gms | German Medical Science

Background: In spite of the progress in vitreoretinal surgery, the anatomical and functional results of severe ocular injuries involving the posterior segment are still discouraging. Perforating injuries and ruptures, that extend posterior to the muscle insertions, have the worst outcome. At the time of secondary intervention between day 7 and 14 post trauma it is not unlikely that severe PVR already occurred. The authors present the preliminary results of an ongoing prospective international trial on severe ocular ruptures and perforating injuries (with entrance and exit wounds, with at least one wound behind the insertion of the rectus muscles), with the posterior segment reconstruction performed already within 100 hours following the trauma.

Method: 6 centers contributed to the preliminary results of the ongoing multicenter prospective trial “Proactive Management of Eyes with Perforating/Rupture/IOFB Injuries".

Results: Among the cases, that were contributed for the study, anatomic and functional results seem to be better with this new approach than with the conventional technique. More than 50% of the cases reached a visual acuity of 0.1 or better, none became completely blind (NLP), or developed a phthisis or had to be enucleated.

Conclusion: Based on a new approach to act rather than to react on alterations secondary to severe posterior segment trauma the functional results of these injuries may be further improved. The prospective multicenter multinational study conducted by the World Eye Injury Register will be continued.