[Clinical analysis of transnasal endoscopic optic nerve decompression for traumatic optic neuropathy in preschoolers]

Objective: To explore the efficacy and safety of endoscopic optic nerve decompression in preschoolers with traumatic optic neuropathy. Methods: The clinical data of 10 cases (12 eyes) of traumatic optic neuropathy in preschoolers aged 1-6 years (mean 3.6 years) admitted to the First Affiliated Hospital of Sun Yat-sen University from 2015 to 2024 were retrospectively analyzed. The visual acuity changes before and after endoscopic optic nerve decompression were compared, and the surgical complications were observed. Clinical effectiveness was defined as an improvement of at least one level in visual acuity. Results: All patients were followed up for 3 to 60 months, and the clinical effective rate was 10/12. The effective rate of 10 eyes with preoperative no light perception was 8/10. There were 2 eyes with preoperative residual vision: 1 eye with visual acuity of 0.01 and 1 eye with light perception only, and the effective rate was 2/2. The time from injury to surgery was 5 to 112 days, with an average of 44.4 days. After eye trauma, the success rate was 1/1 within 7 days after surgery; for 7 eyes with trauma from 8 to 30 days after surgery, the success rate was 5/7; for 4 eyes with trauma from 31 to 112 days after surgery, the effective rate was 4/4. No intracranial, orbital, or nasal complications occurred during or after surgery in any patient. Conclusions: Endoscopic optic nerve decompression is safe and effective in the treatment of traumatic optic neuropathy in preschoolers aged 1-6 years. Surgery remains clinically beneficial even when performed more than 7 days after injury.