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Visual outcomes and prognostic factors of early pars plana vitrectomy for open globe injury

Eye (2023)Cite this article

Subjects

Abstract

Objectives

To identify the clinical features and outcomes of early vitrectomy in patients with open globe injury (OGI) and the prognostic factors for visual outcome.

Methods

This retrospective observational case series included 390 eyes in 389 patients diagnosed with OGI receiving vitrectomy within four days after injury. Preoperative parameters included the injury types, wound locations, consequent tissue damages, initial visual acuity (VA), and ocular trauma score. Postoperative outcome measures included surgical procedures, retinal (re)attachment, complications, and final VA. The logistic analysis evaluated the prognostic factors for visual outcome.

Results

Intraocular foreign bodies (59.2%) and penetrating injuries (28.7%) were the most common injury types. Among the 165 eyes with retinal detachment (RD), 121 (73.3%) had retinal reattachment during early primary vitrectomy, and 32 (19.4%) were repaired during a second or subsequent surgery. Thirteen eyes (3.3%) were enucleated. The final VA improved from the initial level in 207 eyes (55.2%), remained unchanged in 123 (32.8%), and decreased in 45 (12.0%). Multivariable regression revealed that the injury zone, initial VA, RD, and endophthalmitis were associated with poor visual outcomes (P < 0.05).

Conclusions

Higher zone injury, low initial VA, RD, and endophthalmitis are predictors of poor visual outcome in eyes undergoing early vitrectomy for OGI.

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Fig. 1: Examinations of a patient with open globe injury before and after vitrectomy.

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Data availability

Data will be made available upon request.

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Funding

This research was supported by the top military medical science and technology youth training project (20QNPY027). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author information

Author notes

  1. These authors contributed equally: Yan He, Huanyu Tang.

  2. These authors jointly supervised this work: Hua Yan, Yong Liu.

Authors and Affiliations

  1. Southwest Hospital, Army Medical University, Chongqing, 400038, China

    Yan He, Huanyu Tang, Nan Wu, Peng Gu & Yong Liu

  2. Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China

    Yan He, Huanyu Tang, Nan Wu, Peng Gu & Yong Liu

  3. Helen Keller Foundation for Research and Education, Birmingham, AL, USA

    Ferenc Kuhn

  4. Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary

    Ferenc Kuhn

  5. Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China

    Hua Yan

  6. Medical School of Nankai University, Tianjin, China

    Hua Yan

Authors
  1. Yan He
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Contributions

HY and YL was responsible for conducting the research, designing the study; YH and HT contributed to analysing and interpreting the data, and editing and critical revision of the manuscript; NW and PG was responsible for following up with the patients and collecting the data; FK contributed in critical revision of the manuscript.

Corresponding author

Correspondence to Yong Liu.

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He, Y., Tang, H., Wu, N. et al. Visual outcomes and prognostic factors of early pars plana vitrectomy for open globe injury. Eye (2023). https://doi.org/10.1038/s41433-023-02903-3

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  • DOI: https://doi.org/10.1038/s41433-023-02903-3

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