title: Outcomes of vitreoretinal surgery in patients with closed-globe injury.
abstract: OBJECTIVE
  To evaluate the clinical features, visual outcomes, and prognostic factors in patients who underwent vitreoretinal surgery after closed-globe injury.
  
  
  METHODS
  Retrospective review of patients with closed-globe injuries who underwent vitreoretinal surgery between January 2003 and December 2007.
  
  
  RESULTS
  The study cohort included 46 eyes from 46 patients who underwent vitreoretinal surgery for posterior segment injury. Retinal detachment was the most frequent indication for the surgery, in 33 eyes (72%). After surgery, final visual acuity of 20/400 or better was achieved in 35 eyes (76%), while 11 eyes (24%) had visual acuity less than 20/400 (poor visual outcome). The most frequent reason for poor outcome was proliferative vitreoretinopathy (PVR) (6 eyes), followed by macular complications (3 eyes) and optic atrophy (2 eyes). Two cases with PVR became phthisical following repeated vitreoretinal procedures and also lost light perception. Prognostic factors associated with poor outcomes included delayed presentation, presenting visual acuity of less than 20/400, the presence of initial macular detachment, and the need for additional surgical intervention (p<0.05). No statistical difference was found in final visual acuity between eyes with or without retinal detachment (p>0.05). Also, the presence of damage to the anterior segment was not significantly associated with poor visual outcome (p>0.05).
  
  
  CONCLUSIONS
  In patients with posterior segment pathology caused by closed-globe trauma, retinal detachment was the most common reason for vitreoretinal surgery and PVR was the main cause of surgical failure. The poor visual outcomes associated with delayed presentation suggest that patients need to be referred for further management.
authors.affiliation: Department of Ophthalmology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey. erdurman@yahoo.com
authors.forename: Cuneyt F
authors.initials: CF
authors.lastname: Erdurman
authors.forename: Melih O
authors.initials: MO
authors.lastname: Ceylan
authors.forename: Cengiz Han
authors.initials: CH
authors.lastname: Acikel
authors.forename: Hakan A
authors.initials: HA
authors.lastname: Durukan
authors.forename: Tarkan
authors.initials: T
authors.lastname: Mumcuoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003288:Contusions / Q000503:physiopathology / Q000601:surgery; D005131:Eye Injuries / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057972:Posterior Eye Segment / Q000293:injuries*; D011379:Prognosis; D012189:Retrospective Studies; D012591:Scleral Buckling; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D057586:Vitreoretinal Surgery; D014949:Wounds, Nonpenetrating / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult