Outcomes Following Pars Plana Vitrectomy for Severe Ocular Trauma

Bober, Natalia Katarzyna; Kumaran, Neruban; Williamson, Tom H.

doi:10.18502/jovr.v16i3.9449

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Despite European epidemiological data not being available, it is estimated that approximately 1.6 million people are blind due to ocular injuries, worldwide ( 23 ). Ocular injury substantially impacts the quality of life, causing both psychological and physical stress ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

T-shaped pars plana scleral incision to remove large intraocular foreign body

Toro,

Nowomiejska,

Concilio

et al. 2024

Front. Med.

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AimTo investigate the efficacy and safety profile of T-shaped pars plana scleral incision technique in removing large intraocular foreign bodies, during 23-gauge pars plana vitrectomy.MethodsRetrospective interventional case series that included patients diagnosed with a large intraocular foreign body (IOFB). Possible postoperative complications were recorded 24 h, 1 month, 3 and 6 months postoperatively.ResultsThirty eyes of 30 patients (48 ± 5 years old) were enrolled. All IOFBs were successfully removed: mean diameters of 7.8 ± 2.0 mm and 2.6 ± 0.3 mm. Silicone oil and sulfur hexafluoride were used in 27 and 3 eyes, respectively. Lensectomy was performed in 27 eyes. Intraocular lens was implanted at first attempt in 12 eyes; during a second operation in 12 eyes and 6 eyes remained aphakic. At any follow-up, no signs of postoperative complications were observed. Secondary retinal detachment occurred in 12 eyes. Mean preoperative corrected distance visual acuity was 0.04, on the Snellen scale; it increased to 0.07, at last follow-up. Mean intraocular pressure was 17.97 mmHg. All eyes were preserved.ConclusionT-shaped scleral incision could be an effective, safe and easy-to-perform standard procedure to remove large IOFBs during pars plana vitrectomy, without increasing the risk of surgical complications and additional damage to the ocular tissues.

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Section: Discussionmentioning

confidence: 99%

T-shaped pars plana scleral incision to remove large intraocular foreign body

Toro,

Nowomiejska,

Concilio

et al. 2024

Front. Med.

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“…PPV has been implemented in the early removal of intraocular foreign bodies (IOFBs), clearing of vitreous hemorrhage, repair of complex retinal detachments, and treatment of endophthalmitis [ 18 ]. However, patients may require a variable number of operations, with a small percentage still developing phthisis following surgical intervention, particularly in those patients initially presenting with ocular rupture [ 19 ]. In a retrospective study of 113 patients who underwent PPV for ocular trauma, 7.3% of patients developed phthisis; half of the phthisical patients had presented with ocular rupture [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, patients may require a variable number of operations, with a small percentage still developing phthisis following surgical intervention, particularly in those patients initially presenting with ocular rupture [ 19 ]. In a retrospective study of 113 patients who underwent PPV for ocular trauma, 7.3% of patients developed phthisis; half of the phthisical patients had presented with ocular rupture [ 19 ]. Indicators such as a relative APD, poor preoperative VA, retinal detachment, scleral laceration beyond the rectus muscle insertion, traumatic cataract, hyphema, and loss of vitreous have been identified as contributors to poor postoperative VA [ 6 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma

Clevenger,

Cao,

Steinkerchner

et al. 2024

Journal of Ophthalmology

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Introduction. Ocular trauma is a common cause of permanent vision loss in adults. The combination of an accurate clinical examination and imaging offers the best prognostic indicators for patients and helps to navigate treatment modalities. This is a retrospective chart review of examination and imaging findings for ocular trauma and how they correlate with treatment course and visual acuity (VA) outcomes. Methods. Adult patients with ocular trauma presenting to a single institution between January 2013 and December 2020 were evaluated. Initial examination and imaging findings were compared for associations with each other and with VA outcomes. Results. 136 ocular traumas on 134 patients were included. The median presenting logMAR VA was 2.7 (interquartile range (IQR) 1.2–3.7) with 62% open globe injuries. The most commonly reported finding on initial CT scan was globe deformity (30%), on B‐scan was choroidal detachment (20%), and on ultrasound biomicroscopy was intraocular foreign body, ciliochoroidal effusions, or angle recession (21% each). Worse vision was observed for patients positive for retinal detachment on initial B‐scan compared to those negative for this finding at 6‐month (median logMAR 2.7 vs. 0.5; P < 0.0001) and at final post‐injury evaluation (median logMAR 3.7 vs. 0.4; P < 0.0001). Similarly, worse VA was observed for patients with choroidal detachment on initial B‐scan compared to those without this finding at 6‐month (median logMAR 1.4 vs. 0.5; P = 0.002) and at final post‐injury evaluation (median logMAR 2.0 vs. 0.4; P < 0.0001). If positive conjunctiva/sclera examination findings were identified, 66% had positive findings on B‐scan, whereas if the conjunctiva/sclera examination findings were absent, 41% had positive findings on B‐scan (P = 0.005). If anterior chamber (AC) examination findings were positive, 59% had positive findings on B‐scan, whereas if the AC examination findings were absent, 37% had positive findings on B‐scan (P = 0.03). Discussion. The predictive value of examination findings in this study may offer insight as to long‐term visual prognosis. Positive B‐scan or CT findings should increase suspicion for open globe injuries.

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Clinical efficacy of early vitrectomy in patients with severe blunt ocular trauma

Subbotina

Shamkin

Stepanyants

2023

Ophthalmology Reports

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BACKGROUND: Eye injury is an actual problem, occupying a leading position among the main causes of blindness and low vision, accounting for 22.8% in the structure of primary visual disability, of which 53% of cases are due to closed eye injury. Despite the development and widespread introduction into practice of methods of high-tech care for patients of this profile, there are a number of complications that poorly respond to treatment, ultimately leading to the loss of visual function of the injured eye. AIM: Evaluation of the effectiveness of early vitrectomy in patients with severe blunt ocular trauma, based on clinical results obtained during treatment and postoperative follow-up. MATERIALS AND METHODS: The study included 34 patients (34 eyes) with contusion-type eye injury. The mean age of patients was 39 years, among them 30 were men (88.24%) and 4 (11.76%) women. Patients were divided into 2 groups. Group 1 included 11 patients (10 men, 1 woman) with an open-type eye injury with a subconjunctival scleral rupture; upon admission, visual acuity varied from incorrect light projection to 0.01. In group 2, there were 23 patients (20 men, 3 women) with severe closed eye injury, upon admission to the hospital, visual acuity ranged from incorrect light projection to 0.06. In all cases, patients underwent subtotal three-port vitrectomy at an early date (up to 3 days) after injury. RESULTS: On the 1st day after surgery, there was an improvement in visual acuity in all patients. The follow-up period for patients was 6 months. All included patients had a stable anatomical result, no cases of subatrophy were noted, satisfactory functional results were achieved - visual acuity varied from 0.02 to 0.8. After 6 months, 32 out of 34 eyes (94.12%) showed no signs of proliferative vitreoretinopathy. In 2 patients (18.18%) from group 1, the development of proliferative vitreoretinopathy under silicone oil was revealed. Epiretinal membrane was diagnosed in 2 patients (8.7%) from group 2 and in 1 patient (9.09%) from group 1. CONCLUSIONS: Obtained clinical results of treatment of patients with severe blunt ocular trauma indicate the expediency of vitrectomy in early stages after injury, which is an effective treatment method. Long-term results demonstrate stable functional results for 6 months. Vitrectomy performed early after injury serves for prevention of proliferative vitreoretinopathy, but does not completely exclude its development. Performing surgery early after injury increases the prospects for preserving visual functions of the eye and is a positive prognostic factor.

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Outcomes Following Pars Plana Vitrectomy for Severe Ocular Trauma

Cited by 4 publications

References 21 publications

T-shaped pars plana scleral incision to remove large intraocular foreign body

T-shaped pars plana scleral incision to remove large intraocular foreign body

Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma

Clinical efficacy of early vitrectomy in patients with severe blunt ocular trauma

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