Vitrectomy in ocular trauma. Factors influencing final visual outcome

Area of Science:

• Ophthalmology
• Trauma Surgery
• Retinal Surgery

Background:

• Ocular trauma is a significant cause of vision loss.
• Vitrectomy is a key surgical intervention for severe ocular injuries.
• Understanding prognostic factors is crucial for managing patient outcomes.

Purpose of the Study:

• To review outcomes of vitrectomy in ocular trauma cases.
• To identify factors predicting visual prognosis after vitrectomy for trauma.
• To evaluate the impact of surgical techniques on outcomes.

Main Methods:

• Retrospective review of 240 consecutive vitrectomy cases for ocular trauma.
• Multivariate analysis to identify prognostic factors.
• Analysis of injury types, foreign body characteristics, and surgical interventions.

Main Results:

• 71.2% of cases were war-related injuries.
• Intraocular foreign bodies (IOFB) were present in 155 eyes (metallic in 74.8%, ferromagnetic in 61.9%).
• Poor visual outcome predictors: afferent pupillary defect, double perforating injuries, IOFB presence. Vitreous hemorrhage associated with IOFB indicated poor prognosis.
• Foreign bodies in anterior segment/vitreous had better prognosis than retinal-embedded ones.
• Timing of vitrectomy and trauma type did not significantly affect visual results.
• Prophylactic scleral buckling reduced retinal detachment incidence.
• Corneal injuries had better prognosis than scleral injuries.

Conclusions:

• Key prognostic factors for visual outcome in ocular trauma vitrectomy include pupillary defects, injury severity, and IOFB characteristics.
• Surgical management, including prophylactic scleral buckling, can mitigate complications like retinal detachment.
• Location of retained foreign bodies influences prognosis, with anteriorly located ones faring better.