Characteristics of Open Globe Injury in Children under 6

Characteristics of Open Globe Injury in Children under 6 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Characteristics of Open Globe Injury in Children under 6 Rui Li, Ying Zhang, Chenguang Wang, Shounan Qi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1698168/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: To analyze the clinical characteristics of open globe injury (OGI) in children not yet 6. Methods: A retrospective analysis was performed on the medical data of 106 OGI children presented to The Eye Center of the Second Hospital of Jilin University, China, from January 1, 2012, to December 31, 2020. Results: A total of 106 children, including 61 males (57.5%) and 54 females (42.5%), were included, and the mean age was 4.14±1.58 years, with 53.8% injuries in the right eye. Sharp objects (57.5%) were primarily responsible for OGI, including knives for 22 cases (20.8%), glass and porcelain fragments for 18(17.0%), thorn-like objects for 10(9.4%), wooden materials for 10(9.4%). Up to 91.5% of wounds occurred in zone I. The penetrating injury incidence (68 cases, 64.2%) was highest in OGI cases. Concomitant symptoms of OGI included traumatic cataract (47.2%), iris prolapse (44.3%), endophthalmitis (22.4%), vitreous prolapse (17.0%), retinal detachment (5.7%), eyelid laceration (7.5%), and orbital fractures (1.9%). The mentioned wooden materials and thorns-like objects were associated with endophthalmitis development ( p =0.045), and delayed admission ≥24h was an independent risk factor for its onset ( p =0.008). Postoperative visual acuity was significantly correlated with its preoperative counterpart ( p <0.001). Conclusions: Among OGI children under 6, the number of males is slightly larger than that of females. Sharp objects were the main causes of OGI. Raising awareness of the severity of OGI in children and study of the risk factors for endophthalmitis will help develop effective prevention strategies to reduce the incidence of ocular complications. Amblyopia should be attended to during OGI children’s recovery. Children Open globe injury Characteristics Endophthalmitis Amblyopia Figures Figure 1 Background Ocular trauma is among the most common causes of monocular visual disability and deprivation amblyopia in children(1, 2) The incidence of ocular trauma in children varies from 9 to 15/ per 100000 worldwide, in which 25% of injuries are open globe injury (OGI)(1). Despite great advances in microsurgical techniques and understanding of OGI, many postoperative visual outcomes for children were unsatisfactory(3). Some surveys further indicated age range and amblyopia as additional risk factors for poor prognosis in children(4). In addition, endophthalmitis, one of the most serious complications after OGI, also influences the prognosis in children. Besides the high costs of hospitalization and OGI-related treatment, the attendant vision diseases can also cause additional problems, such as disability, reduced life quality, and psychological disorders (5, 6). From the perspective of public health and eye injury prevention, identifying the epidemiology features of OGI is the key to conducting active education and finding effective measures to reduce the occurrence of OGI. Although some studies showed the incidence of pediatric eye injuries decreases per year, preschoolers or younger groups were still more vulnerable to vision loss injuries than other age groups(5, 7) Thus, in this study, the clinical characteristics of OGI in children under 6 were analyzed. Materials And Methods There is a population-based retrospective study about OGI children in The Eye Center of the Second Hospital of Jilin University in China from January 1, 2012, to December 31, 2020. All children under 6 presenting to this hospital were included. Exclusion criteria were: age older than 6, CGI, chemical injuries, thermal burns, the experience of being transferred to another hospital, and incomplete medical records. The systemic medical data of OGI children meeting the criteria were recorded, including age, gender, mechanism and type of OGI, wound location, the interval between the injury occurrence and hospital admission, clinical signs (presence or absence of traumatic cataract, endophthalmitis, IOFB, vitreous prolapse, eyelid laceration, and orbital fracture). All admitted patients underwent detailed ophthalmological examinations, and posttraumatic presenting visual acuity and the best-corrected visual acuity at final follow-up were obtained whenever possible within limited cooperation ability in children. Follow-up ranges from a month to a year. Open globe injury is the full-thickness injury of the cornea and /or the sclera and is classified as penetrating injury, perforating injury, intraocular foreign body, and globe rupture based on the Birmingham Eye Trauma Terminology (BETT) system (10). Data were analyzed using SPSS version 26.0. In the descriptive analysis, categorical variables were expressed by frequency and percentage and continuous variables by mean (standard deviation). T-test and rank-sum test were used to explore the differences between continuous variables. The Chi-square test or Fisher’s exact test was used to study the univariate association between two groups, if statistical significance exists, an odds ratio (OR) with a 95% confidence interval was calculated. Multiple logistic regression analysis was used to analyze the independent predictors associated with the dependent variable. A p -value < 0.05 was considered statistically significant. Results This study includes 106 cases. Table 1 demonstrates the clinical features of all patients, with 8 (7.5%) OGI cases occurring at 1 year old or younger, 11 (10.4%) between 1-2 years old, 16 (15.1%) between 2-3 years old, 22 (20.8%) between 3-4 years old, 21 (19.8%) between 4-5 years old, and 28 (26.4%) between 5-6 years old. The mean age of the hospital patients was 4.14±1.58 years. The present research found that males have a higher OGI prevalence than females, with 61 cases (57.5%) being males and 54 (42.5%) being females. Most injuries were distributed in the 4-6year age group. The age and gender distribution of OGI children is shown in Figure 1. A total of 57 (53.8%) patients suffered a right eye injury, and 49 (46.2%) had a left eye injury. Children might hurt their eyes with dangerous objects due to uncoordinated movements or lack of safety awareness. The material causing the trauma was mostly sharp objects (57.5%), including knives in 22 (20.8%) cases, glass and porcelain fragments in 18 (17.0%), thorn-like objects (bamboo sticks, iron sticks, and needles) in 10 (9.4%), wooden materials in 10 (9.4%). Besides the above goods, other objects causing OGI were displayed in table 1. Among the included patients, 61(59.2%) were referred to our hospital within 24 h, 42(40.8%) were after 24 h, and the time interval between injury and admission was not available for 3 patients. The incidence of penetrating injury (68, 64.2%) was highest, followed by globe rupture (15,14.2%). The rates of intraocular foreign bodies (13) and perforating injury (10) were 12.3% and 9.4%, respectively. There were 73 (68.9%) patients, with full-thickness eye-wall defects in zone I, with 5 (4.7%) in zone II, and 1(0.9%) in zone III. A total of 27(25.5%) were involved in multiple zones, with 18 (17.0%) in zone I and II, 3(2.8%) in zone II and III, 6(5.7%) in all zones, and 91.5% of wounds occurred in zone I. In this group of OGI children under 6, all patients underwent primary surgical repairs. Traumatic cataracts (50,47.2%) were the most common concomitant injuries, and 32 (64%) cases underwent lens extraction, among which only 19 cases (17.9%) also had intraocular lens implantation. Iris prolapse and vitreous prolapse were observed in 47 (44.3%) and 18 (17.0%) cases, respectively. Orbital fractures in (2, 1.9%), followed by retinal detachment (6, 5.7%) and eyelid laceration (8,7.5%). Intraoperatively, 70 (66.0%) OGI patients received intravitreal injection of vancomycin, and 18 (17.0%) underwent pars plana vitrectomy. A total of 24 (22.4%) patients in this group developed endophthalmitis. The Chi-square test or Fisher exact test (table 2) showed injuries caused by the mentioned thorns-like objects and wood materials were statistically associated with the occurrence of endophthalmitis ( p =0.045; OR=4.053;1.064,15.437). Compared with the group data without endophthalmitis (shown in Table 2), the data with this illness indicated the post-injury admission time ( p <0.001) and injury zone ( p =0.002) were significantly associated with endophthalmitis. In addition, endophthalmitis and iris prolapse were significantly correlated, which was a protective factor against endophthalmitis ( p =0.022; OR=0.337;0.129,0.876). We also studied whether age, gender, injury type, vitreous prolapse, traumatic cataract, IOFB, and RD were associated with endophthalmitis, and no statistical significance was found ( p <0.05). Multivariate logistic regression analysis (show in Table 3) was performed on the data, and only delayed presentation ≥24h after trauma was an independent risk factor for endophthalmitis ( p =0.008; OR=4.532; 1.473,13.943). Iris prolapse and injury zone were irrelevant, and more cases should be counted for a more accurate result. One of the 24 endophthalmitis cases showed positive aqueous or vitreous culture (Streptococcus), 22 patients (91.7%) received intravitreal vancomycin, and 7 underwent pars plana vitrectomy with silicone oil tamponade. In this study, both preoperative and postoperative visual acuity was detected in 41 cases (the vision of the remaining patients was failed to measure because of their young age or lack of cooperation). The initial and final VA at the final follow-up are shown in table 4, and postoperative visual acuity was statistically associated with a preoperative counterpart in this study( p <0.001). Discussion The OGI rate of boys (57.5%) in the present study was not high, which was in line with previous studies with the same age group(8, 9). Meanwhile, our data showed that it was not until the age of six that boys had a notably higher OGI rate than girls. That was because all the children were exposed to the same dangerous situations. Thus, they had the same probability of getting injured, but boys were more inclined to participate in stimulating and aggressive activities as they grew older, which explained why the male-to-female ratio is typically higher than 2:1 in studies on pediatric populations under 18 years of age(4, 10-13). This study showed that OGI was most common in children aged 4-6 (71 cases, 67.0%), which were also mentioned in earlier articles(3, 14). Consistent with the results of some studies(3, 13-15), there was a small gap of 1:1.2 between left eye and right eye injuries, In addition, the ratio of injured right eye was significantly higher than the left among children (age ≤6 years) in a previous study, at a ratio of 2:1(9), which is probably because those young children tend to use their dominant hand when developing their manual skills. The OGI is mainly caused by sharp objects, with the rate ranging from 48% to 75%(4, 10, 11, 15, 16), which is consistent with previous clinical records and further confirmed in our data (57.5%). Additionally, the findings agreed with the results of AIDahash et al. (15), who reported that knives cause the most injuries to children. However, Read & Cavuoto(8) concluded that glass should be responsible for the injuries of preschoolers. Other reports showed the children were also frequently hurt by wooden products (12), kitchen items(6, 7), or metallic objects(3, 9, 14). Besides these objects mentioned above, the reason for the injury varies between some other reports because of regional and cultural differences. In a previous study, bows and arrows were a common cause of OGI in Indian children(17). Weiss et al. (18) found 22.6% of firearm-related ocular injuries in the United States occurred in children, and another study(19) in the US showed that eye injury was more caused by motor vehicle crashes. The studies from various regions reported that approximately 63.3%-94.9%(6, 11, 12, 15) of injuries are penetrating ones, which is consistent with our data of 64.2%. As in previous studies, injuries were more common in zone I than in the other zones (6, 9, 13, 14, 16), and up to 91.5% of open wounds occurred in zone I. Multizone injuries were rare (3), but accounted for 1/4 in this study, which may be because children too young to know how to avoid dangerous objects, resulting in the increased damage area. Assessment of children with OGI is quite difficult because of incomplete or even inaccurate injury descriptions and poor cooperation during ocular examinations(10, 20). Therefore, primary treatment may be delayed, increasing the risk of inducing complications. It should be noted that the traumatic cataract was most frequently associated with OGI in the current research, accounting for 47.2% of all cases, of which 19 aphakic patients did not undergo lens implantation since additional surgery did not improve postoperative vision. The most important approach to preventing posttraumatic endophthalmitis in children is the initial eye repair within 24 hours and the use of prophylactic intravitreal antibiotics(20). In the current study, all children diagnosed with OGI underwent primary repair, and intravitreal injection of vancomycin was given priority for 66.0% of patients during the operation. Posttraumatic endophthalmitis following eye injuries is one of the most serious complications (20), and the reported frequency of endophthalmitis among children varies from 13% to 54%(13, 14, 21, 22) in different studies. A previous study showed that the incidence of endophthalmitis in hospitalized patients without associated risk factors was 5.9%, rising to 65.3% and 90.3% when two and three risk factors appeared, respectively(23). Therefore, identifying the relevant factors and timely prevention and treatment significantly impact the prognosis of patients with endophthalmitis, especially younger children. As demonstrated in the study, injuries with thorn-like objects and wood materials were associated with the development of endophthalmitis. Earlier studies(14, 17, 22, 24, 25) also showed that the incidence of endophthalmitis was higher after injuries caused by needles and/or wooden materials. This means that ophthalmologists must be alert to the occurrence of endophthalmitis and take preventive measures promptly when targeting eye injuries caused by such causative agents. Corneal wounds that go deep into the anterior segment have the highest risk for endophthalmitis. In this study, the wounds involving only zone 1 were more common (83.5% vs 63.4%). In a study from India(17), the risk of developing endophthalmitis induced by wounds involving the central cornea (central 5 mm) was 9 times higher than that caused by peripheral corneal wounds. That was probably because the torn cornea is difficult to close smoothly in the early stage, and thus, the contaminated microorganisms are exposed to the ocular cavity and will cause bacteria breeding of the wound when staying there for a long time. In addition, the avascular corneal further led to insufficient immune response and delayed wound healing, increasing the risk of inducing endophthalmitis(14, 17). Bansal et al(20). and Zhang et al.(21) found that intraocular tissue prolapse played an important role in reducing the risk of endophthalmitis in children, and they supposed prolapsed tissue could seal the wound and prevent the entry of microorganisms, thus avoiding eye infection. However, a recent study(17) showed the occurrence of iris and vitreous prolapse through the wound increased the probability of developing endophthalmitis in children aged <18 years by 3 and 5 times, respectively. The authors argued that the prolapsed tissue serves as good culture media for the growth of the contaminant microorganisms. In our univariate analysis, iris prolapse decreased the infection risk, but vitreous prolapse was not statistically associated with endophthalmitis. Studies with larger samples were needed to further analyze whether intraocular tissue prolapse promotes or prevents the microbial invasion. The delayed wound repair is the most important risk factor for posttraumatic endophthalmitis in children(20). Delayed repair is a risk factor for postoperative wound leakage(26), which will result in the edema of the surrounding tissue and increase the risk of wound dehiscence, thereby indirectly affecting the infection of the wound. Similar to those of studies on pediatric ocular injury(21-23, 27), logistic regression analysis of this study identified the delayed wound repair ≥24h was the independent risk factor and compared with the that of the control group (30.4%), the incidence of endophthalmitis in patients with delayed admission≥24 h was significantly higher (75.0%). Other factors associated with endophthalmitis were analyzed in different studies. The authors(23) compared the case group with 15 objects and the control group with 30 patients without endophthalmitis in the same period and found that foreign bodies were an important risk factor for the progression of endophthalmitis. This result was supported by previous studies(23, 25, 28) that showed foreign bodies with complex microorganisms can easily grow in suitable cultures if conditions permit. Notably, foreign bodies have not been found to increase the risk of endophthalmitis in other studies (22, 27) including this present study. In addition, endophthalmitis and traumatic cataract were not statistically associated in this study, which was similar to the results of some previous studies(21, 22, 24) and opposite to the results of other studies(25, 26). Meanwhile, it was controversial whether there is a difference in the incidence of endophthalmitis caused by rupture of the anterior and posterior lens capsules. Sen et al.(17) showed that only the rupture of the posterior capsule was associated with a higher incidence of endophthalmitis in children, which should be verified by more studies. Other factors such as dirty wounds(23), self-healing wounds,(21) rural settings (17, 21), and RD(22) have been shown to be associated with the development of endophthalmitis. Positive culture results were low at 4.2% in this study, while the rate varied from 28% to 67%(17, 22, 24, 29) in other recent studies. The lower rate of culture positivity in this cohort may be due to antibiotic use in some cases before admission since 75.0% of the children in the case group had delayed admission＞24 hours, increasing the chance of empirical antibiotic use. Streptococcus, the only positive bacteria in the study, was mentioned as the most common microorganism in children with endophthalmitis in the latest results(17). In the review by Bansal et al.(20), the most common pathogens causing endophthalmitis in adult patients were Staphylococcus epidermidis and Bacillus, while Streptococcus was the main infectious microorganism for children. However, this conclusion is still controversial in several studies. For children with OGI endophthalmitis reported in North India(24) and Spain(23), the most common gram-positive bacteria are Staphylococcus, while in the study from south India(22), 56% (n = 31) of patients had a gram-positive infection, most common microbe of 15% patients(n = 8) was Enterococcus faecalis, and staphylococcus and Streptococcus were isolated in only 9% (n = 5) of the eyes. The differences in these results may be related to the local geographical environment, so researchers need to consider the local climate when analyzing the common microorganisms in endophthalmitis. The acquisition of visual acuity results was limited because of the younger age of the study subjects. The initial visual acuity was an important determinant of the final visual acuity, which was consistent with previous results(2, 9, 15, 16). It is worth noting that different from other age groups, eye trauma in children could induce the risk of developing amblyopia. A study noted that OGI is commonly associated with two major refractive-related complications, including loss of accommodation due to aphakia and irregular astigmatism caused by corneal scarring(30, 31). These complications can be managed via contact lens wearing, spectacle correction or surgical treatment to reduce the risk of amblyopia. At present, RGP contact lenses have become an effective choice for postoperative visual rehabilitation in children with ocular trauma due to their high oxygen permeability, easy availability, and low bacterial and protein adhesion(30). In addition, during regular follow-up, the use of the amblyopic eye can be facilitated by preventing the visual input from the better eye once the patient’s best-corrected visual acuity decline is identified. Reduced visual input presents a major obstacle to the acquisition and progress of fundamental developmental skills in early and later childhood. The active cooperation of parents and children, the use of glasses or contact lenses to correct refractive errors after surgery, occlusion treatment of amblyopia are beneficial for their vision recovery. There are still some limitations of this study. It was a retrospective study, and thus some risk factors could not be assessed because children could not disclose all the details of the injury. In addition, we did not consider the data of cases treated in other hospitals. Conclusions For children under 6 years with OGI, males have a higher prevalence than females, and sharps are the main cause of the injury. Delayed admission ≥24 hours is an independent risk factor for children with endophthalmitis, and amblyopia is a problem worth noting in the recovery process of children after the injury. List Of Abbreviation Abbreviations: OGI, open globe injury; IOFB, Intraocular foreign body; RD, retinal detachment. Declarations Ethics approval and consent to participate The authors confirm that the study has been approved by the Ethics Committee of the Second Hospital of Jilin University and conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards. In addition, this study has been approved by the Ethics Committee of the Second Hospital of Jilin University to obtain a waiver of the informed consent application. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Conflict of interests The authors claim no conflicts of interest with a public or private agency. Funding This work was supported by the Jilin Province Science and Technology Development Project (Project No.20210101297JC, Project No. JJKH20180222KJ). Authors' contributions All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed byLR, ZY and WCg. QSn analyzed and interpreted the patient data regarding the risk factors for endophthalmitis. The first draft of the manuscript was written by LR, and all authors read and approved the final manuscript. Acknowledgements Not applicable References Boret C, Brehin C, Cortey C, Chanut M, Houze-Cerfon CH, Soler V, et al. Pediatric ocular trauma: Characteristics and outcomes among a French cohort (2007-2016). Arch Pediatr. 2020;27(3):128-34. Cao H, Li L, Zhang M, Li H. Epidemiology of pediatric ocular trauma in the Chaoshan Region, China, 2001-2010. PLoS One. 2013;8(4):e60844. Batur M, Seven E, Akaltun MN, Tekin S, Yasar T. Epidemiology of Open Globe Injury in Children. J Craniofac Surg. 2017;28(8):1976-81. Gupta A, Rahman I, Leatherbarrow B. Open globe injuries in children: factors predictive of a poor final visual acuity. 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Tables Table 1. clinical features of open globe injuries in children(n=106) Characteristics Number (%) Age(years) 0-1 8 7.5% 1-2 11 10.4% 2-3 16 15.1% 3-4 22 20.8% 4-5 21 19.8% 5-6 28 26.4% Gender Male 61 57.5% Female 45 42.5% Affected eye Left 49 46.2% Right 57 53.8% Injury Type Penetration 68 64.2% Perforation 10 9.4% Rupture 15 14.2% IOFB 13 12.3% Presenting Time(h)* <24 61 59.2% ≥24 42 40.8% Zone Zone I 73 68.9% Zone II 5 4.7% Zone III 1 0.9% Multiple Zones 27 25.5% Injury Material Knives 22 20.8% Glass and porcelain fragments 18 17.0% Wooden materials 10 9.4% Thorn-like objects 10 9.4% Corn stalks 4 3.8% Firecrackers 4 3.8% Toys 10 9.4% Stationery 8 7.5% Blunts 11 9.4% Others 9 8.5% Concomitant diagnosis Traumatic cataracts 50 47.2% Iris prolapse 47 44.3% Vitreous prolapse 18 17.0% Endophthalmitis 24 22.4% Retinal detachment 6 5.7% Eyelid laceration 8 7.5% Orbital fractures 2 1.9% Zone I, cornea and limbus; Zone II, 5 mm posterior to the limbal; Zone III, posterior sclera * Excluding 3 cases with unclear time of injury Table 2. Univariate analysis: presentation features associated with the development of endophthalmitis Parameter Teams Endophthalmitis p value Yes No Mean Age± SD 3.88±0.32 4.22±0.17 0.382 Sex Male 14(58.3%) 47(57.3%) 0.929 Female 10(41.7%) 35(42.7%) Injury Type Penetration 13(54.2%) 55(67.1%) 0.177 Perforation 4(16.7%) 6(7.3%) Rupture 2(8.3%) 13(15.9%) IOFB 5(20.8%) 8(9.8%) Zone Zone I 21(87.5%) 52(63.4%) 0.002 Zone II / III 3(12.5%) 6 (7.3%) Zone I and zone II/III 0(0.0%) 24 (29.3%) Presenting Time(h) <24 6(25.0%) 55(69.6%) <0.001 ≥24 18(75.0%) 24(30.4%) IOFB Yes 5(20.8%) 8(9.8%) 0.164 No 19(79.2%) 74(90.2%) Injury Material Knives 4(16.7%) 18(22.0%) 0.776 Glass and porcelain fragments 2(8.3%) 16(19.5%) 0.166 Wooden materials 5(20.8%) 5(6.1%) 0.045 Thorn-like objects 5(20.8%) 5(6.1%) 0.045 Corn stalks 1(4.2%) 3(3.7%) 0.648 Firecrackers 1(4.2%) 3(3.7%) 0.648 Toys 4(16.7%) 6(7.3%) 0.229 Stationery 1(4.2%) 7(8.5%) 0.680 Blunts 1(4.2%) 10(12.2%) 0.450 Others 0(0%) 9(11.0%) 0.204 Traumatic cataracts Yes 14(58.3%) 36(43.9%) 0.213 No 10(41.7) 46(56.1%) Vitreous prolapse Yes 3(12.5%) 15(18.3%) 0.758 No 21(87.5%) 67(81.7%) Iris prolapse Yes 8(33.3%) 49(46.2%) 0.022 No 16(66.7%) 33(40.2%) RD Yes 3(12.5%) 3(3.7%) 0.128 No 21(87.5%) 79(96.3%) Abbreviations: IOFB, Intraocular foreign body; RD, retinal detachment. Table 3. Multivariate Logistic regression analysis of endophthalmitis P value Odds ratio(range) Presenting time (h) 0.008 4.532(1.473-13.943) Iris prolapse 0.314 0.541(0.164-1.788) Vitreous prolapse 0.925 0.915(0.142-5.901) Traumatic cataracts 0.360 1.717(0.540-5.457) IOFB 0.644 1.452(0.299-7.047) RD 0.264 4.653(0.314-68.911) Injury in zone I * Injury in zone II/III 1.000 1.001(0.299-7.069) Injury in zone I and zone II/III 0.998 0.0(0.0) Table 4. Comparison of the initial VA and final BCVA at the last follow-up(1month-1year) VA ≥20/40 20/50-20/100 19/100-5/200 4/200-LP NLP Initial VA 3 6 8 22 2 Final BCVA 13 10 8 10 0 Abbreviations: VA, visual acuity; BCVA, best-corrected visual acuity; LP, light perception; NLP, no light perception Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1698168","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":120781198,"identity":"7b414071-efdb-4c1a-8c77-a0999010c368","order_by":0,"name":"Rui Li","email":"","orcid":"","institution":"The Second Hospital of Jilin University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rui","middleName":"","lastName":"Li","suffix":""},{"id":120781199,"identity":"afa6b089-8797-4870-8233-d17f53b68ffc","order_by":1,"name":"Ying Zhang","email":"","orcid":"","institution":"The Second Hospital of Jilin University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Zhang","suffix":""},{"id":120781200,"identity":"f0c9f64c-c492-4594-9c3d-c5431c07b144","order_by":2,"name":"Chenguang Wang","email":"","orcid":"","institution":"The Second Hospital of Jilin University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chenguang","middleName":"","lastName":"Wang","suffix":""},{"id":120781201,"identity":"e6fa32ad-9402-4c23-b579-63d8b7e23319","order_by":3,"name":"Shounan Qi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtElEQVRIiWNgGAWjYDACZiD+wGMBYhoQr4VxBo8EKVpAungYSNHCd5z92WMbGYnEBvbmbRIMNXcIa5E8zGNunMMD1MJzrEyC4dgzwloMDvOwSYO1SOSYSTA2HCZGC/szaQuQFvk3RGthMJNmANvCQ6QWoF/MJHt4JIzbeNKKLRKOEaGF7/zxZxI/e2xk+9kPb7zxoYYILQwHgJixh4GBDcRJIEIDRAvDD6KUjoJRMApGwUgFAGckMEHe3adIAAAAAElFTkSuQmCC","orcid":"","institution":"The Second Hospital of Jilin University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Shounan","middleName":"","lastName":"Qi","suffix":""}],"badges":[],"createdAt":"2022-05-27 03:14:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1698168/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1698168/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":24805579,"identity":"21b7557a-b9b3-44e9-a527-4743a4785bdf","added_by":"auto","created_at":"2022-08-04 22:06:13","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":28749,"visible":true,"origin":"","legend":"\u003cp\u003eAge and gender distribution of children under 6 years with OGI\u0026nbsp;\u003c/p\u003e","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1698168/v1/995bb5a8fe143df8fcf0d790.jpg"},{"id":27462824,"identity":"8fb16033-8a52-4fdf-bdd9-60ab8f212463","added_by":"auto","created_at":"2022-10-07 10:29:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":251180,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1698168/v1/eaa855db-cb20-4f91-a792-ef61b5a6b6c5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Characteristics of Open Globe Injury in Children under 6","fulltext":[{"header":"Background","content":"\u003cp\u003eOcular trauma is among the most common causes of monocular visual disability and deprivation amblyopia in children(1, 2) The incidence of ocular trauma in children varies from 9 to 15/ per 100000 worldwide, in which 25% of injuries are open globe injury (OGI)(1). Despite great advances in microsurgical techniques and understanding of OGI, many postoperative visual outcomes for children were unsatisfactory(3). Some surveys further indicated age range and amblyopia as additional risk factors for poor prognosis in children(4). In addition, endophthalmitis, one of the most serious complications after OGI, also influences the prognosis in children. Besides the high costs of hospitalization and OGI-related treatment, the attendant vision diseases can also cause additional problems, such as disability, reduced life quality, and psychological disorders (5, 6).\u003c/p\u003e\n\u003cp\u003eFrom the perspective of public health and eye injury prevention, identifying the epidemiology features of OGI is the key to conducting active education and finding effective measures to reduce the occurrence of OGI. Although some studies showed the incidence of pediatric eye injuries decreases per year, preschoolers or younger groups were still more vulnerable to vision loss injuries than other age groups(5, 7) Thus, in this study, the clinical characteristics of OGI in children under 6 were analyzed.\u003c/p\u003e"},{"header":"Materials And Methods ","content":"\u003cp\u003eThere is a population-based retrospective study about OGI children in The Eye Center of the Second Hospital of Jilin University in China from January 1, 2012, to December 31, 2020. All children under 6 presenting to this hospital were included. Exclusion criteria were: age older than 6, CGI, chemical injuries, thermal burns, the experience of being transferred to another hospital, and incomplete medical records. The systemic medical data of OGI children meeting the criteria were recorded, including age, gender, mechanism and type of OGI, wound location, the interval between the injury occurrence and hospital admission, clinical signs (presence or absence of traumatic cataract, endophthalmitis, IOFB, vitreous prolapse, eyelid laceration, and orbital fracture). All admitted patients underwent detailed ophthalmological examinations, and posttraumatic presenting visual acuity and the best-corrected visual acuity at final follow-up were obtained whenever possible within limited cooperation ability in children. Follow-up ranges from a month to a year.\u003c/p\u003e\n\u003cp\u003eOpen globe injury is the full-thickness injury of the cornea and /or the sclera and is classified as penetrating injury, perforating injury, intraocular foreign body, and globe rupture based on the Birmingham Eye Trauma Terminology (BETT) system (10).\u003c/p\u003e\n\u003cp\u003eData were analyzed using SPSS version 26.0. In the descriptive analysis, categorical variables were expressed by frequency and percentage and continuous variables by mean (standard deviation). T-test and rank-sum test were used to explore the differences between continuous variables. The Chi-square test or Fisher\u0026rsquo;s exact test was used to study the univariate association between two groups, if statistical significance exists, an odds ratio (OR) with a 95% confidence interval was calculated. Multiple logistic regression analysis was used to analyze the independent predictors associated with the dependent variable. A \u003cem\u003ep\u003c/em\u003e-value \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis study includes 106 cases. Table 1 demonstrates the clinical features of all patients, with 8 (7.5%) OGI cases occurring at 1 year old or younger, 11 (10.4%) between 1-2 years old, 16 (15.1%) between 2-3 years old, 22 (20.8%) between 3-4 years old, 21 (19.8%) between 4-5 years old, and 28 (26.4%) between 5-6 years old. The mean age of the hospital patients was 4.14\u0026plusmn;1.58 years. The present research found that males have a higher OGI prevalence than females, with 61 cases (57.5%) being males and 54 (42.5%) being females. Most injuries were distributed in the 4-6year age group. The age and gender distribution of OGI children is shown in Figure 1. A total of 57 (53.8%) patients suffered a right eye injury, and 49 (46.2%) had a left eye injury.\u003c/p\u003e\n\u003cp\u003eChildren might hurt their eyes with dangerous objects due to uncoordinated movements or lack of safety awareness. The material causing the trauma was mostly sharp objects (57.5%), including knives in 22 (20.8%) cases, glass and porcelain fragments in 18 (17.0%), thorn-like objects (bamboo sticks, iron sticks, and needles) in 10 (9.4%), wooden materials in 10 (9.4%). Besides the above goods, other objects causing OGI were displayed in table 1.\u003c/p\u003e\n\u003cp\u003eAmong the included patients, 61(59.2%) were referred to our hospital within 24 h, 42(40.8%) were after 24 h, and the time interval between injury and admission was not available for 3 patients. The incidence of penetrating injury (68, 64.2%) was highest, followed by globe rupture (15,14.2%). The rates of intraocular foreign bodies (13) and perforating injury (10) were 12.3% and 9.4%, respectively. There were 73 (68.9%) patients, with full-thickness eye-wall defects in zone I, with 5 (4.7%) in zone II, and 1(0.9%) in zone III. A total of 27(25.5%) were involved in multiple zones, with 18 (17.0%) in zone I and II, 3(2.8%) in zone II and III, 6(5.7%) in all zones, and 91.5% of wounds occurred in zone I.\u003c/p\u003e\n\u003cp\u003eIn this group of OGI children under 6, all patients underwent primary surgical repairs. Traumatic cataracts (50,47.2%) were the most common concomitant injuries, and 32 (64%) cases underwent lens extraction, among which only 19 cases (17.9%) also had intraocular lens implantation. Iris prolapse and vitreous prolapse were observed in 47 (44.3%) and 18 (17.0%) cases, respectively. Orbital fractures in (2, 1.9%), followed by retinal detachment (6, 5.7%) and eyelid laceration (8,7.5%). Intraoperatively, 70 (66.0%) OGI patients received intravitreal injection of vancomycin, and 18 (17.0%) underwent pars plana vitrectomy.\u003c/p\u003e\n\u003cp\u003eA total of 24 (22.4%) patients in this group developed endophthalmitis. The Chi-square test or Fisher exact test (table 2) showed injuries caused by the mentioned thorns-like objects and wood materials were statistically associated with the occurrence of endophthalmitis (\u003cem\u003ep\u003c/em\u003e=0.045; OR=4.053;1.064,15.437). Compared with the group data without endophthalmitis (shown in Table 2), the data with this illness indicated the post-injury admission time (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001) and injury zone (\u003cem\u003ep\u003c/em\u003e=0.002) were significantly associated with endophthalmitis. In addition, endophthalmitis and iris prolapse were significantly correlated, which was a protective factor against endophthalmitis (\u003cem\u003ep\u003c/em\u003e=0.022; OR=0.337;0.129,0.876). We also studied whether age, gender, injury type, vitreous prolapse, traumatic cataract, IOFB, and RD were associated with endophthalmitis, and no statistical significance was found (\u003cem\u003ep\u003c/em\u003e \u0026lt;0.05). Multivariate logistic regression analysis (show in Table 3) was performed on the data, and only delayed presentation \u0026ge;24h after trauma was an independent risk factor for endophthalmitis (\u003cem\u003ep\u003c/em\u003e=0.008; OR=4.532; 1.473,13.943). Iris prolapse and injury zone were irrelevant, and more cases should be counted for a more accurate result. One of the 24 endophthalmitis cases showed positive aqueous or vitreous culture (Streptococcus), 22 patients (91.7%) received intravitreal vancomycin, and 7 underwent pars plana vitrectomy with silicone oil tamponade.\u003c/p\u003e\n\u003cp\u003eIn this study, both preoperative and postoperative visual acuity was detected in 41 cases (the vision of the remaining patients was failed to measure because of their young age or lack of cooperation). The initial and final VA at the final follow-up are shown in table 4, and postoperative visual acuity was statistically associated with a preoperative counterpart in this study(\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe OGI rate of boys (57.5%) in the present study was not high, which was in line with previous studies with the same age group(8, 9). Meanwhile, our data showed that it was not until the age of six that boys had a notably higher OGI rate than girls. That was because all the children were exposed to the same dangerous situations. Thus, they had the same probability of getting injured, but boys were more inclined to participate in stimulating and aggressive activities as they grew older, which explained why the male-to-female ratio is typically higher than 2:1 in studies on pediatric populations under 18 years of age(4, 10-13). This study showed that OGI was most common in children aged 4-6 (71 cases, 67.0%), which were also mentioned in earlier articles(3, 14). Consistent with the results of some studies(3, 13-15), there was a small gap of 1:1.2 between left eye and right eye injuries, In addition, the ratio of injured right eye was significantly higher than the left among children (age \u0026le;6 years) in a previous study, at a ratio of 2:1(9), which is probably because those young children tend to use their dominant hand when developing their manual skills.\u003c/p\u003e\n\u003cp\u003eThe OGI is mainly caused by sharp objects, with the rate ranging from 48% to 75%(4, 10, 11, 15, 16), which is consistent with previous clinical records and further confirmed in our data (57.5%). Additionally, the findings agreed with the results of AIDahash et al. (15), who reported that knives cause the most injuries to children. However, Read \u0026amp; Cavuoto(8) concluded that glass should be responsible for the injuries of preschoolers. Other reports showed the children were also frequently hurt by wooden products (12), kitchen items(6, 7), or metallic objects(3, 9, 14). Besides these objects mentioned above, the reason for the injury varies between some other reports because of regional and cultural differences. In a previous study, bows and arrows were a common cause of OGI in Indian children(17). Weiss et al. (18) found 22.6% of firearm-related ocular injuries in the United States occurred in children, and another study(19) in the US showed that eye injury was more caused by motor vehicle crashes.\u003c/p\u003e\n\u003cp\u003eThe studies from various regions reported that approximately 63.3%-94.9%(6, 11, 12, 15) of injuries are penetrating ones, which is consistent with our data of 64.2%. As in previous studies, injuries were more common in zone I than in the other zones (6, 9, 13, 14, 16), and up to 91.5% of open wounds occurred in zone I. Multizone injuries were rare (3), but accounted for 1/4 in this study, which may be because children too young to know how to avoid dangerous objects, resulting in the increased damage area.\u003c/p\u003e\n\u003cp\u003eAssessment of children with OGI is quite difficult because of incomplete or even inaccurate injury descriptions and poor cooperation during ocular examinations(10, 20). Therefore, primary treatment may be delayed, increasing the risk of inducing complications. It should be noted that the traumatic cataract was most frequently associated with OGI in the current research, accounting for 47.2% of all cases, of which 19 aphakic patients did not undergo lens implantation since additional surgery did not improve postoperative vision. The most important approach to preventing posttraumatic endophthalmitis in children is the initial eye repair within 24 hours and the use of prophylactic intravitreal antibiotics(20). In the current study, all children diagnosed with OGI underwent primary repair, and intravitreal injection of vancomycin was given priority for 66.0% of patients during the operation.\u003c/p\u003e\n\u003cp\u003ePosttraumatic endophthalmitis following eye injuries is one of the most serious complications (20), and the reported frequency of endophthalmitis among children varies from 13% to 54%(13, 14, 21, 22) in different studies. A previous study showed that the incidence of endophthalmitis in hospitalized patients without associated risk factors was 5.9%, rising to 65.3% and 90.3% when two and three risk factors appeared, respectively(23). Therefore, identifying the relevant factors and timely prevention and treatment significantly impact the prognosis of patients with endophthalmitis, especially younger children.\u003c/p\u003e\n\u003cp\u003eAs demonstrated in the study, injuries with thorn-like objects and wood materials were associated with the development of endophthalmitis. Earlier studies(14, 17, 22, 24, 25) also showed that the incidence of endophthalmitis was higher after injuries caused by needles and/or wooden materials. This means that ophthalmologists must be alert to the occurrence of endophthalmitis and take preventive measures promptly when targeting eye injuries caused by such causative agents.\u003c/p\u003e\n\u003cp\u003eCorneal wounds that go deep into the anterior segment have the highest risk for endophthalmitis. In this study, the wounds involving only zone 1 were more common (83.5% vs 63.4%). In a study from India(17), the risk of developing endophthalmitis induced by wounds involving the central cornea (central 5 mm) was 9 times higher than that caused by peripheral corneal wounds. That was probably because the torn cornea is difficult to close smoothly in the early stage, and thus, the contaminated microorganisms are exposed to the ocular cavity and will cause bacteria breeding of the wound when staying there for a long time. In addition, the avascular corneal further led to insufficient immune response and delayed wound healing, increasing the risk of inducing endophthalmitis(14, 17).\u003c/p\u003e\n\u003cp\u003eBansal et al(20). and Zhang et al.(21) found that intraocular tissue prolapse played an important role in reducing the risk of endophthalmitis in children, and they supposed prolapsed tissue could seal the wound and prevent the entry of microorganisms, thus avoiding eye infection. However, a recent study(17) showed the occurrence of iris and vitreous prolapse through the wound increased the probability of developing endophthalmitis in children aged \u0026lt;18 years by 3 and 5 times, respectively. The authors argued that the prolapsed tissue serves as good culture media for the growth of the contaminant microorganisms. In our univariate analysis, iris prolapse decreased the infection risk, but vitreous prolapse was not statistically associated with endophthalmitis. Studies with larger samples were needed to further analyze whether intraocular tissue prolapse promotes or prevents the microbial invasion.\u003c/p\u003e\n\u003cp\u003eThe delayed wound repair is the most important risk factor for posttraumatic endophthalmitis in children(20). Delayed repair is a risk factor for postoperative wound leakage(26), which will result in the edema of the surrounding tissue and increase the risk of wound dehiscence, thereby indirectly affecting the infection of the wound. Similar to those of studies on pediatric ocular injury(21-23, 27), logistic regression analysis of this study identified the delayed wound repair \u0026ge;24h was the independent risk factor and compared with the that of the control group (30.4%), the incidence of endophthalmitis in patients with delayed admission\u0026ge;24 h was significantly higher (75.0%).\u003c/p\u003e\n\u003cp\u003eOther factors associated with endophthalmitis were analyzed in different studies. The authors(23) compared the case group with 15 objects and the control group with 30 patients without endophthalmitis in the same period and found that foreign bodies were an important risk factor for the progression of endophthalmitis. This result was supported by previous studies(23, 25, 28) that showed foreign bodies with complex microorganisms can easily grow in suitable cultures if conditions permit. Notably, foreign bodies have not been found to increase the risk of endophthalmitis in other studies (22, 27) including this present study. In addition, endophthalmitis and traumatic cataract were not statistically associated in this study, which was similar to the results of some previous studies(21, 22, 24) and opposite to the results of other studies(25, 26). Meanwhile, it was controversial whether there is a difference in the incidence of endophthalmitis caused by rupture of the anterior and posterior lens capsules. Sen et al.(17) showed that only the rupture of the posterior capsule was associated with a higher incidence of endophthalmitis in children, which should be verified by more studies. Other factors such as dirty wounds(23), self-healing wounds,(21) rural settings (17, 21), and RD(22) have been shown to be associated with the development of endophthalmitis.\u003c/p\u003e\n\u003cp\u003ePositive culture results were low at 4.2% in this study, while the rate varied from 28% to 67%(17, 22, 24, 29) in other recent studies. The lower rate of culture positivity in this cohort may be due to antibiotic use in some cases before admission since 75.0% of the children in the case group had delayed admission＞24 hours, increasing the chance of empirical antibiotic use. Streptococcus, the only positive bacteria in the study, was mentioned as the most common microorganism in children with endophthalmitis in the latest results(17). In the review by Bansal et al.(20), the most common pathogens causing endophthalmitis in adult patients were Staphylococcus epidermidis and Bacillus, while Streptococcus was the main infectious microorganism for children. However, this conclusion is still controversial in several studies. For children with OGI endophthalmitis reported in North India(24) and Spain(23), the most common gram-positive bacteria are Staphylococcus, while in the study from south India(22), 56% (n = 31) of patients had a gram-positive infection, most common microbe of 15% patients(n = 8) was Enterococcus faecalis, and staphylococcus and Streptococcus were isolated in only 9% (n = 5) of the eyes. The differences in these results may be related to the local geographical environment, so researchers need to consider the local climate when analyzing the common microorganisms in endophthalmitis.\u003c/p\u003e\n\u003cp\u003eThe acquisition of visual acuity results was limited because of the younger age of the study subjects. The initial visual acuity was an important determinant of the final visual acuity, which was consistent with previous results(2, 9, 15, 16). It is worth noting that different from other age groups, eye trauma in children could induce the risk of developing amblyopia. A study noted that OGI is commonly associated with two major refractive-related complications, including loss of accommodation due to aphakia and irregular astigmatism caused by corneal scarring(30, 31). These complications can be managed via contact lens wearing, spectacle correction or surgical treatment to reduce the risk of amblyopia. At present, RGP contact lenses have become an effective choice for postoperative visual rehabilitation in children with ocular trauma due to their high oxygen permeability, easy availability, and low bacterial and protein adhesion(30). In addition, during regular follow-up, the use of the amblyopic eye can be facilitated by preventing the visual input from the better eye once the patient\u0026rsquo;s best-corrected visual acuity decline is identified. Reduced visual input presents a major obstacle to the acquisition and progress of fundamental developmental skills in early and later childhood. The active cooperation of parents and children, the use of glasses or contact lenses to correct refractive errors after surgery, occlusion treatment of amblyopia are beneficial for their vision recovery.\u003c/p\u003e\n\u003cp\u003eThere are still some limitations of this study. It was a retrospective study, and thus some risk factors could not be assessed because children could not disclose all the details of the injury. In addition, we did not consider the data of cases treated in other hospitals.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eFor children under 6 years with OGI, males have a higher prevalence than females, and sharps are the main cause of the injury. Delayed admission \u0026ge;24 hours is an independent risk factor for children with endophthalmitis, and amblyopia is a problem worth noting in the recovery process of children after the injury.\u003c/p\u003e"},{"header":"List Of Abbreviation","content":"\u003cp\u003eAbbreviations: OGI, open globe injury; IOFB, Intraocular foreign body; RD, retinal detachment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors confirm that the study has been approved by the Ethics Committee of the Second Hospital of Jilin University and conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards. In addition, this study has been approved by the Ethics Committee of the Second Hospital of Jilin University to obtain a waiver of the informed consent application.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors claim no conflicts of interest with a public or private agency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Jilin Province Science and Technology Development Project (Project No.20210101297JC, Project No. JJKH20180222KJ).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed byLR, ZY and WCg. QSn analyzed and interpreted the patient data regarding the risk factors for endophthalmitis. The first draft of the manuscript was written by LR, and all authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBoret C, Brehin C, Cortey C, Chanut M, Houze-Cerfon CH, Soler V, et al. Pediatric ocular trauma: Characteristics and outcomes among a French cohort (2007-2016). Arch Pediatr. 2020;27(3):128-34.\u003c/li\u003e\n\u003cli\u003eCao H, Li L, Zhang M, Li H. Epidemiology of pediatric ocular trauma in the Chaoshan Region, China, 2001-2010. PLoS One. 2013;8(4):e60844.\u003c/li\u003e\n\u003cli\u003eBatur M, Seven E, Akaltun MN, Tekin S, Yasar T. Epidemiology of Open Globe Injury in Children. J Craniofac Surg. 2017;28(8):1976-81.\u003c/li\u003e\n\u003cli\u003eGupta A, Rahman I, Leatherbarrow B. Open globe injuries in children: factors predictive of a poor final visual acuity. Eye (Lond). 2009;23(3):621-5.\u003c/li\u003e\n\u003cli\u003eMir TA, Canner JK, Zafar S, Srikumaran D, Friedman DS, Woreta FA. Characteristics of Open Globe Injuries in the United States From 2006 to 2014. JAMA Ophthalmol. 2020;138(3):268-75.\u003c/li\u003e\n\u003cli\u003eGunes A, Kalayc M, Genc O, Ozerturk Y. Characteristics of Open Globe Injuries in Preschool Children. Pediatr Emerg Care. 2015;31(10):701-3.\u003c/li\u003e\n\u003cli\u003ePatel PS, Uppuluri A, Zarbin MA, Bhagat N. Epidemiologic trends in pediatric ocular injury in the USA from 2010 to 2019. Graefes Arch Clin Exp Ophthalmol. 2022;260(4):1387-94.\u003c/li\u003e\n\u003cli\u003eRead SP, Cavuoto KM. Traumatic open globe injury in young pediatric patients: characterization of a novel prognostic score. J AAPOS. 2016;20(2):141-4.\u003c/li\u003e\n\u003cli\u003eIlhan HD, Bilgin AB, Cetinkaya A, Unal M, Yucel I. Epidemiological and clinical features of paediatric open globe injuries in southwestern Turkey. Int J Ophthalmol. 2013;6(6):855-60.\u003c/li\u003e\n\u003cli\u003eLiu X, Liu Z, Liu Y, Zhao L, Xu S, Su G, et al. Determination of visual prognosis in children with open globe injuries. Eye (Lond). 2014;28(7):852-6.\u003c/li\u003e\n\u003cli\u003eSul S, Gurelik G, Korkmaz S, Ozdek S, Hasanreisoglu B. Pediatric open-globe injuries: clinical characteristics and factors associated with poor visual and anatomical success. Graefes Arch Clin Exp Ophthalmol. 2016;254(7):1405-10.\u003c/li\u003e\n\u003cli\u003eChoovuthayakorn J, Patikulsila P, Patikulsila D, Watanachai N, Pimolrat W. Characteristics and outcomes of pediatric open globe injury. Int Ophthalmol. 2014;34(4):839-44.\u003c/li\u003e\n\u003cli\u003eJacobson A, Liles N, Besirli CG, Bohnsack BL. Predictors of visual outcomes in pediatric open globe injuries. J aapos. 2020;24(6):360.e1-.e8.\u003c/li\u003e\n\u003cli\u003eTabatabaei SA, Khameneh EA, Soleimani M, Baramaki A. Open globe injuries in children under 7 years referred to a tertiary center in Iran from 2006 to 2016. Eye (Lond). 2021;35(4):1235-9.\u003c/li\u003e\n\u003cli\u003eAlDahash F, Mousa A, Gikandi PW, Abu El-Asrar AM. Pediatric open-globe injury in a university-based tertiary hospital. Eur J Ophthalmol. 2020;30(2):269-74.\u003c/li\u003e\n\u003cli\u003eXue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries. Int J Ophthalmol. 2020;13(7):1097-101.\u003c/li\u003e\n\u003cli\u003eSen P, Kohli GM, Shah C, Mohan A, Tiwari A, Ingale R, et al. Risk Factors for Development of Endophthalmitis after Open Globe Injury in Children: A Case-Control Study. Ocul Immunol Inflamm. 2021:1-6.\u003c/li\u003e\n\u003cli\u003eWeiss R, He C, Gise R, Parsikia A, Mbekeani JN. Patterns of Pediatric Firearm-Related Ocular Trauma in the United States. JAMA Ophthalmol. 2019;137(12):1363-70.\u003c/li\u003e\n\u003cli\u003eBrophy M, Sinclair SA, Hostetler SG, Xiang H. Pediatric eye injury-related hospitalizations in the United States. Pediatrics. 2006;117(6):e1263-71.\u003c/li\u003e\n\u003cli\u003eBansal P, Venkatesh P, Sharma Y. Posttraumatic Endophthalmitis in children: Epidemiology, Diagnosis, Management, and Prognosis. Semin Ophthalmol. 2018;33(2):284-92.\u003c/li\u003e\n\u003cli\u003eZhang Y, Zhang MN, Jiang CH, Yao Y, Zhang K. Endophthalmitis following open globe injury. Br J Ophthalmol. 2010;94(1):111-4.\u003c/li\u003e\n\u003cli\u003eRishi E, Rishi P, Koundanya VV, Sahu C, Roy R, Bhende PS. Post-traumatic endophthalmitis in 143 eyes of children and adolescents from India. Eye (Lond). 2016;30(4):615-20.\u003c/li\u003e\n\u003cli\u003eAsencio MA, Huertas M, Carranza R, Tenias JM, Celis J, Gonzalez-del Valle F. A case-control study of post-traumatic endophthalmitis at a Spanish hospital. Int Ophthalmol. 2016;36(2):185-94.\u003c/li\u003e\n\u003cli\u003eVenkatesh R, Dave AP, Gurav P, Agrawal M. Post-traumatic endophthalmitis in children. Nepal J Ophthalmol. 2019;11(21):55-63.\u003c/li\u003e\n\u003cli\u003eFaghihi H, Hajizadeh F, Esfahani MR, Rasoulinejad SA, Lashay A, Mirshahi A, et al. Posttraumatic endophthalmitis: report No. 2. Retina. 2012;32(1):146-51.\u003c/li\u003e\n\u003cli\u003eKong GY, Henderson RH, Sandhu SS, Essex RW, Allen PJ, Campbell WG. Wound-related complications and clinical outcomes following open globe injury repair. Clin Exp Ophthalmol. 2015;43(6):508-13.\u003c/li\u003e\n\u003cli\u003eZheng L, Tan J, Liu R, Yang X, He H, Xiao H, et al. The Impact of Primary Treatment on Post-Traumatic Endophthalmitis in Children with Open Globe Injuries: A Study in China. Int J Environ Res Public Health. 2019;16(16).\u003c/li\u003e\n\u003cli\u003eDehghani AR, Rezaei L, Salam H, Mohammadi Z, Mahboubi M. Post traumatic endophthalmitis: incidence and risk factors. Glob J Health Sci. 2014;6(6):68-72.\u003c/li\u003e\n\u003cli\u003eWu H, Ding X, Zhang M, Xu G. Pediatric posttraumatic endophthalmitis. Graefes Arch Clin Exp Ophthalmol. 2016;254(10):1919-22.\u003c/li\u003e\n\u003cli\u003ePradhan ZS, Mittal R, Jacob P. Rigid Gas-Permeable Contact Lenses for Visual Rehabilitation of Traumatized Eyes in Children. Cornea. 2014;33(5):486-9.\u003c/li\u003e\n\u003cli\u003eItoi M, Higashihara H, Yamagishi K, Hyakutake Y, Sotozono C. The Challenge of Contact Lens Visual Rehabilitation for Open Globe Injuries in Children Under 5 Years of Age. Eye Contact Lens. 2021;47(5):292-4.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eclinical features of open globe injuries in children(n=106)\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eNumber\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e0-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e7.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e10.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e2-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e15.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e3-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e20.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e19.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e26.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e57.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e42.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eAffected eye\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eLeft\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e46.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eRight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e53.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eInjury Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003ePenetration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e64.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003ePerforation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eRupture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e14.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eIOFB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e12.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003ePresenting Time(h)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026lt;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e59.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026ge;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e40.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eZone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eZone I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e68.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eZone II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e4.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eZone III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e0.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eMultiple Zones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e25.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eInjury Material\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eKnives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e20.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eGlass\u0026nbsp;and porcelain fragments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e17.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eWooden materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eThorn-like objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eCorn stalks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e3.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eFirecrackers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e3.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eToys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eStationery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e7.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eBlunts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e8.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eConcomitant diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eTraumatic cataracts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e47.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eIris prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e44.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eVitreous prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e17.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eEndophthalmitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e22.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eRetinal detachment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e5.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eEyelid laceration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e7.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003eOrbital fractures\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e1.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eZone I, cornea and limbus; Zone II, 5 mm posterior to the limbal; Zone III, posterior sclera\u003c/p\u003e\n\u003cp\u003e* Excluding 3 cases with unclear time of injury\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eUnivariate analysis: presentation features associated with the development of endophthalmitis\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eParameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eTeams\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"43.01412872841444%\"\u003e\n \u003cp\u003eEndophthalmitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003ep\u0026nbsp;value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.175182481751825%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"51.824817518248175%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eMean Age\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e3.88\u0026plusmn;0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e4.22\u0026plusmn;0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.382\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e14(58.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e47(57.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.929\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e10(41.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e35(42.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eInjury Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003ePenetration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e13(54.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e55(67.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003ePerforation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e4(16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e6(7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eRupture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e2(8.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e13(15.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eIOFB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e5(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e8(9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eZone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eZone I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e21(87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e52(63.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eZone\u0026nbsp;II /\u0026nbsp;III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e3(12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e6 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eZone I and zone II/III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e0(0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e24 (29.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003ePresenting Time(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e\u0026lt;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e6(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e55(69.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e\u0026ge;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e18(75.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e24(30.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eIOFB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e5(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e8(9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e19(79.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e74(90.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eInjury Material\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eKnives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e4(16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e18(22.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.776\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eGlass and porcelain fragments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e2(8.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e16(19.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eWooden materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e5(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e5(6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eThorn-like objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e5(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e5(6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eCorn stalks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e1(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e3(3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.648\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eFirecrackers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e1(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e3(3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.648\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eToys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e4(16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e6(7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eStationery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e1(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e7(8.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.680\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eBlunts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e1(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e10(12.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.450\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.666666666666668%\"\u003e\n \u003cp\u003e0(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.68686868686869%\"\u003e\n \u003cp\u003e9(11.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.95959595959596%\"\u003e\n \u003cp\u003e0.204\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eTraumatic cataracts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e14(58.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e36(43.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e10(41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e46(56.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eVitreous prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e3(12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e15(18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.758\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e21(87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e67(81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eIris prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e8(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e49(46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e16(66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e33(40.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"22.29199372056515%\"\u003e\n \u003cp\u003eRD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.722135007849293%\"\u003e\n \u003cp\u003e3(12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.29199372056515%\"\u003e\n \u003cp\u003e3(3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"12.40188383045526%\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.73076923076923%\"\u003e\n \u003cp\u003e21(87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.13461538461539%\"\u003e\n \u003cp\u003e79(96.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: IOFB, Intraocular foreign body; RD, retinal detachment.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Multivariate Logistic regression analysis of endophthalmitis\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003eOdds ratio(range)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003ePresenting time (h)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e4.532(1.473-13.943)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eIris prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e0.541(0.164-1.788)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eVitreous prolapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e0.915(0.142-5.901)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eTraumatic cataracts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e1.717(0.540-5.457)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eIOFB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.644\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e1.452(0.299-7.047)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eRD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e4.653(0.314-68.911)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eInjury in zone I *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eInjury in zone II/III\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e1.001(0.299-7.069)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.808664259927795%\"\u003e\n \u003cp\u003eInjury in zone I and zone II/III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"30.144404332129962%\"\u003e\n \u003cp\u003e0.998\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"31.04693140794224%\"\u003e\n \u003cp\u003e0.0(0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eComparison of the initial VA and final BCVA at the last follow-up(1month-1year)\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eVA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e\u0026ge;20/40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e20/50-20/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e19/100-5/200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e4/200-LP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eNLP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eInitial VA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eFinal BCVA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: VA, visual acuity; BCVA, best-corrected visual acuity; LP, light perception; NLP, no light perception\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Children, Open globe injury, Characteristics, Endophthalmitis, Amblyopia","lastPublishedDoi":"10.21203/rs.3.rs-1698168/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1698168/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eTo analyze the clinical characteristics of open globe injury (OGI) in children not yet 6.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA retrospective analysis was performed on the medical data of 106 OGI children presented to The Eye Center of the Second Hospital of Jilin University, China, from January 1, 2012, to December 31, 2020. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e A total of 106 children, including 61 males (57.5%) and 54 females (42.5%), were included, and the mean age was 4.14±1.58 years, with 53.8% injuries in the right eye. Sharp objects (57.5%) were primarily responsible for OGI, including knives for 22 cases (20.8%), glass and porcelain fragments for 18(17.0%), thorn-like objects for 10(9.4%), wooden materials for 10(9.4%). Up to 91.5% of wounds occurred in zone I. The penetrating injury incidence (68 cases, 64.2%) was highest in OGI cases. Concomitant symptoms of OGI included traumatic cataract (47.2%), iris prolapse (44.3%), endophthalmitis (22.4%), vitreous prolapse (17.0%), retinal detachment (5.7%), eyelid laceration (7.5%), and orbital fractures (1.9%). The mentioned wooden materials and thorns-like objects were associated with endophthalmitis development (\u003cem\u003ep\u003c/em\u003e=0.045), and delayed admission ≥24h was an independent risk factor for its onset (\u003cem\u003ep\u003c/em\u003e=0.008). Postoperative visual acuity was significantly correlated with its preoperative counterpart (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Among OGI children under 6, the number of males is slightly larger than that of females. Sharp objects were the main causes of OGI. Raising awareness of the severity of OGI in children and study of the risk factors for endophthalmitis will help develop effective prevention strategies to reduce the incidence of ocular complications. Amblyopia should be attended to during OGI children’s recovery.\u003c/p\u003e","manuscriptTitle":"Characteristics of Open Globe Injury in Children under 6","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-08-04 22:06:11","doi":"10.21203/rs.3.rs-1698168/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0e952cd0-4fed-4d23-971f-b07a25efa685","owner":[],"postedDate":"August 4th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-10-07T10:29:26+00:00","versionOfRecord":[],"versionCreatedAt":"2022-08-04 22:06:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1698168","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1698168","identity":"rs-1698168","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}