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Traumatic pediatric retinal detachment: a comparison between open and closed globe injuries
Luis Sarrazin1, Edward Averbukh, Michael Halpert
1Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
American Journal of Ophthalmology
|June 9, 2004
Summary
Pediatric retinal detachment from open or closed globe injuries shows similar characteristics. Surgical outcomes were guarded and comparable, indicating a need for improved treatment strategies in children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Retinal detachment is a serious complication of ocular trauma in children.
- Understanding the differences and similarities between open and closed globe injuries is crucial for effective management.
Purpose of the Study:
- To compare pediatric retinal detachment resulting from open versus closed globe trauma.
- To analyze the characteristics, surgical interventions, and outcomes for each injury type.
Main Methods:
- Retrospective analysis of 138 pediatric retinal detachments (1980-2000) at a tertiary referral center.
- Comparison of 37 eyes with open globe injury and 23 eyes with closed globe injury.
- Evaluation of detachment characteristics, surgical procedures, and anatomic/functional outcomes.
Main Results:
- Similar incidence in detachment type, tear characteristics, extent, and surgical timing for both injury types.
- Anatomic success rates were 46% for open globe and 65% for closed globe injuries.
- Visual acuity improvement was limited (23-25%) and comparable, with preoperative macular attachment being the sole predictor of favorable visual outcome.
Conclusions:
- Retinal detachment in children, regardless of open or closed globe injury, shares similar characteristics, likely due to secondary globe deformation.
- Current surgical outcomes are guarded and comparable, highlighting the need for innovative approaches to improve visual results in pediatric ocular trauma.