249 Vitrectomie, lensectomie et implantation intra-oculaire dans le même temps opératoire dans le traitement des traumatismes oculaires

Abstract

To analyze the postoperative anatomic and functional outcomes in addition to complications after combined lensectomy, vitrectomy and primary intraocular lens (IOL) implantation in patients with traumatic eye injury. Retrospective review of patients with traumatic cataract and posterior segment injury who underwent combined lensectomy, vitrectomy and primary IOL implantation with a minimum follow up (FU) of 3 months. Thirteen consecutive patients (all male) with a mean age of 42.8 years (range 17-82 years) underwent combined lensectomy, vitrectomy and primary IOL implantation from February 2000 to January 2006. Postoperative FU ranged from 3 to 54 months (mean 17.6 months). Best corrected visual acuity (BCVA) at presentation ranged from 20/30 to hand movement and was worse than 20/200 in 8 patients (61%). Four patients (31%) had blunt trauma with no globe rupture. Of the 9 patients (69%) with a penetrating eye injury (PEI), 8 had an intraocular foreign body (IOFB) with one retinal detachment at presentation. Four patients had primary closure at the time of the vitrectomy. All 8 IOFBs were removed, seven patients had additional scleral buckling and four intravitreal gas injection. BCVA at last follow up ranged from 20/20 to 20/300 and was 20/40 or better in 8 eyes (62%). All retinas remained attached. One eye had subsequent surgery for epiretinal membrane proliferation and ptosis. These results suggest that combined vitrectomy, lensectomy and primary intraocular lens implantation can offer good visual rehabilitation in patients with traumatic cataract and posterior segment injury.