Lesniak Sebastian P, Bauza Alain, Son Jung H, Zarbin Marco A, Langer Paul, Guo Suquin, Wagner Rudolph S, Bhagat Neelakshi
Institute of Ophthalmology and Visual Science, New Jersey Medical School, 90 Bergen Street, Suite 6100, Newark, NJ 07101, USA.
J Pediatr Ophthalmol Strabismus. 2012 Mar-Apr;49(2):73-9. doi: 10.3928/01913913-20110712-02. Epub 2011 Jul 19.
To evaluate the epidemiology, anatomical characteristics, and clinical outcomes of pediatric traumatic open globe injuries and to compare the observed final visual acuity to the expected visual acuity as predicted by the Ocular Trauma Score (OTS).
Retrospective chart review of 89 pediatric patients (89 eyes) with open globe injury presenting between 1997 and 2008.
Sixty-five patients (73%) were male, average age was 9.7 years, and mean follow-up was 22.6 months. The most common causes of trauma were: accidents (79%), violence (10%), and motor vehicle accidents (9%). Penetrating ocular injury was the most common trauma (54%), followed by blunt rupture (34%). Zone 1 injuries represented 49% of cases, and zones 2 and 3 represented 29% and 21%, respectively. No patient developed endophthalmitis. The average presenting and final visual acuities were logarithm of the minimum angle of resolution 1.927 and 1.401, respectively. Lens trauma was noted in 44 (49%) eyes. Twenty-eight patients (31%) had retinal detachment within 6 months of presentation. Total retinal attachment was achieved in 12 (63%) of 19 eyes undergoing repair. Enucleation was performed in 9 (10%) patients. Final visual acuities were not statistically different from visual acuities predicted by OTS (P > .05).
The visual prognosis in pediatric open globe injury is poor. The zone of injury may correlate with poor final visual acuity, risk of retinal detachment, and subsequent need for an enucleation. The final predicted visual acuity correlated well with the observed final visual acuity in these patients.
评估儿童外伤性开放性眼球损伤的流行病学、解剖学特征和临床结局，并将观察到的最终视力与眼外伤评分（OTS）预测的预期视力进行比较。
对1997年至2008年间就诊的89例儿童开放性眼球损伤患者（89只眼）进行回顾性病历审查。
65例（73%）为男性，平均年龄9.7岁，平均随访时间22.6个月。最常见的外伤原因是：意外事故（79%）、暴力（10%）和机动车事故（9%）。穿透性眼外伤是最常见的外伤类型（54%），其次是钝性破裂伤（34%）。1区损伤占病例的49%，2区和3区分别占29%和21%。无患者发生眼内炎。初始视力和最终视力的平均值分别为最小分辨角对数1.927和1.401。44只眼（49%）发现晶状体损伤。28例患者（31%）在就诊后6个月内发生视网膜脱离。19只接受修复的眼中，12只（63%）实现了视网膜完全附着。9例患者（10%）接受了眼球摘除术。最终视力与OTS预测的视力无统计学差异（P>.05）。
儿童开放性眼球损伤的视觉预后较差。损伤区域可能与最终视力差、视网膜脱离风险以及随后的眼球摘除需求相关。在这些患者中，最终预测视力与观察到的最终视力相关性良好。
