Surgical results of 23-gauge pars plana vitrectomy in adult traumatic retinal detachment

To evaluate the anatomic and functional results of 23gauge pars plana vitrectomy (PPV) in eyes with traumatic retinal detachment (RD), medical records of patients who had each undergone PPV surgery after traumatic RD diagnoses were retrospectively reviewed. Patients who had at least 6 months of follow-up were included in the study. Patients' clinical characteristics, preoperative and postoperative distance corrected visual acuities, anatomical success rates, and complications were analyzed. Twenty-seven eyes from 27 patients were included in the study. Mean patient age was 48±17 years, and 96% of th e cases were male. Mean follow-up period was 8±3 months. Seventeen (63%) patients had closed and 10 (37%) patients had open globe trauma. Five (19%) patients had an intraocular foreign body. Mean time from trauma to PPV was 34±33 days. Anatomical success was achieved in 19 (70%) eyes. Functional success was achieved in 13 (48%) eyes. Preoperative (baseline) visual acuity was the only factor associated with functional success. Traumatic RD may result in severe visual loss in the majority of cases despite the advancements in PPV techniques. Functional success rate is higher in patients presenting better preoperative (baseline) visual acuity.

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Negrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiology 1998; 5: 143-169.

Balles MW. Traumatic retinopathy. In: Albert DM, Jakobiec FA (Eds). Principles and Practice of Ophthalmology. Philadelphia: WB Saunders 1994; 1029-1031.

Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmology Clinics of North America 2002; 15: 163-165.

Zhang X, Liu Y, Ji X, Zou Y. A Retrospective Study on Clinical Features and Visual Outcome of Patients Hospitalized for Ocular Trauma in Cangzhou, China. Journal of Ophthalmology 2017; 7694913.

Cillino S, Casuccio A, Di Pace F, Pillitteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmology 2008; 8: 6.

Morris DS, Willis S, Minassian D, Foot B, Desai P, and Mac Ewen CJ. The incidence of serious eye injury in Scotland: a prospective study. Eye 2014; 28: 34-40.

Nowomiejska K, Choragiewicz T, Borowicz D, et al. Surgical management of traumatic retinal detachment with primary vitrectomy in adult patients. Journal of Ophthalmology 2017; 5084319.

Stryjewski TP, Andreoli CM, Eliott D. Retinal detachment after open globe injury. Ophthalmology 2014; 121: 327-333.

Nashed A, Saikia P, Herrmann W.A, Gabel VP, Helbig H, Hillenkamp J. The outcome of early surgical repair with vitrectomy and silicone oil in open-globe injuries with retinal detachment. American Journal of Ophthalmology 2011; 151: 522-528.

Rouberol F, Denis P, Romanet JP, Chiquet C. Comparative study of 50 early-or late-onset retinal detachments after open or closed globe injury. Retina 2011; 31: 1143-1149.

Unver YB, Acar N, Kapran Z, Altan T. Prognostic factors in severely traumatized eyes with posterior segment involvement. Turkish Journal of Trauma & Emergency Surgery 2009; 15: 271-276.

De Juan E Jr, Strenberg P Jr, Michels RG. Penetrating ocular injuries. Types of injuries and visual results. Ophthalmology 1983; 90: 1318-1322.