Severe ocular trauma managed with primary pars plana vitrectomy and silicone oil.
OBJECTIVE
This study evaluated the outcome of severely injured eyes treated with early primary vitrectomy with silicone oil filling.


METHODS
A total of 435 eye injuries, which required surgical intervention, were reviewed retrospectively. In 13 eyes (3%) pars plana vitrectomy and silicone oil filling were performed as primary surgical repair. Silicone oil filling was restricted to cases with laceration of the retina larger than 4 disc diameters (nine eyes), primary retinal detachment larger than two quadrants (two eyes) and/or persistent intrasurgical hemorrhage (12 eyes). All patients underwent surgery within 24 hours.


RESULTS
After a mean follow-up period of 28.7 months (range, 9-70 months), 11 eyes achieved a visual acuity ranging from 20/25 to 20/200. Silicone oil was removed in 11 of 13 eyes after 5.8 +/- 4.6 months. Recurrent proliferative vitreoretinopathy developed in two eyes.


CONCLUSIONS
Silicone oil tamponade after early primary pars plana vitrectomy may be an alternative for primary repair after trauma, especially in severely injured eyes with retinal lacerations larger than 4 disc diameters, persistent intrasurgical bleeding, and/or primary retinal detachments.
Spiegel
D
D
Klinik und Poliklinik für Augenheilkunde, Universität Regensburg, Germany.
Nasemann
J
J
Nawrocki
J
J
Gabel
V P
VP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000869:Anterior Eye Segment / Q000293:injuries* / Q000473:pathology; D002648:Child; D002829:Choroid / Q000293:injuries* / Q000473:pathology; D005129:Eye Foreign Bodies / Q000473:pathology / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000473:pathology / Q000601:surgery*; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012160:Retina / Q000293:injuries* / Q000473:pathology; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D012827:Silicone Oils