[Early vitrectomy with primary silicone oil injection in very severely injured eyes]

Performing early vitrectomy with primary silicone oil filling in 11 severely injured eyes (large or multiple intraocular foreign bodies, double perforations, ruptures - all with vitreous hemorrhage and retinal detachment), the authors succeeded in treating the posterior segment trauma with adequate hemostasis in ten cases. During postoperative follow-up of between 12 and 39 months there were no recurrences of hemorrhage. Primary retinal reattachment was achieved in seven eyes. A traction detachment due to proliferative vitreoretinopathy developed in three eyes at a relatively late stage (6-19 months postoperatively): reoperation was successful in two cases. With regard to functional results, six eyes had a visual acuity of between 1/25 and 0.6, and in four it was in the range between perception of light projection and hand movements. There were three cases with keratopathy encouraged by aniridia or hypotonia. One eye with emulsification of the silicone oil developed a secondary glaucoma which responded to topical treatment. In three cases the silicone oil was removed without complications. In one eye there was an expulsive choroidal hemorrhage which could not be managed intraoperatively and which led to phthisis and amaurosis postoperatively.