Clinical features and outcome of posttraumatic endophthalmitis in children / 中华实验眼科杂志

ABSTRACT

Objective To investigate the clinical feature and treatment outcome of paediatric posttraumatic endophthalmitis.Methods A retrospective case study was performed.Twenty-six paediatric posttraumatic endophthalmitis children with 26 eyes were enrolled in Shandong Eye Hospital from April 2014 to April 2017.The clinical features,causes of trauma,time and mode of treatment,complications and visual acuity were analyzed.The subjects were graded according to the prognostic status,and the prognosis of the children was compared among different treatment time,vitrectomy time,operation frequency and antibiotic application.Results Of 26 cases,including 20 males and 6 females,aged from 1 year to 13 years,the average age was (6.56±3.25) years.The subjects were divided into infant group (2 cases,7.69％),preschool group (10 cases,38.46％) and school age group (14 cases,53.85％).The main cause of injury was wire,accounting for 34.62％ (9/26).Syringe needles accounted for 15.38％ (4/26).Fireworks accounted for 11.54％ (3/26).All of the 26 cases received vitrectomy,24 cases combined with lens extraction (92.31％).Among the 26 cases,8 cases had no primary visual acuity record;in the remaining 18 cases,the visual acuity at last follow-up was significantly improved when compared with the preoperative primary visual acuity (x2 =7.385,P =0.033).The positive rate of pathogenic bacteria culture in aqueous humor and vitreous humor was 23.08％ (6/26),gram-positive cocci was the main pathogenic bacteria of posttraumatic endophthalmitis,which account for 83.3％ (5/6).The prognostic grade was grade 1 in 15 cases (57.7％),grade 2 in 7 cases (26.9％) and grade 3 in 4 cases (15.4％).There were significant differences in the number of prognostic grading cases among children with different hospitalizing time or vitrectomy time (all at P＜0.05).The hospitalizing time,time of vitrectomy,number of operations and systemic application of antibiotics were positively correlated with the prognosis grade (rs =0.580,0.414,0.428,0.535;all at P ＜ 0.05).Conclusions Children with posttraumatic endophthalmitis should undergo vitrectomy as early as possible,which can receive better prognosis.