Rt-PA-assisted Vitreoretinal Surgery for Open Globe Injury with Suprachoroidal Hemorrhage: Outcomes and Predictive...

This study aimed to investigate the visual and anatomic outcomes of recombinant tissue plasminogen activator (rt-PA)-assisted vitreoretinal surgery for open globe injury (OGI) with suprachoroidal hemorrhage (SCH) and to identify the prognostic factors.

A total of 94 eyes (94 patients) with OGI and SCH received suprachoroidal rt-PA injection, followed by suprachoroidal drainage and vitreoretinal surgery on the next day. The patients' demographic information, characteristics of injury, anatomical and visual outcomes were recorded. Multivariate regression analysis was performed to identify the prognostic factors for visual outcomes of less than counting fingers and retinal detachment at the last visit.

SCH in 76 (80.9%) eyes were completely drained during surgery after a median interval of 5 days between injury and vitrectomy. The proportion of eyes with visual acuity is better than counting fingers increased from 4.26% to 48.94%. The rate of retinal attachment was 84.04% (79/94) at 3 months and 77.66% (73/94) at the last follow-up after surgery. Retinal loss was the only predictive factor for poorer visual outcomes (OR = 9.425, 95% confidence interval, CI = 3.929 - 22.610, p < 0.001), and retinal detachment (OR = 2.626, 95% CI = 1.249- 5.521, p = 0.011) at the last follow up.

rt-PA-assisted vitreoretinal surgery is an efficient management approach to restore ocular structure and partial visual function in open globe injury with SCH. Retinal loss is the prognostic factor for both poor visual and anatomical outcomes.