Timing and Outcomes of Vitreoretinal Surgery after Traumatic Retinal Detachment

Abstract

Traumatic retinal detachments are a significant cause of morbidity. There are currently no evidence-based guidelines on the appropriate time to perform vitreoretinal surgery to repair a traumatic retinal detachment. Early intervention, within seven days of the inciting trauma, may decrease proliferative vitreoretinopathy and postoperative endophthalmitis. Later intervention may yield a reduced risk of inflammation and hemorrhage, particularly in cases of concomitant open globe injuries. This article reviews the literature on the management of retinal detachments associated with ocular trauma from the years 2006 to 2016. Particular focus was placed on the timing of surgery, concomitant open globe injury, anatomical success rates, visual acuity, and complication rates. In this review, anatomical success was not significantly related to timing of intervention when compared between early and delayed intervention in eyes with and without concomitant open globe injuries. Visual acuities postoperatively varied widely despite timing of intervention due to the large variation in mechanism and extent of ocular injuries. Proliferative vitreoretinopathy was a common complication. Preliminary data indicate that endophthalmitis rates may be lower when early vitreoretinal surgery is performed. There is insufficient data to conclude whether early or delayed surgery leads to improved outcomes, highlighting the need for further research in this domain.

Traumatic Retinal Detachment Caused by Nerf Gun Shot in a Pediatric Patient

“…9 Postoperative visual outcomes vary widely; however, attachment of the macula at presentation has been associated with a higher postoperative visual acuity and a poorer visual acuity at presentation is associated with a lower postoperative visual acuity. 9 Pediatric patients who had anatomical success during retinal detachment surgery correlated with higher postoperative visual acuity. 6 Our patient surprisingly still had a macula-on retinal detachment despite being 1 month after his injury and onset of symptoms.…”

Silicone Oil–filled Foldable Capsular Vitreous Body Versus Silicone Oil Endotamponade for Treatment of No Light Perception After Severe Ocular Trauma

“…A review study reported that the anatomical success was not significantly related to the timing of intervention; however, there are insufficient data to conclude whether early or delayed surgery leads to improved outcomes at long-term follow-up. 18 Both the methods have a specific effect on vision improvement; postoperative BCVA of the SO group was significantly better than that of the FCVB group. Retinal reattachment is a prerequisite for vision recovery.…”

“…A review study reported that the anatomical success was not significantly related to the timing of intervention; however, there are insufficient data to conclude whether early or delayed surgery leads to improved outcomes at long-term follow-up. 18 …”

Incidence and Risk Factors Affecting the Recurrence of Primary Retinal Detachment in a Tertiary Hospital in Spain

“…In our study, a considerable number of patients were classified as having complex RD, including those with macular hole (n = 18), complex cataract (n = 26), previous filtering glaucoma surgery (n = 13), chronic RD (n = 9), traumatic RD (n = 43), giant retinal tear (n = 21), total RD (n = 42) and vitreous haemorrhage (n = 82). Some of these factors have been shown to increase the risk of surgical failure, and this may explain our higher recurrence rates [ 18 , 19 , 20 , 21 , 22 , 23 ].…”