Outcomes of Delayed Vitrectomy in Open-Globe Injuries in Young Patients

Sandinha, Maria Teresa; Newman, William; Wong, David; Stappler, Theodor

doi:10.1097/iae.0b013e31820840ef

Cited by 13 publications

(7 citation statements)

References 13 publications

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“…Conversely, the later the vitrectomy, the higher the incidence and severity of postoperative complications, mainly PVR [22, 23]. However, other authors investigated longer time [24] (mean 49 days) and they concluded that a delayed approach is compatible with good visual prognosis in relatively young patients.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Nowomiejska

Chorągiewicz

Borowicz

et al. 2017

Journal of Ophthalmology

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Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Nowomiejska

Chorągiewicz

Borowicz

et al. 2017

Journal of Ophthalmology

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“…Sadly, it is still rather common to have the vitrectomy deferred past 2 weeks (very late) [14], even though the disadvantages of such an approach have long been proven [15,16]. Apart from the patient's general condition or other, unavoidable logistical circumstances [17], this long delay is very difficult to justify: it brings hardly any benefit while substantially increasing the incidence and severity of postoperative scarring (PVR, ciliary body destruction and consequent phthisis).…”

Section: Open-globe Traumamentioning

confidence: 99%

The Timing of Reconstruction in Severe Mechanical Trauma

Kuhn

2013

Ophthalmic Res

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Serious ocular trauma involving the posterior segment remains rather common and, despite many technological advances in recent years, continues to represent a significant management challenge to the ophthalmologist. One of these challenges is to identify the most optimal timing for the ultimate reconstruction, namely vitrectomy. While it is fairly obvious that suture-closure of the wound of open-globe injuries should be done as soon as possible, it is less clear whether vitrectomy should be performed in the same surgical session (primary comprehensive reconstruction) or be deferred (staged approach), and if so for how long. In this review, 4 options for staging are offered: early (days 2-4); delayed (days 5-7); late (days 8-14), and very late (past 2 weeks). The earlier the vitrectomy, the higher the risk of intraoperative complications. Conversely, the later the vitrectomy, the higher the incidence and severity of postoperative complications, of which proliferative vitreoretinopathy is the most damaging.

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“…12 Proper timing of vitrectomy is very important in functional and anatomic prognosis but the benefits of early versus delayed vitrectomy remain controversial. 4,25 The common suggestion is to operate on 10-14 days after OGI, waiting for restoration and PVD, along with avoiding proliferation at same time. Risk of acute inflammatory response and damageassociated hemorrhage could also be reduced during these 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

Liu

Wang

Yang

et al. 2021

European Journal of Ophthalmology

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Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

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Outcomes of Delayed Vitrectomy in Open-Globe Injuries in Young Patients

Abstract: This consecutive case series underlines the fact that a delayed approach is compatible with good visual prognosis in relatively young patients.

Cited by 13 publications

References 13 publications

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

The Timing of Reconstruction in Severe Mechanical Trauma

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

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