PURPOSE Complex ocular injuries in children involving the cornea, lens and retina usually lead to irreversible visual impairment. Though the development of cataract and vitreoretinal surgical techniques succeeded in salvaging many poor prognosis eyes, the post operation therapy should pay more attention to deprivation amblyopia in order to improve the final vision. In this study, we investigated the valuation of occlusion therapy assisted by wearing spectacles or implanting intraocular lens post the surgeries of cataract and vetreoretina in pediatric patients.
METHODS 51 children with ocular trauma ranged from 3 to 12 years old were included into this study, including 39 cases of open global injuries and 12 cases of ocular blunt injuries. The patients underwent series surgeries, including suture of the cornea or sclera wound, cataract extraction, vitrectomy, and repair of retinal detachment in some cases. Occlusion therapy was prescribed to 29 eyes wearing spectacles and 22 eyes implanting intraocular lens (IOL) for 6 to 12 months. All the children were followed up for 12 to 60 months, mean 41.5 months after the final operations.
RESULTS Corrected visual acuity was improved in 38 eyes (74.5%), not improved in 13 eyes (25.5%), including 6 eyes with a leucoma involving the central cornea, 5 eyes with a retina scar involving the macula, 2 eyes for unsatisfied overall patching time. Occlusion therapy assisted by wearing spectacles (75.9%) and implanting IOL (72.7%) similarly improved the visual acuity of the injured eyes.
CONCLUSION Occlusion therapy after the correction of optical error by wearing spectacles and implanting IOL were
valuable in treating deprivation amblyopia due to ocular trauma and series surgeries in pediatric patients. Spectacles were dependable during the occlusion therapy in the early stage post surgery, but should be finally substituted by IOL after achieving a satisfied visual acuity in order to encourage binocular vision.