Early vitrectomy in the management of the severely traumatized eye

In a series of 112 consecutive patients who underwent vitrectomy because of severe penetrating ocular trauma, good visual recovery (6/12 [20/40] or better) was achieved in 15 of 23 patients (65%) who underwent surgery within 72 hours of the injury (Group 1), in seven of 14 patients (50%) who underwent surgery three to ten days after injury (Group 2), in eight of 22 patients (36%) who underwent surgery ten to 14 days after injury (Group 3), in two of five patients (40%) who underwent surgery 14 to 30 days after injury (Group 4A), and in 17 of 48 patients (35%) who underwent surgery more than 40 days after injury (Group 4B). Functional vision (6/12 [20/40] to counting fingers) was achieved in three of 23 patients (13%) in Group I, five of 14 patients (36%) in Group 2, six of 22 patients (27%) in Group 3, two of five patients (40%) in Group 4A, and in 22 of 48 patients (46%) in Group 4B. These data indicated that definitive early surgical intervention, including vitrectomy, should be considered as part of the primary repair or performed within 72 hours of the injury. Early surgery provides a statistical better prognosis for good visual recovery than a delay of three to 14 days or longer.