Results of pars plana vitrectomy in closed-globe injuries

To assess surgical and visual outcomes with pars plana vitrectomy (PPV) in closed-globe injuries resulting in anterior and posterior segment pathologies and evaluate the factors influencing the prognosis.

Retrospective observational study. Forty-seven eyes of 47 consecutive patients who underwent PPV because of closed-globe injury between January 1992 and August 2003 were reviewed. Surgical and visual outcomes and prognostic factors were analyzed according to the Ocular Trauma Classification System.

Preoperative visual acuity was less than 4/200 in 49% of eyes, classified as grades IV to V. After surgery, this ratio was 23% (P < .05). Final visual acuity was statistically significantly better in grade I (P = .0001), grade II (P = .002), and relative afferent pupillary defect-negative (P = .0001) injuries. Maculopathy was the most common adverse outcome influencing final visual acuity (32%), followed by secondary glaucoma (13%) and proliferative vitreoretinopathy (8%).

PPV is a favorable treatment modality in severe closed-globe injuries. Assessment of injuries with respect to the Ocular Trauma Classification System seemed to predict visual outcomes in this series.