Primary Pars Plana Vitrectomy in the Treatment of Penetrating Eye Injuries
Affecting the Vitreous Body with an Intraocular Foreign Body
Valešová L., Dotřelová D., Hycl, J., Kalvodová B., Štěpánková J., Dvořák J., Janek M.
Oční klinika VFN a 1. LF UK, Praha, přednosta doc. MUDr. M. Filipec, CSc. |
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Summary:
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.
Key words:
intraocular foreign body - pars plana vitrectomy
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