Preventive scleral buckling and silicone oil tamponade are important for posttraumatic endophthalmitis successfully managed with vitrectomy.

摘要

AIMS: Posttraumatic endophthalmitis (PTE) managed with pars plana vitrectomy (PPV) and a variety of other methods often resulted in retinal detachment (RD), which deteriorates postoperative visual acuity (VA). We investigated initial ocular conditions, surgical management and outcomes of PTE patients and analyzed their relationship in order to find the necessary management for different patients' conditions. METHODS: Retrospective study. Medical records of 62 consecutive patients who were diagnosed with PTE and managed with PPV were retrospectively analyzed. The included patients were divided into two groups depending on their initial VA, with light perception (LP) as borderline: group A (12 cases; VA=LP) and group B (50 cases; VA>LP). Specific variables related to surgical outcomes were analyzed, including: initial VA; intraocular foreign body; location and length of the wound; microbiologic test; cataract extraction; scleral buckling; silicon oil tamponade; gas tamponade, and retinal restoration. Data were statistically analyzed by the chi2 test, by univariate analysis for predictors and by multivariate logistic regression analysis. RESULTS: RD happened in 19 (30.6%) of the 62 cases included. There were 6 cases (50%) in group A and 13 cases (26%) in group B which resulted in RD. Statistical analysis demonstrated that none of the related factors were correlated to the occurrence of RD (all factors: p>0.05) in group A, but in group B, scleral buckling (with: 2/22, 9%; without: 11/28, 39%; p<0.05) and silicone oil tamponade (with: 0/6; without: 13/44, 30%; p<0.05) were statistically significantly correlated to the occurrence of RD. CONCLUSIONS: Preventive scleral buckling and silicone oil tamponade are important for patients with good initial VA (VA>LP) to be successfully managed by PPV.