The Impact of Primary Treatment on Post-Traumatic Endophthalmitis in Children with Open Globe Injuries: A Study in China

Zheng, Lingling; Tan, Junlian; Liu, Rongjiao; Yang, Xueru; He, Hao; Xiao, Hang; He, Lian

doi:10.3390/ijerph16162956

Cited by 14 publications

(6 citation statements)

References 24 publications

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“…Delayed repair is a risk factor for postoperative wound leakage(26), which will result in the edema of the surrounding tissue and increase the risk of wound dehiscence, thereby indirectly affecting the infection of the wound. Similar to those of studies on pediatric ocular injury (21)(22)(23)27), logistic regression analysis of this study identi ed the delayed wound repair ≥24h was the independent risk factor and compared with the that of the control group (30.4%), the incidence of endophthalmitis in patients with delayed admission≥24 h was signi cantly higher (75.0%).…”

Section: Discussionsupporting

confidence: 74%

“…This result was supported by previous studies (23,25,28) that showed foreign bodies with complex microorganisms can easily grow in suitable cultures if conditions permit. Notably, foreign bodies have not been found to increase the risk of endophthalmitis in other studies (22,27) including this present study. In addition, endophthalmitis and traumatic cataract were not statistically associated in this study, which was similar to the results of some previous studies (21,22,24) and opposite to the results of other studies (25,26).…”

Section: Discussioncontrasting

confidence: 57%

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Characteristics of Open Globe Injury in Children under 6

Zhang

Wang

et al. 2022

Preprint

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Background: To analyze the clinical characteristics of open globe injury (OGI) in children not yet 6.Methods: A retrospective analysis was performed on the medical data of 106 OGI children presented to The Eye Center of the Second Hospital of Jilin University, China, from January 1, 2012, to December 31, 2020. Results: A total of 106 children, including 61 males (57.5%) and 54 females (42.5%), were included, and the mean age was 4.14±1.58 years, with 53.8% injuries in the right eye. Sharp objects (57.5%) were primarily responsible for OGI, including knives for 22 cases (20.8%), glass and porcelain fragments for 18(17.0%), thorn-like objects for 10(9.4%), wooden materials for 10(9.4%). Up to 91.5% of wounds occurred in zone I. The penetrating injury incidence (68 cases, 64.2%) was highest in OGI cases. Concomitant symptoms of OGI included traumatic cataract (47.2%), iris prolapse (44.3%), endophthalmitis (22.4%), vitreous prolapse (17.0%), retinal detachment (5.7%), eyelid laceration (7.5%), and orbital fractures (1.9%). The mentioned wooden materials and thorns-like objects were associated with endophthalmitis development (p=0.045), and delayed admission ≥24h was an independent risk factor for its onset (p=0.008). Postoperative visual acuity was significantly correlated with its preoperative counterpart (p<0.001).Conclusions: Among OGI children under 6, the number of males is slightly larger than that of females. Sharp objects were the main causes of OGI. Raising awareness of the severity of OGI in children and study of the risk factors for endophthalmitis will help develop effective prevention strategies to reduce the incidence of ocular complications. Amblyopia should be attended to during OGI children’s recovery.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 57%

Characteristics of Open Globe Injury in Children under 6

Zhang

Wang

et al. 2022

Preprint

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“…We suggest that prevention strategies based on age or type of injuries to be considered. For pediatric ocular injuries, prevention system or education program to avoid accidents in potentially dangerous activities should www.nature.com/scientificreports/ www.nature.com/scientificreports/ be implemented 20 . Parents or teachers have to play an important role in supervision 6 .…”

Section: Discussionmentioning

confidence: 99%

Incidence and seasonality of major ocular trauma: a nationwide population-based study

Kwon

Choi

Bae

2020

Sci Rep

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We designed this study to identify the epidemiological characteristics and trends of various types of ocular trauma in the population of the Republic of Korea. We conducted a nationwide, populationbased, cross-sectional study using the Korean national Health insurance claims database for January 2010 to December 2018. We compiled the monthly numbers of patients diagnosed with hyphema and those who received open reduction surgery due to orbital blowout fracture (Bof), primary closure of the cornea or sclera (pccS), or intraocular foreign body (iofB) removal. We obtained annual and monthly incidence rates, and differences according to age, sex, yearly trends, and seasonal variations. The incidence rate (per 100,000 person-years) was high in the order of hyphema (18.43), BOF (11.58), PCCS (1.99) and IOFB removal (0.39). Male predominance was evident in all types of major ocular trauma, but the age distribution varied with the type: hyphemas were most prevalent at 10-14 years of age, BOFs at 25-29 years of age, and open globe injuries (OGIs) at age 60 and older. Although all types of trauma showed significant seasonality, hyphemas (amplitude: 174.81) and BOFs (23.17) showed higher amplitudes compared to OGIs (PCCS: 11.96; IOFB removal: 6.72). While the incidence of blunt trauma injuries, including hyphemas and orbital BOFs, decreased steadily from 2010 to 2018, that of OGIs showed no remarkable change. Ocular trauma is an important cause of visual impairment 1-3 , and the World Health Organization has reported that globally 55 million people experience serious ocular trauma every year 4. Depending on the type and severity of the trauma, not only the cost for treatments could be high, but also it could remain irreversible poor visual impairments following the injury 5. Additionally, blindness under the age of 20 is predominantly due to ocular trauma and its socioeconomic cost is very large 2, 6-8. The eyeball injury is classified as either closed globe injury or open globe injury (OGI) 9-11. The OGI, defined as full thickness wound in cornea or sclera, is classified as rupture and laceration. Corneal or scleral laceration is further classified as perforation, penetrating injury, and intraocular foreign body (IOFB) 9. Usually, the OGIs require primary closure of the cornea or sclera (PCCS) or surgery of IOFB removal. Epidemiological studies identifying trends or causes of ocular trauma are essential for establishing appropriate prevention measures. However, previous reports have limitations such as targeting a specific type of ocular trauma 12 , analyzing only emergency visits 1, 2 , small populations 3 , or including a limited number of institutions 11. In the present study, we sought to identify the epidemiological features of major types of ocular trauma, including closed globe injuries such as hyphemas and orbital blowout fractures (BOFs) and OGIs, based on the Korean National Health Insurance (NHI) claims database. Results Hyphema. From 2010 to 2018, the average annual incidence (per 100,000 person-years) of hyphe...

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“…[4] Endophthalmitis is one of the most serious and poor prognosis complications after OGI, which is preventable by primary wound closure. [31] About one-third (33.6%) of cases underwent surgeries twice, and 12.7% of them underwent surgeries three times. Lensectomy and deep vitrectomy were the most common types of surgery performed after the initial operation.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and Clinical Features of Pediatric Open Globe Injuries: A Report from Southern Iran

Sadeghi¹,

Azimi

Abdollahi

et al. 2023

JOVR

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Purpose: To evaluate the epidemiological features of open globe injury (OGI) in a tertiary ophthalmic center in the south of Iran. Methods: The medical files of pediatric patients diagnosed with OGI between March 2014 and March 2019 were reviewed retrospectively. Demographic data, laterality, time of injury, cause of trauma, location and mechanisms, complications, and the involved tissues, visual acuity, type of operation, and antibiotic therapy were all analyzed. Data were processed using the SPSS. Results: In total, 110 eyes of 108 patients were included. Ages <7 years comprised 49.1%, 7–12 years 26.4%, and 13–18 years 24.5% of cases. Of the 108 patients, 76 (70.3%) were males. No significant difference between right versus left eyes was seen. The incidence of OGI was lowest in winter and highest in spring, and it had more prevalence on the weekends. Sharp objects were the most common cause of OGI in ages <7 years, while blunt objects, accidents and falls, and guns and fireworks were more prevalent in older children. Home was the most common place of injury overall. The most common type of injury was penetrating trauma. Upon arrival, most of the children had a visual acuity <0.1 decimal. Primary wound closure was the most prevalent type of surgery done predominantly within 24 hr from admission time. Conclusion: Ages <7 years and male gender were the most common age and sex of pediatric OGI, respectively, and sharp objects were the predominant etiology. Early management and primary repair are essential for prevention of complications such as endophthalmitis and amblyopia.

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The Impact of Primary Treatment on Post-Traumatic Endophthalmitis in Children with Open Globe Injuries: A Study in China

Cited by 14 publications

References 24 publications

Characteristics of Open Globe Injury in Children under 6

Characteristics of Open Globe Injury in Children under 6

Incidence and seasonality of major ocular trauma: a nationwide population-based study

Epidemiological and Clinical Features of Pediatric Open Globe Injuries: A Report from Southern Iran

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