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. 2021 May;10(5):1346-1354.
doi: 10.21037/tp-21-162.

Pediatric open globe injury in left-behind children treated by pars plana vitrectomy in China

Xiaonan Zhuang  1 , Rui Jiang  1 , Gezhi Xu  1 , Zhongcui Sun  1
Affiliations

Pediatric open globe injury in left-behind children treated by pars plana vitrectomy in China

Xiaonan Zhuang et al. Transl Pediatr. 2021 May.

Abstract

Background: To analyze the clinical features of pediatric open globe injury (OGI) in left-behind children (LBC) and in non-left-behind children (non-LBC) prospectively.

Methods: Patients diagnosed with OGI were included and divided into 2 groups: LBC and non-LBC. A complete ophthalmological examination was performed. Primary wound repair was completed within 8 hours from initial administration. Pars plana vitrectomy (PPV) was subsequently performed for retained intraocular foreign body (IOFB), endophthalmitis, retinal detachment, or non-clearing vitreous hemorrhage.

Results: A total of 96 patients (4 to 15 years old) were recruited, including 54 LBC and 42 non-LBC. Rupture of the eyeball (P<0.001), endophthalmitis (P<0.001), primary hospitalization time (PHT) over 24 hours (PHT >24 h) (P=0.016), traumatic cataract (P=0.013), vitreous hemorrhage (P=0.040), numbers of surgeries (P<0.001), and lower OTS scores and grades (P<0.001) predisposed patients to poorer final visual acuity (VA). Compared with non-LBC, LBC were significantly younger (P<0.001), had lower OTS scores (P=0.020), had longer PHT (P<0.001), and worse baseline (P=0.011) and final VA (P<0.001). The 3 most common injury sources were pencils (20 cases, 20.8%), knives (11 cases, 11.5%), and iron wire (7 cases, 7.3%). Pencils were the major injury source for IOFB (14 cases, 53.8%). LBC were significantly more likely to be injured by instruments which should be routinely kept away from children (P=0.009).

Conclusions: The prognosis of pediatric OGI was worse in LBC than in non-LBC. It is necessary to improve the guardianship of LBC. Many tragedies may be avoided if adult instruments are properly stored and if children are educated to properly use writing devices.

Keywords: Pediatric open globe injury (OGI); injury source; left-behind children (LBC); pars plana vitrectomy (PPV).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tp-21-162). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Preoperative factors correlated with visual prognosis. Rupture of the eyeball (P<0.001), endophthalmitis (P<0.001), primary hospitalization time over 24 hours (PHT >24 h) (P=0.016), traumatic cataract (P=0.013), and vitreous hemorrhage (P=0.040) were correlated with poorer final visual acuity. NLP, no light perception; PHT, primary hospitalization time.
Figure 2
Figure 2
Comparison between LBC and non-LBC. Compared with non-LBC, LBC were significantly younger (P<0.001) (A), had lower OTS scores (P=0.020) (B), had longer primary hospitalization time (P<0.001) (C), and worse baseline (P=0.011) and final visual acuity (P<0.001) (D). LBC, left-behind children; non-LBC, non-left-behind children.
Figure 3
Figure 3
Sector graph of injury sources. Composition of injury sources in all the patients. Of all the patients, the 3 most common injury sources were pencils (20 cases, 20.8%), knives (11 cases, 11.5%), and iron wire (7 cases, 7.3%).
See this image and copyright information in PMC

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