Visual outcomes and prognostic factors of early pars plana vitrectomy for open globe injury

Eye (Lond). 2024 May;38(7):1355-1361. doi: 10.1038/s41433-023-02903-3. Epub 2023 Dec 30.

Abstract

Objectives: To identify the clinical features and outcomes of early vitrectomy in patients with open globe injury (OGI) and the prognostic factors for visual outcome.

Methods: This retrospective observational case series included 390 eyes in 389 patients diagnosed with OGI receiving vitrectomy within four days after injury. Preoperative parameters included the injury types, wound locations, consequent tissue damages, initial visual acuity (VA), and ocular trauma score. Postoperative outcome measures included surgical procedures, retinal (re)attachment, complications, and final VA. The logistic analysis evaluated the prognostic factors for visual outcome.

Results: Intraocular foreign bodies (59.2%) and penetrating injuries (28.7%) were the most common injury types. Among the 165 eyes with retinal detachment (RD), 121 (73.3%) had retinal reattachment during early primary vitrectomy, and 32 (19.4%) were repaired during a second or subsequent surgery. Thirteen eyes (3.3%) were enucleated. The final VA improved from the initial level in 207 eyes (55.2%), remained unchanged in 123 (32.8%), and decreased in 45 (12.0%). Multivariable regression revealed that the injury zone, initial VA, RD, and endophthalmitis were associated with poor visual outcomes (P < 0.05).

Conclusions: Higher zone injury, low initial VA, RD, and endophthalmitis are predictors of poor visual outcome in eyes undergoing early vitrectomy for OGI.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Eye Foreign Bodies / diagnosis
  • Eye Foreign Bodies / physiopathology
  • Eye Foreign Bodies / surgery
  • Eye Injuries, Penetrating* / diagnosis
  • Eye Injuries, Penetrating* / physiopathology
  • Eye Injuries, Penetrating* / surgery
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Prognosis
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery
  • Retrospective Studies
  • Visual Acuity* / physiology
  • Vitrectomy* / methods
  • Young Adult