gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Importance of timing of vitrectomy for opening eye (globe) injury – An analysis on correlation of proliferative vitroretinopathy (PVR), retinal detachment and timing of vitrectomy

Meeting Abstract

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  • M.A. Zhizhong - Beijing/China

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V036

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/rg2008/08rg036.shtml

Published: June 18, 2008

© 2008 Zhizhong.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Purpose: To investigate the effect of PVR, retinal detachment (RD), and timing of vitrectomy (TV) on the prognosis of opening eye injury.

Methods: A series of 357 eyes from 347 patients sustained opening injury and underwent vitrectomy. All subtypes of opening injuries were included. Time duration from injury to vitrectomy ranged from less than 14 days up to more than 30 days. Referring to the independent predictive risk factors presented by logistic regression, we analyzed the effect of PVR and RD occurring preoperatively and delayed vitrectomy on the prognosis.

Results: The 224 eyes (62.75%) gained best corrected visual acuity (BCVA);20/800 at last follow-up, a noticeable increase over 115 eyes (32.21%) with preoperative BCVA on matched level (p=0.000). No light perception occurred to 37 eyes. Anatomical unfavorable outcome occurred in 79 eyes (22.10%) including 17 enucleated eyes and 22 atrophic eyes. 12 eyes with low pressure tended to be atrophic and 28 eyes became cilicon oil-dependent. Either PVR and RD occurring preoperatively or vitrectomy performed 14 days after injury would significantly deteriorate the unfavorable outcome (p values were 0.000, 0.000, 0.042 respectively). Incidence of PVR significantly increased in the eyes with RD initially occurring after injury (p=0.000) and with delayed vitrectomy (p=0.000). More RDs (73.20%) were identified(p=0.047) in the eyes undergoing vitrectomy;30 days than within 30 days (63.24%).Anatomically, RD complicated with PVR(36.41%) showed worse outcome than without PVR (6.58%, p=0.000). VA less than 20/800 in last follow-up was more in the eyes with PVR (50.26%) than without PVR (6.58%, p=0.000). Univariate logistic analysis showed that no light perception, closed-funnel RD, PVR and expulsive choroidal hemorrhage were independent risk factors.

Conclusion: Opening eye injury threatens both ocular structures and visual function. Preoperative occurrence of PVR and RD were risk factors to unfavorable outcome. RD complicated with PVR deteriorated unfavorable prognosis. Delayed vitrectomy was a critical risk factor to occurrence of PVR. Timing of vitrectomy in openly injured eyes is closely related to prognosis.