Gamze YILDIRIM BİÇER, Kürşad Ramazan ZOR

Travma sonrası açık glob yaralanması olan pediatrik hastaların klinik ve epidemiyolojik özellikleri

Amaç: Bu çalışmada bölgemizdeki pediatrik açık glob yaralanmalarının epidemiyolojisi ve klinik özelliklerini sunmaya çalıştık. Gereç ve Yöntem: Ocak 2012 ile Aralık 2022 tarihleri arasında açık glob yaralanması tanısı alan 18 yaş altı hastaların tıbbi kayıtları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, yaralanma zamanı, yaralanma bölgesi, yaralanma tipi ve yaralanma nedeni gibi demografik verileri kaydedildi. İlk ve son görme keskinlikleri ve başvuru anındaki oküler bulgular kaydedildi. Yaralanmaya eşlik eden oküler bulguların nihai görme seviyesi ile ilişkisi değerlendirildi. Bulgular: Hastaların yaş ortalaması 7,62 ±4,22 yıl idi. Hastaların çoğunluğu erkekti (n=28, %66,7). Sağ göz en çok yaralanan gözdü (n=30, %71,4). Hastaların yaklaşık %72,5'inin (n=29) başlangıç görme keskinliği 20/200'den daha kötüydü. Hastaların %50'sinin (n=20) nihai görme keskinliği ise 20/200'ün altındaydı. En sık görülen yaralanma tipi penetran travmaydı (n=18, %42,9). Travmanın en yoğun olduğu bölge Zon I (n=30, %71,4) idi. En fazla travmatizan obje metal nesnelerdi (n=13, %31), En sık eşlik eden klinik bulgu lens hasarıydı (n=18, %42,9). İris hasarı, lens hasarı, hifema, vitre hemorajisi, retina dekolmanı, endoftalmi, yaralanma tipi, yaralanmaya sebep olan materyal ve yaralanma yeri nihai görme ile anlamlı şekilde ilişkiliydi. Sonuç: Bölgemizde pediatrik yaş grubunda açık glob yaralanmaları en çok 12 yaş altı erkek çocuklarda izlenmektedir. Delici ve kesici metal cisimler travmanın en önemli nedeni olarak görünmektedir. Ebeveynler ve tüm bakıcılar, olası yaralanmaları önlemek için açık glob yaralanmalarının ciddiyeti konusunda bilgilendirilmelidir.

Anahtar Kelimeler:

acil cerrahi, oküler travma, açık glob yaralanması, pediatrik travmalar, görme kaybı

Clinical and epidemiological characteristics of pediatric patients with post-traumatic open globe injury

Purpose: The aim of this study was to determine the epidemiology and clinical features of pediatric traumatic open globe injuries in our region. Materials and Methods: Medical records of patients under the age of 18 who were diagnosed with open globe injury between January 2012 and December 2022 were retrospectively reviewed. Demographic data of the patients such as age, gender, time of injury, area of injury, type of injury, and cause of injury were recorded. Initial and final visual acuity and ocular findings at admission were recorded. Factors associated with final visual acuity were evaluated. Results: The mean age of the patients was 7.62 ±4.22 years. The majority of the patients were male (n=28, 66,7%). The right eye was the most injured (n=30, 71.4%). The initial visual acuity of approximately 72.5% (n=29) of the patients was worse than 20/200. And the final visual acuity of 50% of the patients (n=20) was below 20/200. The most common type of injury was penetrating trauma (n=18, 42.9%). The region with the highest trauma was Zone I (n=30, 71.4%). The most traumatic materials were metallic objects (n=13, 31%). The most common accompanying clinical finding was lens damage (n=18, 42.9%). Iris damage, lens damage, hyphema, vitreous hemorrhage, retinal detachment, endophthalmitis, type of injury, material causing the injury, and injury area were significantly associated with final vision. Conclusion: In our region, open globe injuries were mostly observed in boys under 12 years in the pediatric age group. Penetrating and cutting metallic objects seem to be the most important cause of trauma. Parents and all caregivers should be informed of the seriousness of open globe injuries to prevent possible injuries.

Keywords:

emergency surgery, ocular trauma, open globe injury, pediatric traumas, vision loss,

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