The application of fluid-air exchange during vitreoretinal surgery for severe posterior segment ocular trauma

Abstract

Objective To evaluate the clinical outcomes of the vitreoretinal surgery combined with fluid-air exchange for severe posterior segment ocular trauma. Methods Thirty eyes of 30 cases of severe posterior segment ocular trauma were involved in this study. Vitreoretinal surgery combined with fluid-air exchange were performed on these eyes. The intraocular conditions during the surgeries, the operating time, the pre-and postoperative visual acuity, retinal and choroidal reattachment, and postoperative complications were recorded. The patients were followed up for 6 months. Results The operations of vitreoretinal surgery combined with fluid-air exchange were performed successfully in all 30 eyes which provided effective condition of hemostasis and clear surgical field. The operation time ranged from 50 to 90 minutes, mean (63.84 ± 11.13) min. B-scan ultrasonography were taken after operation and showed that the retina and choroid became reattached in all cases. The last follow-up examination of the fundus after the surgery showed that retinal reattachment succeeded completely in 27 eyes but in 3 eyes incompletely. Postoperative complications included corneal edema in 9 eyes, hypema in 6 eyes, anterior chamber inflammation in 13 eyes, secondary glaucoma in 7 eyes, epiretinal membranes or subretinal proliferation in 26 eyes, and so-called silicone oil dependency in 8 eyes. The visual acuity was no light perception in 2 eyes, light perception in 4 eyes, handmovement in 6 eyes, and counting finger or better in 8 eyes. The postoperative visual acuity was significantly better than the preoperative one, and the difference was statistically significant (χ2=24.79, P=0.000). Conclusion The vitreoretinal surgery combined with fluid-air exchange could provide convenient surgical field and facilitate hemostasis, which is an improved technique for the treatment of severe posterior segment ocular trauma in order to avoid evisceration of the eye. Key words: Vitreoretinal surgery; visual field; Hemostasis; Fluid-air exchange