Preoperative Proliferative Vitreoretinopathy in Open-Globe Injuries: Chronological Observations Based on the Inner...

Area of Science:

• Ophthalmology
• Trauma Surgery
• Pathology

Background:

• Open-globe injuries (OGIs) can lead to severe visual impairment.
• Proliferative vitreoretinopathy (PVR) is a major complication following ocular trauma.
• Understanding the timeline of PVR development is crucial for effective treatment.

Purpose of the Study:

• To describe the chronological clinicopathological changes in Zone III OGIs.
• To elucidate the early development of PVR after ocular trauma.

Main Methods:

• Analysis of 37 eyes with Zone III OGIs from the Eye Injury Vitrectomy Study (EIVS).
• Histopathological examination (H&E, PAS staining) of wound tract tissue.
• Retrospective review of intraoperative videos for PVR progression.

Main Results:

• Histopathology showed inflammation, exudation, fibroblast migration, and fibrous membrane formation within 14 days.
• Retinal structures were preserved initially, but thinning and degeneration occurred later.
• Clinical proliferative activity began by 7-14 days, intensifying after two weeks with irreversible retinal remodeling.

Conclusions:

• PVR progresses rapidly after OGIs, with significant retinal changes by two weeks.
• Early pars plana vitrectomy (PPV) may preserve retinal integrity.
• Individualized surgical timing is necessary due to risks associated with acute-phase intervention.