[Preventive surgical scleral buckling of retinal detachment after severe ocular injuries]

We performed surgical scleral buckling with an encircling band to prevent retinal detachment in twenty eyes with severe ocular injury (three contusions, seventeen penetrating eye injuries including twelve eyes with intraocular foreign bodies). All surgical buckling were performed during the two weeks following the injury. The purpose of this surgical procedure is to prevent the traction from contracting vitreous base which it itself secondary to vitreoretinal proliferation; several factors promote this latter outcome: perforating injury, vitreous hemorrhage, intraocular foreign body and the mix of vitreous substance and lens material. This prophylaxis is justified by the high frequency and often bad prognosis of post-traumatic retinal detachment. A mean follow-up of thirteen months showed no contusion associated delayed retinal detachment, with a final visual acuity superior to 7/10: thus, preventive surgical buckling appears efficient; perforating injuries were followed by retinal detachment in three cases; of these, two were reattached, and the final visual acuity depended on associated destructions. With the limitation of a short follow-up, this surgical procedure seems to be able to prevent most of the delayed retinal detachments.