Clinical observation of the vitreous surgery for open-globe injuries in different timing after the trauma

Abstract

To evaluate the clinical efficacy and influential factors of vitrectomy for open-globe injuries in different timing. Prospective cohort study. The clinical effect and complication of the vitrectomy performed by the same surgeon for open-globe injury in different timing (2-4 d or 10-14 d) from April 2011 to January 2013 were compared.Emergent intraocular surgeries such as intraocular foreign body and traumatic endophthalmitis were excluded. A total of 33 patients (33 eyes) were included in the study with 15 cases in the early group (2-4 d) and 18 cases in routine group (10-14 d). The rate of retinal re-attachment showed that 11 of 13 eyes that had retinal detachment were re-attached in the early group.One of 13 eyes had retinal re-attachment after the second surgery and 1 eye failed to re-attach.Five of 15 eyes with retinal detachment had retina re-attached in the routine group. Four of 15 eyes had retina re-attached after second surgery and 6 eyes failed to re-attach. There was a statistical significance between the two groups (U = 46.500, Z = -2.638, P = 0.008). The eye-globe saving rate had no statistical significance (χ² = 3.48, P = 0.095).Fourteen eyes had been saved and 1 eye failed to have vitrectomy in the early group. Twelve eyes had been saved and 6 eyes failed to have vitrectomy in the routine group. The incidence of traumatic proliferative vitreo-retinopathy(TPVR) had statistical significance between the two groups (χ² = 12.34, P = 0.001).One eye occurred TPVR in the early group and 12 eyes occurred TPVR in the routine group. The visual acuity recovery showed that patients in the early group had better vision recovery than patients in the routine group (U = 61.500,Z = -2.858, P = 0.004). Complications like intraoperative bleeding and postoperative infection had no significant difference between the two groups. Cases performing vitrectomy earlier had relatively good prognosis.