Management of retinal detachment due to closed globe injury by pars plana vitrectomy with and without scleral buckling.
OBJECTIVE
To investigate the effect of circumferential scleral buckling on the prognosis for patients undergoing pars plana vitrectomy and lensectomy for severe closed globe injury.


METHODS
A total of 33 cases in which pars plana vitrectomy and lensectomy were performed after severe closed globe injury between January 1990 and January 2003 were studied retrospectively. All patients had zone III contusion type injury according to The Ocular Trauma Classification Group criteria. Of the 33 patients, 15 (group 1) also underwent peripheral scleral buckling; 18 did not (group 2).


RESULTS
The mean age +/- SD was 34.8 +/- 17.5 years (range, 8-73 years). There were 6 female (18%) and 27 male (82%) patients. The two groups did not differ significantly in terms of preoperative visual acuity (P = 0.76) or postoperative visual improvement (P = 0.46). In groups 1 and 2, 4 (26%) and 3 (17%) patients developed recurrent retinal detachment for which they underwent reoperation. Other postoperative complications were as follows: group 1-phthisis (1 patient; 7%), proliferative vitreoretinopathy (1 patient; 7%), and optic atrophy (1 patient; 7%); group 2, proliferative vitreoretinopathy (2 patients; 11%) and optic atrophy (2 patients; 11%).


CONCLUSIONS
Circumferential scleral buckling did not appear to offer advantages for patients undergoing pars plana vitrectomy and lensectomy for severe closed ocular injury involving the posterior chamber.
Ersanli
Dilaver
D
Ophthalmology Clinic, GATA Haydarpasa Training Hospital, Istanbul, Turkey. dersanli@e-kolay.net
Sonmez
Murat
M
Unal
Melih
M
Gulecek
Oguz
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005131:Eye Injuries / Q000150:complications*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D017075:Laser Coagulation; D007908:Lens, Crystalline / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000293:injuries*; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000150:complications*
D005466:Fluorocarbons; C042852:perflutren