Clinical Course and Predictive Factors of Final Visual Acuity in Children with Penetrating Ocular Trauma

Kim, Jong Hyun; Yu, Young Suk

Abstract

PURPOSE
To investigate the clinical course and the predictive factors of final visual acuity in children with penetrating ocular trauma. METHODS: The medical records of 63 eyes of 62 children with penetrating ocular trauma were reviewed retrospectively, and the relationships between factors and final visual acuity were analyzed. RESULTS: Penetrating ocular trauma was frequent in male patients and preschool age children. The most common mechanism of injury was sharp trauma, and the most common location of injury was limited to the cornea. Among the associated injuries, uveal prolapse and lens damage were most frequent. As a primary operative management, primary wound closure was done in 62 eyes, and evisceration in one eye. Over half took an operation more than twice, and the lens damage is the most common cause of additional operation. Endophthalmitis was found in 4.8%, and phthisis in 6.3%. Final visual acuity over 0.5 was 35.5%, between 0.025 and 0.5 was 33.9%, and under 0.025 was 30.6%. Relationships between factors and final visual acuity were analyzed using single variate and multivariate analysis, and the presence of lens damage or posterior segment involvement was a significant predictor of final visual acuity. CONCLUSIONS: In spite of marked improvement in the microsurgical techniques, penetrating ocular trauma in children showed bad prognosis that 2/3 of them achieved final visual acuity under 0.5. The presence of lens damage or posterior segment involvement was a significant predictive factor of final visual acuity in patients with penetrating ocular trauma. We hope that using these predictive factors help clinicians decide appropriate treatment for children with penetrating ocular trauma.