Qin Zuo-Xin, He Yan, Xu Yu-Fei, Yu Tao, Liu Yong, Wu Nan
Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China.
Int J Ophthalmol. 2021 Sep 18;14(9):1321-1326. doi: 10.18240/ijo.2021.09.05. eCollection 2021.
To investigate the clinical characteristics and predictive factors of pediatric ocular trauma patients with vitrectomy.
Pediatric ocular trauma patients (aged 14y or younger) who received vitrectomy in Southwest Hospital between January 2007 and December 2017 were reviewed retrospectively. Age, gender, mechanism of injury, final visual acuity (VA), and prognostic factors were analyzed.
A total of 139 eyes in 139 pediatric patients were included in the study. The mean age was 7.4±3.7 years old and the male-to-female ratio was 5:1. There were 104 (74.8%) open globe injuries and 35 (25.2%) closed globe injuries. The top one traumatic eye injuries were penetrating injuries occur through sharp metal objects (43.9%). After vitrectomy, 116 patients had favorable anatomic outcome at the last follow-up, and 30 eyes (21.6%) achieved VA of 20/200 or better. Following univariate analysis, we found zone III injuries (=0.021), poor initial VA (=0.005), endophthalmitis (=0.024), and recurrent retinal detachment (<0.001) were poor prognostic factors for pediatric ocular trauma. After Logistic regression analysis, the poor initial VA (odds ratio: 8.276, 95%CI: 1.597-42.897, =0.012) and recurrent retinal detachment (odds ratio: 6.455, 95%CI: 2.372-17.562, <0.001) were significantly correlated with unfavorable vision outcome in pediatric ocular trauma.
The treatment of vitrectomy for severe ocular trauma results in favorable anatomic outcomes, but VA improvement is not as good as anatomic outcomes. Initial VA and recurrent retinal detachment are the independent prognostic indicators for unfavorable visual outcome of severe pediatric ocular trauma.
探讨小儿玻璃体切割术眼外伤患者的临床特征及预测因素。
回顾性分析2007年1月至2017年12月在西南医院接受玻璃体切割术的14岁及以下小儿眼外伤患者。分析年龄、性别、损伤机制、最终视力（VA）及预后因素。
本研究共纳入139例小儿患者的139只眼。平均年龄为7.4±3.7岁，男女比例为5:1。开放性眼球损伤104例（74.8%），闭合性眼球损伤35例（25.2%）。最常见的眼外伤类型为锐器金属物穿透伤（43.9%）。玻璃体切割术后，116例患者在末次随访时解剖结构恢复良好，30只眼（21.6%）视力达到20/200或更好。单因素分析后，我们发现Ⅲ区损伤（P=0.021）、初始视力差（P=0.005）、眼内炎（P=0.024）及视网膜脱离复发（P<0.001）是小儿眼外伤预后不良因素。Logistic回归分析后，初始视力差（比值比：8.276，95%可信区间：1.597 - 42.897，P=0.012）及视网膜脱离复发（比值比：6.455，95%可信区间：2.372 - 17.562，P<0.001）与小儿眼外伤视力不良结局显著相关。
严重眼外伤玻璃体切割术治疗可获得良好的解剖学结局，但视力改善不如解剖学结局。初始视力及视网膜脱离复发是严重小儿眼外伤视力不良结局的独立预后指标。
