Mahatab Alam Khanzada, Ashok Kumar Narsani, Arshad Ali Lodhi.
Factors affecting the final visual acuity, after repair of open globes in children.
J Liaquat Uni Med Health Sci Jan ;11(3):127-32.

BACKGROUND: In children ocular trauma, although preventable public health problem is the leading cause of monocular blindness worldwide and therefore has significant socio-economic impact. OBJECTIVE: To determine the visual outcome after open globe injuries in children in relation to different risk factors. DESIGN: Prospective and Observational. SETTING: Department of Ophthalmology Liaquat University of Medical and Health Science during September 2008 to August 2009. METHODS: All open globe injuries were repaired with 10/0 or 8/0 sutures, postoperatively prophylactic broad spectrum antibiotics prescribed while corticosteroid eye drops / injections given if indicated. All patients were kept under follow-up for 1, 2, 4 and 6 weeks. The variables that can affect visual outcome after open globe considered includes, type of injury (defined by the mechanism of injury), grade of injury (defined by the initial visual acuity), zone of injury (defined by the location of wound), length of wound (<5mm, 5-10mm and >10mm) and time interval (<24 h, 24> 48 h and 48-72 h) between injury and repair were recorded. Associated variables, such as nature of injuring object and endophthalmitis were also considered for analysis. Final visual outcome, good visual acuity (>0.05 or more) and poor visual acuity (0.1 or less) were recorded. RESULT: Good visual out come (visual acuity 0.5 or better) was achieved in 36(69.23%) patients and poor visual out come (visual acuity 0.1 or less) in 16(30.76%) patients. Univariate analysis showed that the type C injury (P=0.04), zone of injury III (P=<0.001), wound length between 5- 10mm (P=0.002) and >10mm (P=<0.001) and time interval between injury & repair between 48-72 hours (P=0.15) were the risk factor for poor visual out come. Univariate analysis revealed that sharp object causing injury like scissor (P=<0.001) knife (P=0.065), stone (P=0.002), firecracker (P=<0.001) and bangle piece (P=0.002) were also found as risk factor for poor vision. A statistical significance was defined as p <0.05. CONCLUSION: The prevalence of pediatric ocular trauma is higher in developing countries probably due to less stringent laws relating to child care. Many of the injuries in children can be prevented by parental supervision, awareness of child's activities and use of proper protective measures.

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