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儿童非穿透性眼内异物的人口统计学、临床特征及预后

Demographic, clinical features, and outcomes of pediatric non-penetrating ocular foreign bodies.

作者信息

Smadar Lital, Dotan Gad, Abumanhal Muhammad, Achiron Asaf, Spierer Oriel

机构信息

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ophthalmology Unit, Schneider Children's Medical Center, Petah Tikva, Israel.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2020 Jul;258(7):1469-1474. doi: 10.1007/s00417-020-04688-7. Epub 2020 Apr 15.

DOI:10.1007/s00417-020-04688-7
PMID:32296989
Abstract

PURPOSE

Data regarding ocular foreign body (FB) in the pediatric population is sparse. The purpose of this study is to describe the demographic features and the outcomes of pediatric non-penetrating ocular FB.

METHODS

The charts of all children with non-penetrating ocular FB who presented at a tertiary medical center between 2011 and 2018 were retrospectively reviewed. Data analyzed included demographics, ocular FB site, the need for general anesthesia, or sedation for FB removal and clinical outcomes.

RESULTS

Three hundred and fifty-two children (58.8% boys) with a mean age of 7.7 ± 3.7 years were included. Two hundred and fifty-one (71.3%) children presented on the same day of injury. Patients with developmental delay presented more often with restlessness than patients without developmental delay (p < 0.0001). One hundred and forty-six (41.5%) of FBs were found on the conjunctiva, 128 (36.4%) under the eyelid, and 62 (17.6%) on the cornea. In 19 (4.5%) cases, general anesthesia or sedation was required for FB removal. A multivariate analysis identified young age (OR 0.976, 95% CI 0.961-0.992, p = 0.003), corneal FB (OR 50.84, 95% CI 10.08-256.37, p < 0.0001), and developmental delay (OR 18.56, 95% CI 1.22-283.45, p = 0.036), as significant predictors for the need of general anesthesia or sedation. Among patients with corneal FB, in two (3.2%) cases, the corneal FB was complicated by infectious keratitis, resulting in mild corneal scar.

CONCLUSION

The rate of general anesthesia for non-penetrating ocular FB removal in children is low. Children presenting with non-penetrating ocular FB have good prognosis without long-term complications.

摘要

目的

关于儿科人群眼内异物(FB)的数据较少。本研究的目的是描述儿科非穿透性眼内异物的人口统计学特征和治疗结果。

方法

回顾性分析2011年至2018年在一家三级医疗中心就诊的所有非穿透性眼内异物患儿的病历。分析的数据包括人口统计学、眼内异物位置、取出异物时是否需要全身麻醉或镇静以及临床结果。

结果

纳入352名儿童(58.8%为男孩),平均年龄7.7±3.7岁。251名(71.3%)儿童在受伤当天就诊。发育迟缓的患儿比无发育迟缓的患儿更常出现躁动(p<0.0001)。146例(41.5%)眼内异物位于结膜,128例(36.4%)位于眼睑下,62例(17.6%)位于角膜。19例(4.5%)取出异物时需要全身麻醉或镇静。多因素分析确定年龄小(OR 0.976,95%CI 0.961-0.992,p=0.003)、角膜异物(OR 50.84,95%CI 10.08-256.37,p<0.0001)和发育迟缓(OR 18.56,95%CI 1.22-283.45,p=0.036)是全身麻醉或镇静需求的显著预测因素。在角膜异物患者中,2例(3.2%)角膜异物并发感染性角膜炎,导致轻度角膜瘢痕。

结论

儿童非穿透性眼内异物取出术的全身麻醉率较低。非穿透性眼内异物患儿预后良好,无长期并发症。

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