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

OBJECTIVES: To evaluate the epidemiology, etiology, and outcomes of pediatric open-glob injury patients treated at a tertiary medical center in Istanbul, Turkey.
METHODS: The records of 56 pediatric patients who underwent primary open-globe injury repair at our clinic between 2016-2021 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 (VA), associated features, the trauma-hospital admission and hospital admission-surgery durations were also recorded. The Pediatric Penetrating Ocular Trauma Score (POTS) was calculated in order 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 knife (10.7%). The mean size of injury was 4.73±2.92 mm; of which 60.7% (34) cases were zone 1, 33.9% (19) cases zone 2, and 5.4% (3) cases zone 3 injury according to the 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 significant influence on the postoperative visual outcome (p=0.019). The mean duration between trauma-hospital admission was 18.9±43.8 hours; while hospital admission-surgery was 8.6±3.7 hours.
DISCUSSION AND CONCLUSION: Our study demonstrated that the visual acuity at presentation and the presence of lens injury are visual prognostic factors for pediatric open-globe injuries.