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Kristen Harris Nwanyanwu, Rashmi Kapur, Harit Bhatt, Norman P Blair, Jennifer I Lim; Impact of surgical technique on outcomes in vitreoretinal surgery after open globe repair. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3833.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the impact of different vitreoretinal surgical techniques on visual outcomes in vitreoretinal surgery after open globe injury.
A retrospective chart review of patients who underwent repair of open globe injury and subsequent vitreoretinal surgery at the Illinois Eye and Ear Infirmary from 1998-2008 was performed. Means and standard deviation were used to characterize continuous variables. Categorical data was described using frequencies and percentages. Fisher’s exact test was used to compare frequencies and student’s t-test was used to compare means.
Among the 315 open globe repairs, 77(24.4%) also underwent vitreoretinal surgery. Patients were followed for an average (SD) 2.2 (2.6) years. The average age (SD) of the patients was 39.6 (16.6) years old. Twenty-two percent of the population was female, 32.5% were Black, and 35.1% were Latino. Patients underwent vitreoretinal surgery an average (SD) of 36 (43) days following open globe repair. LogMAR visual acuity improved from 2.26 to 1.75 (p<0.10) following repair with a statistically significant increase in the number of patients with better than light perception vision after the procedures (45% vs. 77%, p<0.0004). Better final visual acuity correlated with a higher presenting ocular trauma score (r -0.406, p<0.0013). The most common indication for vitreoretinal surgery was retinal detachment (62%), which was followed by vitreous hemorrhage (48%), and intraocular foreign body (12%). Pars plana vitrectomy was the most common surgical technique (98.7%), while 42.9% underwent scleral buckle, 42.9% underwent lensectomy, 50.6% underwent silicone oil placement, and 15.6% underwent retinectomy. Patients demonstrated better visual acuity when vitreoretinal surgery was performed without retinectomy (logMAR 1.71 vs. 2.74, p<0.0004). Other surgical procedures did not demonstrate statistically significant difference in visual acuity outcomes.
Visual outcomes improved beyond light perception after open globe injury with subsequent vitreoretinal surgery. While visual acuity was better when retinectomy was not employed, the use of scleral buckle, lensectomy, and silicone oil did not impact visual outcomes.
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