Ocular trauma is the most common cause of monocular vision loss in children. Among the patients with eye trauma in China, 15%-20% are children. The complexity of diagnosis and treatment and the uncertainty of prognosis are high because the ocular tissue of children is not fully developed and the history collection and examination are difficult. In order to further standardize the treatment of children's eye trauma and improve the treatment level, China Ocular Trauma Society has formulated Expert consensus of the treatment of pediatric ocular trauma in China by combining domestic and foreign literature and the actual medical situation in China. This consensus provides detailed recommendations on the classification, cause of injury, history collection, examination methods, diagnosis and treatment principles of pediatric eye trauma. This consensus applies to Chinese ophthalmologists and medical personnel engaged in the treatment of children's eye trauma, aiming to provide scientific guidance for the diagnosis and treatment of children's eye trauma, assist clinical decision-making, and further improve the treatment level of children's eye trauma in China.
Emergency treatment of ocular trauma is a systematic and complicated work. Rapid and correct diagnosis and treatment are needed to maximize the recovery of ocular structure and function. In recent years, China has made remarkable progress in the emergency treatment of ocular trauma, including the development of Expert consensus on the norms of emergency treatment of ocular trauma in China (2019), the establishment of a national ocular trauma database, and the development of VisionGo Artificial Intelligence prediction system for ocular trauma. These measures improve the treatment level of ocular trauma and provide support for the prediction of postoperative visual acuity in severe traumatic eyes. However, with the development of economy and society, the characteristics of ocular trauma in our country have changed. For example, the majority of hospitalized patients were open ocular injuries, farmers and workers were the main occupational groups, and the proportion of eye injuries caused by traffic injuries increased year by year, and the proportion of women and minors increased. Although the annual loss of life of ocular trauma disability in China has decreased faster than the world average, the emergency treatment of ocular trauma still faces many challenges, such as regional differences, insufficient primary medical resources, lack of standardized training, and insufficient promotion of emergency treatment standards. In order to cope with these challenges, it is necessary to further strengthen the popularization of science and technology for the prevention and treatment of ocular trauma, standardize the emergency treatment process, strengthen the training of grass-roots medical personnel, strengthen the safety of emergency surgery, and pay special attention to the particularity of children's ocular trauma. In addition, relevant research has been actively carried out to establish a complete database of emergency patients with ocular trauma to promote the accurate prevention and treatment of ocular trauma.
ObjectiveTo observe and preliminarily evaluate the clinical efficacy of a magnetizable intraocular magnetic foreign body extractor combined with pars plana vitrectomy (PPV) for the treatment of posterior segment small-to-medium-sized magnetic intraocular foreign bodies (IOFB). MethodsA retrospective clinical study. A total of 12 patients (12 eyes) with consecutive posterior segment magnetic IOFB who underwent PPV combined with IOFB removal at the Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University, from September 2024 to May 2025, were enrolled. All affected eyes underwent best-corrected visual acuity (BCVA), B-scan ultrasonography and/or CT examination. BCVA was measured using a standard logarithmic visual acuity chart, and the results were converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. All patients received standard three-port, 23G or 25G PPV via the pars plana. The IOFB were removed using a magnetizable intraocular magnetic foreign body extractor through a corneal wound or limbal incision. The postoperative follow-up period ranged from 3 to 15 months. Preoperative and postoperative BCVA, changes in corneal astigmatism, and intraoperative and postoperative complications were compared. Wilcoxon signed-rank test was used to compare logMAR BCVA and corneal astigmatism before surgery and at the last follow-up. ResultsAmong the 12 patients, 11 patients were male and 1 patient was female. The median age was 40.58 years. The IOFB were located in the vitreous cavity (6 eyes), on the retinal surface (5 eyes), and within the retina (1 eye). All IOFB were magnetic, with a maximum diameter of 5 mm. The IOFB were successfully removed in all affected eyes without the need for excessive intraoperative assistance. The preoperative logMAR BCVA was 1.65 (0.57, 2.30). At the last follow-up, logMAR BCVA and corneal astigmatism were 0.17±0.08 and 0.38 (0.13, 0.94) D, respectively. Compared with preoperative values, BCVA was significantly improved postoperatively (Z=?3.061, P=0.002). Correlation analysis showed no significant correlation between preoperative BCVA and either final BCVA or corneal astigmatism (r=0.183, 0.172; P=0.568, 0.590). No complications related to IOFB removal, such as retinal injury, retinal tear, or vitreous hemorrhage, occurred in any of the affected eyes. ConclusionPPV combined with a magnetizable intraocular magnetic foreign body extractor can safely and effectively remove posterior segment small-to-medium-sized magnetic foreign bodies, reduce complications, and improve postoperative visual acuity.
