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Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
Published on: August 25, 2021
Pediatric Open-Globe Injuries: Clinical Characteristics and Outcomes of Repair in a Tertiary Center in Istanbul,
Asli Kirmaci Kabakci1, Burcu Kemer Atik2, Elif Hazal Livan1
1Department of Ophthalmology, University of Health Sciences, Prof. Dr. Cemil Tascioglu State Hospital, Istanbul, Türkiye.
Insights
This study analyzed pediatric open-globe injuries in Istanbul, finding that initial visual acuity and lens injury significantly impact long-term outcomes. These factors are crucial for predicting visual prognosis in young patients.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Pediatric open-globe injuries represent a significant cause of vision loss in children.
- Understanding the epidemiology and etiology of these injuries is crucial for developing effective prevention and treatment strategies.
- Tertiary medical centers play a vital role in managing complex pediatric ocular trauma.
Purpose of the Study:
- To evaluate the epidemiology, etiology, and outcomes of pediatric open-globe injuries treated at a tertiary medical center in Istanbul, Türkiye.
- To identify prognostic factors influencing visual outcomes in pediatric open-globe injury patients.
- To assess the utility of the Pediatric Penetrating Ocular Trauma Score (POTS) in predicting final visual acuity.
Main Methods:
- Retrospective review of 56 pediatric patients undergoing primary open-globe injury repair between 2016 and 2021.
- Data collection included demographics, injury characteristics (object, size, zone), and visual acuities (VAs).
- The Pediatric Penetrating Ocular Trauma Score (POTS) was calculated to assess its correlation with final VA.
Main Results:
- The majority of injuries occurred at home, with knives being a common cause.
- Mean initial VA improved significantly by the final follow-up (p<0.001).
- POTS significantly correlated with final VA (p=0.001), and lens injury negatively impacted visual outcomes (p=0.019).
Conclusions:
- Initial visual acuity at presentation is a significant prognostic factor for pediatric open-globe injuries.
- The presence of lens injury is also a critical factor influencing the final visual outcome.
- These findings aid in better predicting and managing visual prognosis in pediatric ocular trauma.
Objectives:
To evaluate the epidemiology, etiology, and outcomes of pediatric open-glob injury patients treated at a tertiary medical center in Istanbul, Türkiye.
Methods:
The records of 56 pediatric patients who underwent primary open-globe injury repair at our clinic between 2016 and 2021 were retrospectively reviewed. Data about demographics, date-setting of the injury, type of the traumatizing object, injury size, and zone were collected. The initial and final best-corrected visual acuities (VAs), associated features, trauma-hospital admission, and hospital admission-surgery durations were also recorded. The Pediatric Penetrating Ocular Trauma Score (POTS) was calculated to evaluate its effect on the final VA.
Results:
Fifty-six eyes of 56 patients with a median age of 8 years who were followed up for at least 6 months were included. The majority of the injuries took place at home (62.5%), while the most common traumatizing object was a knife (10.7%). The mean size of injury was 4.73±2.92 mm; of which 60.7% (34) cases were in zone 1, 33.9% (19) cases in zone 2, and 5.4% (3) cases in zone 3 injury according to Ocular Trauma Classification group. The mean VA of 1.48 ± 1.21 logMAR at presentation was improved to 0.83±1.13 logMAR at the last visit (p<0.001). The POTS was significantly correlated with the final VA (p=0.001; r=-0.473). Iris prolapse was observed in 31 patients (55.4%), whereas the lens was injured in 26 (46.4%) cases and displayed a significant influence on the post-operative visual outcome (p=0.019). The mean duration between trauma-hospital admission was 18.9±43.8 h; while hospital admission-surgery was 8.6±3.7 h.
Conclusion:
Our study demonstrated that the VA at presentation and the presence of lens injury are visual prognostic factors for pediatric open-globe injuries.
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