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F. Kuhn, V. Mester, R. Morris; A Proactive Treatment Approach for Eyes With Perforating, Rupture, or Deep–impact Intraocular Foreign Body Injury . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5469.
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Purpose: Perforating/rupture and deep impact intraocular foreign body (PE–RU–IO) injuries continue to have a poor prognosis with most eyes losing useful vision, due to proliferation originating from the exit wound or the development of retinal folds. Methods: We designed a new, proactive treatment method, which is applicable in most eyes with PE–RU–IO trauma. The strategy involves limited, indirect ophthalmoscopic vitrectomy during the primary repair; heavy topical corticosteroid therapy postoperatively; and complete vitrectomy within 4 days, including prophylactic retinectomy around the exit wound, evacuation of subretinal blood, laser retinopexy, and silicone oil implantation. Results: In the six consecutive eyes in which the proactive treatment approach was used, no incarceration of the retina into the exit wound, proliferative vitreoretinopathy, retinal detachment, or retinal folding has occurred. The median visual acuity improved from count fingers to 1.0 in the four eyes without macular involvement. Conclusions: Far–reaching conclusions must not be made based on this limited series, but the proactive treatment approach appears promising in preventing proliferation–related complications such as tractional retinal detachment or retinal fold development. A large prospective clinical trial is being started to analyze the results of the new treatment approach for all PE–RU–IO injuries.
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