Pediatric Open-Globe Injuries: Clinical Characteristics and Outcomes of Repair in a Tertiary Center in Istanbul, Turkey.

Abstract

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.