Primary vitrectomy as a preventive surgical procedure in the treatment of severely injured eyes.

Faulborn, J.; Atkinson, Andrew; Olivier, D

doi:10.1136/bjo.61.3.202

Cited by 56 publications

(24 citation statements)

References 12 publications

(9 reference statements)

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“…Thus an accident was involved in a total of 5% of these cases. The number of admissions as the result of trauma to the eye is reported in the literature as about 10% of the total number of ophthalmological admissions (Maltzman et al, 1976;Faulborn et al, 1977). The proportion of ocular perforations is probably between 20% and 50%.…”

Section: Resultsmentioning

confidence: 99%

The visual prognosis of a perforation of the eyeball: A retrospective study

Bastiaensen

1981

Doc Ophthalmol

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In the literature there is agreement about the variable prognosis of an ocular perforation, but analysis of the factors which affect the prognosis is rare. In this article the factors which determined the final visual in 60 perforation cases are discussed. One third of the total number of eye lost useful vision (visual acuity less than 0.1) while 43% retained good sight (visual acuity greater than 0.8). The visual outcome is considered for each prognostic factor. It is striking that the three most unfavourable prognostic factors often occur together: a traffic accident, a large to extremely large perforation and a corneo-scleral localization. Suggestions for the prevention of the most frequent causes are made, and early therapeutic measures are described which should be able to be performed in every large clinic.

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Section: Resultsmentioning

confidence: 99%

The visual prognosis of a perforation of the eyeball: A retrospective study

Bastiaensen

1981

Doc Ophthalmol

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“…Yet, others (20) advocate delayed surgery for seven to fourteen days because of the problem of intraocular bleeding. Secondary hemorrhage was also a major complication in a series of 72 severely injured eyes treated by primary vitrectomy as a prophylactic surgical procedure (12). We now propose, after the primary repair and, in part, depending on the facilities available, that certain patients be referred or managed in the early phase (within four to seven days after injury) for a combined surgical procedure, i.e., removal of vitreous and other tissue incarcerated in the wound, removal of vitreous hemorrhage, and reattachment of the retina in one procedure.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, a much higher percentage of patients achieve good vision after penetrating ocular injury (32,11,12). This improvement largely reflects the better results obtained by repairing anterior segment injuries with microsurgical techniques (Neubauer 28,29,Eagling 12 and Faulborn 13).…”

Section: Introductionmentioning

confidence: 91%

Results of pars plana vitrectomy in penetrating ocular trauma

Ryan

1978

Int Ophthalmol

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Thirty-four severely injured eyes were operated with pars plana vitrectomy. The nine cases with involvement exclusively of the anterior segment alone were operated with success in all cases. However, the injuries of the posterior segment still reflect significant problems in that only 50 percent obtained successful visual results. This reflects, in great part, the degree of severity of the initial damage. The theoretical rationale for pars plana vitrectomy in penetrating ocular trauma is discussed. Because of the many variables from patient to patient and injury to injury, conflicting clinical impressions as to appropriate management prevail. In the abscence of a definitive clinical trial or suitable experimental model, our guidelines for the role and proper timing of pars plana vitrectomy for penetrating ocular trauma are presented.

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“…In some contraction of epiretinal membranes at the macula results in macular pucker, while in others massive periretinal proliferation leads to inoperable retinal detachment (Hutton et al, 1976;Benson and Machemer, 1976;Faulborn et al, 1977;Winthrop et al, 1978). In the rabbit eye epiretinal membranes were not common and were probably glial in origin, as indicated by the bridges connecting the epiretinal fibrous tissue and the retina.…”

Section: ) Fibrous Ingrowth and Intravitreal Fibrous Proliferationmentioning

confidence: 99%

Experimental posterior penetrating eye injury in the rabbit. II. Histology of wound, vitreous, and retina.

Cleary¹,

Ryan²

1979

British Journal of Ophthalmology

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SUMMARY The histological findings of the wound, the vitreous, and the retina in the rabbit eye with experimental posterior penetrating injury are described. Wound healing had just begun at 3 days after injury and was well established by 9 to 12 days. It involved proliferation of cells from the episclera and from the choroid. The progression to a fibrous ingrowth from the wound occurred only in eyes with blood in the vitreous. The intravitreal fibroblastic proliferation had begun at 6 days after injury and seemed to be derived from the choroid, the nonpigmented ciliary epithelium and, posteriorly, from the optic nervehead. During the development of retinal detachment the configuration of the peripheral and posterior retina, together with the orientation of vitreous strands, suggested the presence of vitreous traction. We postulate that the presence of contractile fibroblasts (myofibroblasts) in the vitreous may provide the mechanism for vitreous traction. The retinal detachments were also characterised by epiretinal and subretinal membranes, but these were not prominent. The end-stage appearance of a soft, shrunken eye with cyclitic membrane formation and retinal detachment resembles the outcome in many human eyes after severe penetrating injuries.Severe penetrating injuries in human eyes are characterised histologically by intraocular fibrosis with cyclitic membrane formation and traction retinal detachment (Hogan and Zimmerman, 1962;Coles and Haik, 1972). In fact, traction retinal detachment is the main reason for loss of vision in those injuries which are confined to the posterior segment (Eagling, 1975).It has been shown in the preceding paper (Cleary and Ryan, 1979) that the experimental model of a posterior penetrating injury in the rabbit eye results in cyclitic membrane formation and in traction retinal detachment. In the present paper we describe the sequence of histological changes. Materials and methodsAs previously described, rabbit eyes were injured by a standard wound which was 8 mm long through the pars plana, avoiding the lens and the peripheral retina. Prolapsed vitreous was abscissed and the wound carefully closed by microsurgical techniques with interrupted sutures of 8-0 silk. After wound Address for reprints: Mr Philip E. Cleary, FRCS, Ardkeen Hospital, Waterford, Ireland closure the fundus was inspected by indirect ophthalmoscopy and the area of the wound and the peripheral retina examined by scleral indentation. In some eyes autologus blood and in others balanced salt solution was injected through a 25-gauge needle inserted through the wound and under ophthalmoscopic control into the mid-vitreous, with avoidance of the lens and the retina.The eyes were enucleated at 3-day intervals for the first 3 weeks after injury as well as at 2 and 3 months after injury. Each group consisted of a minimum of 3 eyes. The eyes were fixed in Bouin's fixative for 24 hours and were then sectioned through the optic nerve and midpoint of the wound for gross examination. Each half eye was examined under the diss...

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Primary vitrectomy as a preventive surgical procedure in the treatment of severely injured eyes.

Cited by 56 publications

References 12 publications

The visual prognosis of a perforation of the eyeball: A retrospective study

The visual prognosis of a perforation of the eyeball: A retrospective study

Results of pars plana vitrectomy in penetrating ocular trauma

Experimental posterior penetrating eye injury in the rabbit. II. Histology of wound, vitreous, and retina.

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