Primary vitrectomy in total and subtotal hemophthalmos of traumatic etiology

Abstract

Purpose: to present the functional results of primary early vitrectomy in patients with subtotal and total hemophthalmos with penetrating wounds and severe contusions of the eye. Material and methods. 41 patients were observed, including 24 patients (24 eyes) with a penetrating eye injury and 17 patients (17 eyes) with a severe eye contusion. All patients had subtotal or total hemophthalmos. All patients underwent a 25G three-port vitrectomy no later than 3 days after the injury. 33 patients received a tamponade with silicone oil 5700, and 8 patients received gas-air mixture C3F8. The follow-up period was 6 months. Results. On the first day after surgery, 31 patients treated with silicone oil tamponade showed an improvement in visual acuity. With gas-air tamponade, visual acuity as light perception was obtained for 1 day; as the gas resorbed, objective vision appeared in all 8 cases. Six months after the surgery, a good anatomical result was achieved: no signs of subatrophy were detected in any of the presented patients. An unfavorable outcome (lacking or incorrect light perception) was observed in 4 cases (9.75%), a relatively favorable functional outcome in the form of objective vision less than 0.1, in 17 cases (41.5%), a favorable outcome with visual acuity above 0.15 in 20 cases (49%). Signs of proliferative vitreoretinopathy were noted in 8 patients (19.5%), which in cases of severe penetrating wounds and contusions and a number of complicating factors is a good result as compared to the available literature statistics. Conclusion. Our study shows that in patients with total and subtotal hemophthalmos with penetrating eye wounds and severe contusions, primary vitrectomy should be performed at an early stage. After the surgery the patients receive a statistically significant increase in visual acuity, have a stable anatomical result and, in the long term, obtain a good functional result.

Keywords

• penetrating wounds of the sclera
• severe eye contusion
• early microsurgical treatment
• proliferative vitreoretinopathy
• vitrectomy