Wei Jin
Renmin Hospital of Wuhan University
China
Title: Efficacy and experiences of 23-gauge pars plan vitrectomy in pediatric traumatic endophthalmitis in rural China
Biography
Biography: Wei Jin
Abstract
Purpose: Post-traumatic endophthalmitis is a rare but serious complication of open global injury (OGI), representing a major turning point for the children’s visual prognosis. We aim to identify the epidemiology, etiology, culture results; anatomic outcomes and to report the experiences and skills of 23-gauge pars plana vitrectomy (PPV) in pediatric post-traumatic endophthalmitis in rural China over a 6-year period. Methods: One hundred and seven eyes of 107 consecutive patients aged below 15 who were diagnosed as post-traumatic endophthalmitis between September 2009 and October 2015 were included in this retrospective study. All patients were undergone combined PPV and silicone oil tamponade. We extracted the following parameters: age, gender, wound anatomy, intraocular foreign body (IOFB) characteristics, initial and final best corrected visual acuity (BCVA), anatomically reattachment. The VA were predicted using the ocular trauma score (OTS), and the predictions were compared with the BCVA using Fisher’s tests (SPSS version 17.0). Results: Seventy patients (65.42%) were male while thirty-seven (34.58%) were female, average age was 7.84 ±2.31 years, and mean follow-up was 13.31±3.15 months. The top three causes of injuries were: metallic substances (22.43%), scissors (16.82%) and firework (15.89%). Zone 1 injuries presented 14.02% (15/107) of the cases, and zone 2 and 3 presented 64.49% (69/107) and 21.50% (23/107), respectively. Lens trauma was noted in 53 (49.53%) eyes. An overall significant difference was observed among groups OST-1 (P=0.001) and OST-2 (P=0.012). Total retinal attachment was achieved in 99 of 107 eyes (92.52%) undergoing repair. Conclusions: If endophthalmitis is associated, surgery is urgent. The use of PPV combined silicone oil tamponade dramatically improved the prognosis of VA. However, prevention is always better than cure. Increasing awareness of the serious nature of endophthalmitis will help to develop a comprehensive plan for educating both parents and children to minimize preventable pediatric OGI.