April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Posterior Segment Complications in Pediatric Open Globe Injuries
Author Affiliations & Notes
  • Rahul S. Tonk
    UMDNJ-Robert Wood Johnson Med School, New Brunswick, New Jersey
  • S. Lesniak
    UMDNJ-Robert Wood Johnson Med School, New Brunswick, New Jersey
  • M. Zarbin
    IOVS-New Jersey Med School, Newark, New Jersey
  • P. Langer
    IOVS-New Jersey Med School, Newark, New Jersey
  • N. Bhagat
    IOVS-New Jersey Med School, Newark, New Jersey
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5584. doi:
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    • Get Citation

      Rahul S. Tonk, S. Lesniak, M. Zarbin, P. Langer, N. Bhagat; Posterior Segment Complications in Pediatric Open Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5584.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To describe the characteristics of posterior segment (PS) injuries in pediatric traumatic open globe injuries.

Methods: : Retrospective chart review. Of 103 pediatric eyes with traumatic open globes presenting to University Hospital, Newark from 1997-2008, 29 (28%) were identified with PS injuries.

Results: : 25 (86.2%) cases were male. The average age at presentation was 5.2 years. The average follow-up length was 27 months. The average presenting visual acuity (VA) was 2.33 and the final VA was 1.93 in logMAR. Ocular injury type was penetrating in 15 (51.7%), rupture in 13 (44.8%) and perforating in 1 (3.4%). Zone 1 (Z1) injuries represented 8 (27.6%) of the injuries; Zone 2 (Z2), 12 (41.4%); and Zone 3 (Z3), 9 (31%). PS complications identified included retinal detachment (RD), vitreous hemorrhage (VH), intraocular foreign bodies (IOFB), hemorrhagic choroidals (HC), retinal incarceration, cataracts, and dislocated lens fragments. 20 eyes (69%) had RD; 1 (5%) had concurrent IOFB and 19 (95%) concurrent VH. 4 (20%) were Z1 injuries, 8 (40%) were Z2 and 8 (40%) were Z3. 18 eyes (90%) underwent RD repair (RDR) by pars plana vitrectomy (PPV), 5 (27.8%) of which also underwent scleral buckling. The other 2 RD eyes received palliative care on account of being pre-phthisical or with VA of no light perception (NLP). 5/18 eyes (27.8%) achieved anatomic success after the first RDR. Proliferative vitreo-retinopathy (PVR) was the major cause of recurrent RD in 12/13 (92.3%) eyes. 7 (53.8%) of these eyes underwent one or more additional PPV with 5 (71.4%) ultimately achieving anatomic success. The overall anatomic success for RD was 55% (10/18 eyes); this required on average 1.5 PPV. 27 eyes (93.1%) had VH; etiologies included RD, traumatic cataract with anterior segment injury, retinal tear, incarcerated retina, subretinal hemorrhage, choroidal rupture, and HC. 10 eyes (37%) were treated operatively with PPV and 17 (63%) were observed. Of the observed VH, 6 (35.3%) resolved completely over an average period of 71.5 days. 1 eye (3.4%) had a PS IOFB; this eye also had RD and VH, and underwent primary PPV with open globe repair. 11 eyes (37.9%) had HC. These were either drained at the time of PPV or resolved spontaneously. 6 (21%) of 29 eyes presented with lens fragments in the vitreous; all of which underwent pars plana lensectomy. No eyes underwent enucleation.

Conclusions: : Twenty-eight percent of pediatric open-globe injuries were associated with PS complications in our study. Most of the eyes underwent PS surgery with PPV and had a poor visual outcome.

Keywords: trauma 
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