Primary pars plana vitrectomy in the treatment of penetrating eye injuries affecting the vitreous body with an intraocular foreign body
Abstract
The method of choice in the treatment of penetrating eye injuries affecting the vitreous body with an intraocular foreign body is in the majority of patients primary pars plana vitrectomy with transvitreal extraction of the foreign body (FB). During the period from April 1999 till September 2000 the authors treated thus at the Ophthalmological Clinic of the General Faculty Hospital and 1st Medical Faculty Charles University Prague 26 eyes of 26 young men with an average age of 34 years.
The mean interval between the injury and primary PPV was 8.5 days. The patients were followed up on average for 23.5 months.
The entrance of the penetrating injury was in 17 eyes in the cornea or limbus, in 9 eyes in the sclera. In two eyes posttraumatic endophthalmitis developed.
The intraocular FB was 6 mm2 in size in 16 eyes and 6-20 mm2 in 10 eyes. In primary PPV we indicated in 14 eyes internal tamponade with gas or silicone oil.
On account of late retinal complications which developed as a result of proliferative vitreoretinopathy we indicated in eight eyes PPV reoperation. At the endof the investigation period in 3 eyes inoperable detachment of the retina developed.
As the main negative prognostic factor for final visual acuity the authors evaluated a size of the FB greater than 6 mm2, other negative prognostic factors are the scleral entrance injury, complications of the entrance injury (prolapse of the iris, vitreous body, haemophthalmus) and the development of posttraumatic exogenous endophthalmitis.