Analysis of traumatic glaucoma in children

Objective To analyze the clinical characteristics of traumatic glaucoma in children. Methods This is a retrospective study.The data of 67 eyes of 67 cases with secondary glaucoma in 425 children with ocular trauma, aged 1 to 14 years, from Jan. 2014 to Dec. 2018 in First Affiliated Hospital of Zhengzhou University were analysed retrospectively. There were 52 eyes of 52 cases with secondary glaucoma caused by closed ocular trauma in closed ocular trauma group, and 15 eyes of 15 cases with secondary glaucoma caused by open ocular trauma in open ocular trauma group. The clinical characteristics, treatment methods and efficacy of treatment of the two groups were analyzed. The follow-up time was 1 month- 2 years. Results There were 251 cases of closed ocular trauma and 174 cases of open ocular trauma in children. The incidence of secondary glaucoma caused by closed ocular trauma (20.72%, 52/251) was higher than that of open ocular trauma (8.62%, 15/174), and the difference was statistically significant (χ2=11.323, P=0.001). The onset time of secondary glaucoma caused by closed ocular trauma was earlier than that of open ocular trauma. Hyphema (40.38%, 21/52) was the main cause of secondary glaucoma due to closed ocular trauma, and the mixed mechanism was the main cause of secondary glaucoma due to open ocular trauma (73.33%, 11/15). The two groups received conventional medicine first, and 22 cases (42.31%, 22/52) of closed ocular trauma group and 3 cases (20.00%, 3/15) in open ocular trauma group were converted to surgery because of lose control of IOP. The difference in surgery rate was not statistically significant between the two groups(χ2=2.477, P=0.116). At the last follow-up, the mean IOP of closed ocular trauma group was higher than that of open ocular trauma group (t=2.828, P=0.006). There was no statistical significance in BCVA between the two groups at the last follow-up (t=-1.244, P=0.218). Conclusion Secondary glaucoma caused by closed ocular trauma is more common than open ocular trauma. Treatment with medicine is still the first choice, but filtering surgery is an effective way to control secondary glaucoma with closed ocular trauma. Key words: Glaucoma, traumatic, children; Trauma, ocular, closed; Trauma, ocular, open