visual acuity of the patients; LP-HM in 9 (21.4%), counting finger in 2 (4.8%), between 0.1 and 0.5 in 9 (21.4%), and between 0.6 and 1.0 in 22 (52,4%). The mean OTS was 77.21 and the mean POTS was 46.78. The level of agreement between the predicted VA for OTS and that for POTS was almost perfect (kappa = 0.8726).
Conlusions
In conclusion, the original ocular trauma score is still the gold standard in the final visual acuity prediction since it consists of only six criteria and can be easily calculated, but it is the criteria that should be considered as concomitant eye pathologies may affect final visual acuity. Nevertheless, performing the surgery without delay and reconstruction of the anatomical structures at the highest possible level play a vital role in order to reach the maximum level of final visual acuity. OTS has high ability to predict visual acuity for pediatric traumatic cataract following open globe injuries. POTS is also a reliable prognostic model for very young child without initial vision or RAPD, but is only for open globe injuries.
Financial Disclosure
We do not have any financial interest to disclose.
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