Outcome of Vitrectomy and Chorioretinectomy in Perforating Eye Injuries

Abstract

Purpose: To evaluate the anatomical and functional results of patients who underwent pars plana vitrectomy for perforating eye injuries as well as to analyze the benefit of the chorioretinectomy procedure. Methods: Retrospective and descriptive study of 24 eyes of 22 patients with perforating eye injuries operated on at the Centro Hospitalar do Porto between January 2006 and December 2012. Results: An early vitrectomy was accomplished in 67% of the eyes and a delayed vitrectomy in 33% of the eyes. A concomitant chorioretinectomy was carried out in 78%. Final proliferative vitreoretinopathy (PVR) was found in 11%. The anatomical success was 83%. At the final follow-up, 78% had best-corrected visual acuity equal to or superior to 5/200. Of the eyes that underwent early vitrectomy, 58% regained a visual acuity of 40/200 or better, versus 17% of the cases that underwent delayed vitrectomy. Conclusion: Early vitrectomy with prophylactic chorioretinectomy seems to be an effective approach to prevent PVR and improve the visual outcome and globe survival in perforating injuries.

Prophylactic chorioretinectomy for eye injuries with high proliferative‐vitreoretinopathy risk

“…As in previously published studies concerning PCR (Ozdek et al, 2013, Ferreira et al, 2015, the rate of PVR development was low in our series, seen in 16% of the injured eyes (as opposed to the expected >60% reported in the literature) and requiring multiple reoperations. However, in no eye did the PVR originate from the treatment (PCR) site, but from elsewhere in the vitreous cavity.…”

“…Ozdek et al (2013) and Ferreira et al (2015) have confirmed the benefit of this proactive surgical technique performed during the "acute" (the primary surgery) or "subacute" (within the first 100 hr) stage; in this article we present our own results from early PCR to prevent PVR in the severely injured eye.…”

Prophylactic Chorioretinectomy in Open Ocular Trauma: A Series of 36 Eyes

“…As vitreous hemorrhage, vitreous and inflammatory component incarceration are frequent and known factors in PVR development, an early vitrectomy allows their immediate removal, which has at least the theoretical advantage of minimizing PVR development. Ferreira et al [10], Schrader [29], Coleman [30], and De Juan et al [31] reported better visual outcome in eyes that underwent early vitrectomy. The results of our study contribute to confirming this tendency: 15 out of 27 eyes (55.6%) that underwent early vitrectomy regained a visual acuity of 40/200 or better versus 1 out of 4 eyes (25%) that underwent delayed vitrectomy.…”

“…In the study by Ozdek et al [9], the PVR rate was 2 out of 13 patients (15.3%) when the procedure could be accomplished. In 2015, Ferreira et al [10] reported a PVR rate of only 7% in the subgroup of patients with a perforating globe injury that underwent a prophylactic chorioretinectomy. Within this study, only 4 out of 31 eyes with a complete chorioretinectomy developed PVR.…”

“…The first published results using this new technique showed a PVR reduction from > 60 to < 10% [7]. Subsequently, other series also reported better visual outcomes and smaller PVR rates with this procedure [8][9][10]. The purpose of this study was to analyze the results achieved following vitrectomy and chorioretinectomy in eyes with perforating and deepimpact IOFB injuries.…”