Ocular trauma treated with pars plana vitrectomy: early outcome report

Mansouri, M R; Tabatabaei, Seyed Ali; Soleimani, Mohammad; Kiarudi, Mohammad Yaser; Molaei, Saber; Rouzbahani, Mehdi; Mireshghi, Meysam; Zaeferani, Mohsen; Ghasempour, Mehrbod

doi:10.18240/ijo.2016.05.18

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…A study led by Mansouri et al . showed that the timing of vitrectomy was not associated with the visual outcome among 90 patients with ocular injuries involving the posterior segment 18 . Similarly, Ghoraba et al .…”

Section: Discussionmentioning

confidence: 97%

Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

et al. 2019

Sci Rep

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Mechanical ocular trauma could lead to disastrous visual outcomes. There has been a controversy regarding the timing of vitrectomy for such cases. This study aimed to find out the optimal timing of vitrectomy for severe mechanical ocular trauma. Patients with severe mechanical ocular trauma who had undergone vitrectomy were enrolled and followed up for at least 6 months. Clinical data were collected including ocular trauma score (OTS), the timing of vitrectomy upon injury, visual acuity, vitrectomy results, post-operation complications and etc. All cases were classified according to the timing of vitrectomy upon injury into 3 groups: group A 1–7 days, group B 8–14 days, group C more than 14 days. A total of 62 cases were enrolled, including 20 eyes in group A, 25 eyes in group B, and 17 eyes in group C. No significant differences were shown of the gender, age or OTS among the 3 groups. Both functional success rate and visual outcome were optimal in group B, then in group A, and worst in group C. These results suggested that the best timing of vitrectomy for severe mechanical ocular trauma is 8–14 days upon injury; second best is 1–7 days; worst is after 14 days.

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Section: Discussionmentioning

confidence: 97%

Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

et al. 2019

Sci Rep

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“…All data were anonymized and de-identified before analysis. Indications for vitrectomy following ocular trauma included [ 1 ] intraocular foreign bodies, [ 2 ] suspected posterior capsule rupture, [ 3 ] dense vitreous hemorrhage with b scan suspicious for retinal detachment, [ 4 ] zone 2/3 injuries (zone 1 may also have been involved), and/or [ 5 ] endophthalmitis. All vitrectomies were performed using the 23 g Constellation system (Alcon Laboratories Inc, USA).…”

Section: Methodsmentioning

confidence: 99%

“…It is estimated that there are around 2.0 million cases of eye trauma that occur each year in the United States, with approximately 1 million individuals having permanent visual impairment because of injury [ 1 ]. Pars plana vitrectomy (PPV) has played a major role in improving outcomes of ocular trauma by allowing posterior segment reconstruction, clearing vitreous opacities, and preventing endophthalmitis [ 2 ]. However, the optimum timing of PPV has been a topic of on-going debate [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points

et al. 2022

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Background The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less challenging as there is a lower risk of bleeding and posterior vitreous detachment induction is easier. The purpose of this work is to report the functional and anatomical outcomes following ocular traumatic injuries in a United States-based cohort, emphasizing the time of intervention. Methods This was a retrospective case series of 110 patients with traumatic ocular injuries who underwent PPV between 2008 to 2020. Patients were grouped into four timing categories: same day (0 days), early (1–7 days), delayed (8–14 days), and late (> 14 days). Multivariable regression models controlling for confounding were implemented to assess the impact of vitrectomy timing on anatomical and functional outcomes. Visual acuity (VA) at baseline and after surgery, proliferative vitreoretinopathy (PVR), and enucleation for each vitrectomy timing category were recorded. Results Patient demographics and severity of ocular trauma were comparable across timing categories. Final VA in LogMAR was found to have a stepwise worsening as the time of ocular trauma to vitrectomy was increased (p < 0.05). For every one-step increase in the vitrectomy timing category, there was an adjusted 0.24 (CI 0.04–0.44) increase in final VA. No patient in the same day vitrectomy group had an enucleation or PVR, while patients who had late vitrectomies had the largest number of both enucleations and PVR (44.4% and 52.0%, respectively). In adjusted analysis, there was 3.11 increased odds (CI 1.03–9.42) of developing PVR for a one-step increase in vitrectomy timing (p < 0.05). Conclusion Vitrectomy on the same day of injury has the best final VA, and the lowest incidence rates of PVR and enucleation in comparison to other timing categories, regardless of etiology.

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“…1 Pars plana vitrectomy (PPV) has played a major role in improving the outcomes of ocular trauma with reconstruction of the posterior segment, clearance of vitreous opacities, and prevention of endophthalmitis. 2 The use of oral prednisone in the perioperative period after globe repair is controversial and has been proposed as a meas ure to reduce the incidence of postsurgical inflammation and proliferative vitreoretinopathy (PVR). The role of adjuvant therapies such as oral prednisone remains a topic of debate.…”

Section: Introductionmentioning

confidence: 99%

Effect of Oral Prednisone on the Prevention and Management of Proliferative Vitreoretinopathy After Open-Globe Injury

Yao,

Chauhan,

Uwaydat

2024

Journal of VitreoRetinal Diseases

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Purpose: To determine the impact of oral prednisone on final visual acuity (VA) and prevention of proliferative vitreoretinopathy (PVR) in patients having pars plana vitrectomy (PPV) for globe injuries. Methods: A retrospective chart review was performed of all globe injuries with an initial repair and subsequent PPV between 2009 and 2018. Data included the initial VA, zones of injury, initial closure date, time to secondary intervention (PPV), oral prednisone (1 mg/kg/day) use, the final VA, and enucleation rate. Multivariable regression models were used to assess the impact of oral prednisone use on anatomic and functional outcomes. Results: The mean (±SD) patient age was 46.25 ±18.56 years (range, 13-92); 131 (83.9%) were men. Oral prednisone intake was recorded in 81 patients (52.3%). The prednisone group had significantly more zone 3 involvement ( P = .001), worse initial VA (2.28 vs 1.92; P = .003), and a greater mean number of surgeries ( P = .020) than the no-steroids (control) group but an equivalent final logMAR VA (1.57 vs 1.52; P = .881). The prednisone group had significant VA improvement ( P = .025); however, oral prednisone use did not predict the development of PVR (29.23% vs 12.90%; odds ratio [OR], 2.81; 95% CI, 0.89-8.85) or retinal detachment (27.27% vs 29.58%; OR, 0.59; 95% CI, 0.23-1.56). Conclusions: Despite a worse initial clinical presentation, patients who received oral prednisone had significant visual improvement compared with the control group. However, oral prednisone (1 mg/kg/day) use at the time of injury did not decrease the PVR rate.

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Ocular trauma treated with pars plana vitrectomy: early outcome report

Cited by 9 publications

References 26 publications

Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points

Effect of Oral Prednisone on the Prevention and Management of Proliferative Vitreoretinopathy After Open-Globe Injury

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