Open globe injuries in children: a retrospective analysis.

PURPOSE: To study the outcome of open globe injuries in patients aged <14 years and compare the results between patients who presented approximately 30 years ago and a recent series. METHODS: Between January 1970 and January 1993, 180 eyes of children who presented with an open globe injury were retrospectively analyzed. Patients were divided into two groups. One group of children underwent treatment of an open globe injury between January 1970 and December 1981 (group A) and another between December 1985 and January 1993 (group B). Main outcome measures studied were final visual acuity and enucleation rates. Risk factors studied included age, race, sex, visual acuity, type of trauma, and various injury characteristics at presentation. RESULTS: The factors associated with visual outcomes included: age, type of injury, wound size, initial visual acuity, and retinal detachment. Final visual outcome and enucleation rates were not significantly different between the older series (group A) and the recent series (group B). Lenticular damage, location, posterior extent of the injury, and presence of an intraocular foreign body had been significant prognostic factors in the older series, but were not statistically associated with the prognosis in the recent series. CONCLUSION: The nature of the injury and the patient's age are the main determining factors in the outcome of open globe injuries in children.

Morphometric analysis of pars plana development in humans.

BACKGROUND: Quantitative features of pars plana development in humans are not well characterized. Knowledge of the dimensions of this region is important for our understanding of the anatomy of infant eyes for the purposes of surgery. The purpose of this study was to provide a morphometric description of pars plana growth in relation to 1) postconceptional age and 2) axial length. METHODS: We reviewed histologic specimens from 204 human eyes of postconceptional ages ranging from 10 weeks to 5 years. Axial length and temporal pars plana width were measured directly with a reticule system. The relationships among pars plana width, axial length, and postconceptional age were examined. RESULTS: The most rapid phase of pars plana growth occurred between 26 weeks and 35 weeks gestation. A linear relationship between pars plana width and axial length existed once the axial length reached 12 mm (correlation coefficient = 0.918; P = 0.0001). In infants of 38-42 weeks postconceptional age, mean pars plana width was 1.87 mm (range, 0.9-2.8 mm; standard direction = 0.48 mm), and mean axial length was 17.7 mm (range, 15-23 mm; standard direction = 1.9 mm). After the age of 62 weeks postconception, all eyes had a temporal pars plana width > or = 3 mm and an axial length > or = 19 mm. The estimated age at which there was a 95% chance of the pars plana width being > or = 3 mm was 64.4 weeks (95% fiducial confidence limits, 60.8-86.2 weeks). CONCLUSIONS: The pars plana first develops during the second trimester of gestation. A rapid growth phase occurs between 26 weeks and 35 weeks postconception. The dimensions of the pars plana are correlated closely with axial length and postconceptional age. Assuming that a pars plana width of 3 mm is required for surgery to be performed via a pars plana approach, we estimate that pars plana vitreous surgery can be performed when the patient is at least 62 weeks old (postconception), which is a 6-month-old full-term infant.