Posterior segment trauma: types of injuries, result of vitreo-retinal surgery and prophylactic broad encircling scleral buckle.
OBJECTIVE
To evaluate the result of pars plana vitrectomy (PPV) and prophylactic broad encirling scleral buckle in posterior segment trauma and to define factors that lead to functional failure.


METHODS
Retrospective, noncomparative, interventional case series.


METHODS
Prophylactic broad encircling scleral buckle, PPV, SF6/C3F8 or silicone oil implantation if required.


RESULTS
Ninety-two patients (94 eyes) with open globe ocular injuries involving posterior segment, were treated between January 1988 and December 2004. The mean age was 33.1 years Common sources of injuries were industrial and automobile accidents. After a follow up period of at least 6 months, 62 of 94 eyes (65.96%) achieved visual acuity of 20/400 or better and 6 eyes (6.38%) lost vision to no light perception. Eyes that had sharp perforating injuries with retained IOFB had better visual outcome than the others. Twenty-three of 38 eyes (60.53%) that had sharp perforating injuries with retained IOFBs achieved a visual acuity of 20/70 or better Eyes with traumatic retinal detachment had a reattachment rate of 78.18% and a functional success rate of 56.36%. The detachment rate in vitrectomized eyes with prophylactic broad encircling scleral buckle was 3.19 %. Main reasons for functional failure (V.A. <20/400) were macular damage, retinal detachment with PVR and optic nerve injury. Endophthalmitis occurred in 6.25%.


CONCLUSIONS
Sharp perforating ocular injuries have the best visual prognosis among all types of injuries. Pars plana vtrectomy and prophylactic broad encircling scleral buckle, can salvage and prevent subsequent retinal detachment in these severely traumatized eyes.
Warrasak
Sukhuma
S
Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Rama 6 Rd, Rajthevee, Bangkok 10400, Thailand. sukhuma@csloxinfo.com
Euswas
Ataya
A
Hongsakorn
Supawat
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005129:Eye Foreign Bodies / Q000150:complications / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D012591:Scleral Buckling; D014821:Vitrectomy