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Corneal laceration by sharp objects in children seven years of age and younger
Fani Segev1, Ehud I Assia, Noga Harizman
1Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.
Insights
Proper management of penetrating corneal injuries in young children can lead to excellent vision. Key interventions include prompt cataract surgery, lens implantation, YAG laser for opacification, refractive correction, and patching to prevent amblyopia.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Young children are susceptible to amblyopia following penetrating eye injuries.
- Effective management strategies are crucial for preserving visual function in pediatric penetrating eye trauma.
Purpose of the Study:
- To evaluate the management of penetrating corneal injuries without intraocular foreign bodies in children aged 7 years or younger.
- To assess the long-term visual acuity outcomes in this patient cohort.
Main Methods:
- Retrospective chart review of children aged 7 or younger with penetrating corneal injuries.
- Inclusion criteria: sharp object injury, no intraocular foreign body, and follow-up exceeding 18 months.
- Data collected: initial examination, surgical procedures, amblyopia management, and final visual acuity.
Main Results:
- Twenty children were included, with a mean age of 4.3 years and a mean follow-up of 58 months.
- All patients required primary surgical intervention; 6 had traumatic cataract extraction with 4 receiving intraocular lens (IOL) implantation.
- Final visual acuity was 20/40 or better in 14 eyes; amblyopia prevention measures like patching were utilized in 11 patients.
Conclusions:
- Appropriate management of pediatric penetrating corneal injuries can achieve excellent visual rehabilitation.
- Key interventions include timely cataract extraction, IOL implantation, YAG capsulotomy for opacification, refractive error correction, and amblyopia treatment.
- Prompt and comprehensive care is vital for optimizing visual outcomes in young children with severe eye trauma.
Purpose:
Young children are prone to develop amblyopia after penetrating injury. We sought to evaluate the management of penetrating corneal injury without intraocular foreign body (IOFB) in children
Methods:
A retrospective chart review was performed in 2 ophthalmology departments to identify children
Results:
Twenty children eligible for the study were identified. The mean age was 4.3 years, and mean follow-up time was 58 months. The corneal wound size range was 1-10 mm, with 8 eyes having wounds >or=6 mm. All patients required primary surgical management. Traumatic cataract extraction was performed at the primary operation in 6 eyes, with intraocular lens (IOL) implantation in 4 eyes. Additional surgical procedures were performed in 12 eyes. Yttrium-Aluminum-Garnet (YAG) capsulotomy was performed in 3 eyes with secondary cataract. Twelve patients required spectacle or contact lens correction, and 11 patients had patching for amblyopia prevention. At the end of follow-up, visual acuity was 20/40 or better in 14 eyes, 20/50 to 20/100 in 4 eyes, no light perception (NLP) in 1 eye, and unknown in 1 eye.
Conclusions:
Proper management of penetrating corneal injury in young children can result in excellent visual rehabilitation. Major measures include prompt traumatic cataract extraction with either primary or secondary IOL implantation, opening of posterior capsular opacification with YAG laser, correction of refractive errors, and patching for amblyopia prevention.
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