Diagnostic ultrasound and pars plana vitrectomy in penetrating ocular trauma

The purpose of this study is to evaluate the accuracy of diagnostic ultrasonography in the preoperative evaluation of eyes with media opacity after penetrating ocular trauma and correlate the preoperative findings with ultimate visual outcome.

A retrospective comparison was made between the preoperative ultrasound diagnoses and the intraoperative findings in 46 eyes of 45 patients undergoing pars plana vitrectomy after penetrating ocular trauma associated with dense media opacities. The preoperative echographic findings were correlated with long-term visual and anatomic outcome.

Preoperative echography was both sensitive and specific in evaluating traumatized eyes for retinal detachment, intraocular foreign bodies, posterior scleral wounds, and hemorrhagic choroidal detachments. The overall anatomic success rate was 87% (40/46) with 48% (22/46) of eyes obtaining visual acuity of 20/200 or better after surgery. The visual prognosis was worse in those eyes in which preoperative echography detected retinal detachment, subretinal blood, massive choroidals, or posterior exit wounds.

Diagnostic echography is accurate and provides useful prognostic information in eyes with media opacity after penetrating ocular trauma.