Timing of vitrectomy after penetrating ocular injuries

The visual outcome, as well as the preoperative sensory and anatomic status, of 49 eyes undergoing vitrectomy within 72 hours after a penetrating injury, was compared to 54 eyes with penetrating injury operated on by vitrectomy at longer intervals. The eyes operated on within 72 hours of the injury had a better visual outcome than those operated on later, but this difference was not statistically significant. However, there were important differences between the two patient groups. Eyes undergoing vitrectomy within 72 hours had a better initial visual acuity after injury, a greater percentage of anteriorly located lacerations, fewer cases of severe vitreous hemorrhage, and a higher proportion of cases with an intraocular foreign body. Each of these factors had been shown previously to be associated with a comparatively favorable visual prognosis in eyes treated by conventional means of wound repair without vitrectomy. Therefore, the visual acuity differences among the two main groups in this study are probably due to differences in the types of cases selected for early versus later vitrectomy, rather than to the difference in the timing of surgery.