Prognostic Factors For Penetrating Eye Injuries In Children And The Application Of Pediatric Ocular Trauma Score In 82 Patients

Objective To analyze the related factors that affect the final visual acuity(FVA)in children with penetrating eye injury and to validate whether the pediatric ocular trauma score(POTS)is a valuable tool for predicting the FVA of penetrating eye injuries in children.Methods 1.A retrospective study of 82 children(82 eyes)with penetrating eye injuries was performed.All patients were admitted to Tianjin Eye Hospital between January 2013 and March 2018.The clinical data including gender,age,presentation interval,cause of injury,initial visual acuity(IVA),location of injury,wound conditions: organic/unclean injury,delay of surgery(>48h),follow-up time,final visual acuity(FVA)and major ocular manifestations were retrospectively analyzed.Major ocular manifestations consisted of hyphema,traumatic cataract(TC),vitreous hemorrhage(VH),endophthalmitis,retinal detachment(RD).2.FVA ≥0.1 was considered as good outcome and FVA <0.1 as poor outcome.3.Age,location of injury,IVA,wound conditions: organic/unclean injury and accompanying ocular manifestations including hyphema,TC,VH,endophthalmitis and RD were analyzed by the Pearson Chi-squared test and Fischer exact test to evaluate their effect on FVA.4.The 82 children with eye penetrating injury were scored by POTS.Spearman rank test was used to explore the correlation with FVA and POTS.Results 1.In this study,the ratio of male to female in 82 children with penetrating eye injuries was 1.9:1.And the high-risk age of suffering penetrating eye injuries was 7-9 years old.The average age of suffering penetrating eye injuries in men(7.91 ± 3.02 years)was significantly higher than that in women(6.50 ± 2.66 years)(t = 2.038,P = 0.040);2.The results of the Pearson Chi-squared test and Fischer exact test showed: IVA(P = 0.000),age(P = 0.007),RD(P = 0.017),hyphema(P = 0.034),TC(P = 0.019)and endophthalmitis(P = 0.000)had a significant effect on the FVA;3.In the classification of POTS-l,the number of eyes with FVA ≥0.5 was 0;In the classification of POTS-4,the number of eyes with FVA <0.1 was 0;all the patients had a visual outcome of FVA≥ 0.5 in the classification of POTS-5.After analysis by Spearman rank correlation test,we found the correlation between the FVA and POTS grade was statistically significant(r = 0.568,P = 0.000),the correlation between FVA and the total score of POTS was also statistically significant(r = 0.547,P = 0.000).Conclusion 1.Factors that were significantly associated with better FVA of children with penetrating eye injuries were age at presentation,IVA,RD,hyphema,TC and endophthalmitis.2.The POTS is a reliable tool to predicting the FVA of children with penetrating eye injuries.