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Vitreoretinal surgery after childhood ocular trauma.
R M Sheard1, K Mireskandari, E Ezra
1Moorfields Eye Hospital, City Road, London, UK. richard@richardsheard.net
Eye (London, England)
|April 8, 2006
Summary
Vitreoretinal surgery salvaged many children with serious eye injuries, improving vision for over half. Two-thirds achieved 6/60 or better vision, though retinal detachment complications impacted outcomes.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Trauma Care
Background:
- Childhood ocular trauma is a leading cause of monocular blindness.
- Vitreoretinal surgery offers salvage for severely injured eyes in adults.
- A significant portion of serious eye injuries occur in children.
Purpose of the Study:
- To report indications, complications, and outcomes of vitreoretinal surgery in pediatric ocular trauma.
- To evaluate the effectiveness of surgical interventions for vision restoration.
- To identify factors associated with poor visual outcomes in children.
Main Methods:
- Retrospective case note review of 61 children (≤16 years) undergoing vitreoretinal surgery.
- Analysis of injury types (open vs. closed globe), surgical procedures, and visual acuity.
- Mean follow-up of 19.6 months.
Main Results:
- 45.9% open globe injuries, 54.1% closed globe injuries.
- Retinal re-attachment rates: 70.6% (scleral buckling) vs. 46.7% (vitrectomy).
- Median visual acuity improved from counting fingers to 6/36; traumatic retinal detachment requiring vitrectomy correlated with poor outcomes.
Conclusions:
- Vitreoretinal intervention improved vision in 57.1% of children and stabilized vision in 19.6%.
- Two-thirds achieved final visual acuity of 6/60 or better.
- Proliferative vitreoretinopathy was a major cause of redetachment and significantly associated with poor outcomes.