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Combined anterior and posterior segment injuries in children: a review
1University Eye Hospital, University of Leipzig, Liebigstrasse 10-14, Leipzig, Germany. petra.meier@medizin.uni-leipzig.de
Insights
Pediatric eye injuries involving both anterior and posterior segments need specialized surgical care due to unique healing characteristics. Optimal outcomes require tailored strategies and long-term follow-up by pediatric ophthalmologists.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Children's eyes have unique characteristics, including increased scarring and risk of amblyopia, making combined anterior and posterior segment injuries challenging.
- Special attention is required for pediatric ocular trauma due to the potential for severe visual impairment.
Purpose of the Study:
- To review the surgical management, complications, and prognosis of combined anterior and posterior segment injuries in children.
- To highlight the distinct aspects of treating pediatric ocular trauma compared to adults.
Main Methods:
- Literature review of current surgical management strategies for combined anterior and posterior segment injuries in pediatric patients.
- Analysis of prognostic factors influencing treatment success.
Main Results:
- Optimal treatment involves specific strategies: secondary operations, encircling buckle surgery, lens management, temporary keratoprosthesis use, and endophthalmitis management.
- Key prognostic factors and late complications such as secondary glaucoma and strabismus were analyzed.
Conclusions:
- Surgical management for combined anterior and posterior segment injuries in children differs significantly from adult protocols.
- Long-term, specialized care by pediatric ophthalmology specialists, including orthoptic follow-up, is crucial for optimal outcomes.
Background:
Combined anterior and posterior segment injuries in children require special attention to the unique characteristics of children's eyes, including a pronounced tendency to scar formation and proliferation, adherence of the posterior vitreous, as well as the danger of amblyopia.
Methods:
This article reviews the current body of literature documenting the main aspects of surgical management, complications, and prognosis of combined anterior and posterior segment injuries in children.
Results:
For optimal treatment success, special strategies are necessary with regard to: 1) comprehensive secondary operation for internal reconstruction, 2) encircling buckle surgery, 3) management of the lens, 4) use of a temporary keratoprosthesis, 5) endophthalmitis, and 6) late complications, e.g., secondary glaucoma, secondary strabismus, leukoma cornea, and phthisis bulbi. Further crucial prognostic factors were analyzed.
Conclusion:
Combined anterior and posterior segment injuries in children require optimal surgical treatment management that varies from adult treatment with regard to several essential aspects. Care should be provided by pediatric ophthalmology specialists with orthoptic follow-up as necessary, over many years.
