Traumatic pediatric retinal detachment following open globe injury

Purpose: It was the aim of this study to describe the clinical features and surgical outcomes of retinal detachment following open globe injuries in a pediatric population. Methods: The study was a retrospective chart review of 33 children who had undergone surgery for retinal detachment after open globe injury. Results: The mean age was 11 years (range 4-18) and the mean follow-up period was 57.1 months (range 6-204). Twenty-five patients (76%) were males. Of the open globe injuries, 21 (64%) were penetrations, 6 (18%) intraocular foreign bodies, and 6 (18%) ruptures. Eighteen retinal detachments (55%) were identified by B-scan. Eighteen eyes (55%) had total retinal detachment and 23 eyes (70%) showed macular involvement. Twenty-one eyes (64%) presented with proliferative vitreoretinopathy (PVR) grade C or worse. Retinal reattachment was successful in 12 eyes (36%). Best-corrected visual acuity of 20/100 or better was noted in 4 eyes (12%) preoperatively and in 12 eyes (35%) postoperatively. Features seen in patients with a poor surgical outcome included undetermined or light perception only preoperative vision (p = 0.012), diagnosis by B-scan (p = 0.003), the presence of PVR grade C or worse (p = 0.001), total retinal detachment (p = 0.001), and macula-off status (p = 0.016). Conclusions: Our findings suggest that retinal detachment caused by open globe injuries in the pediatric population is associated with worse surgical results and unsatisfied visual outcomes. Early vitrectomy, before a diagnosis of retinal detachment is made by serial echographic examinations, may be considered to reduce the incidence of PVR. Further clinical research is required to identify ways to improve the outcomes for these patients.