Department of Ophthalmology, Ataturk State Hospital, Antalya, Turkey.
Department of Ophthalmology, Gulhane Training and Research Hospital, Ankara, Turkey.
Eye (Lond). 2021 Jul;35(7):2008-2015. doi: 10.1038/s41433-020-01204-3. Epub 2020 Oct 6.
The objective of this study is to evaluate the effect of vitrectomy timing on anatomical and functional outcomes in cases with open-globe injuries caused by improvised explosive devices (IEDs).
A retrospective review of ocular injuries caused by IEDs was undertaken. The eyes were classified into four groups based on the timing of vitrectomy: early (Group-1; 2-4 days), delayed (Group-2; 5-7 days), late (Group-3; 8-14 days) and very late (Group-4; >14 days).
The medical records of 351 patients were reviewed, and 212 patients were excluded. A total of 189 eyes of the remaining 139 patients were analysed. Visual improvements were statistically significant compared to the baseline values in all groups (p < 0.001). The early group showed better functional and structural outcomes when compared to the other groups. There was also no proliferative vitreoretinopathy (PVR) in the early group, while PVR was at the highest rate (25%) in the very late group and constituted the most significant reason for recurrent retinal detachment.
Both functional and anatomical outcomes were better in the early group. Delayed surgery may be indicated for some cases, but 1-week interval seems to be an optimal time-frame in open globe injuries due to IEDs.
本研究旨在评估爆炸装置（IED）致开放性眼球损伤患者行玻璃体切除术时机对解剖和功能结局的影响。
对因 IED 致眼外伤的病例进行回顾性研究。根据玻璃体切除术时机将眼分为 4 组：早期（第 1 组，2-4 天）、延迟（第 2 组，5-7 天）、晚期（第 3 组，8-14 天）和极晚期（第 4 组，>14 天）。
共分析了 139 例患者的 189 只眼，这些患者的病历均被回顾，其中 212 例被排除。与基线值相比，所有组的视力改善均具有统计学意义（p<0.001）。与其他组相比，早期组的功能和结构结局更好。早期组无增生性玻璃体视网膜病变（PVR），而极晚期组的 PVR 发生率最高（25%），是复发性视网膜脱离的最主要原因。
早期手术组的功能和解剖结局均更好。对于某些病例可能需要延迟手术，但对于因 IED 所致开放性眼球损伤，1 周的间隔似乎是最佳的时间框架。
