Clinical Outcomes Of Early Vitrectomy In Severe Open Globe Injuries

Open globe injuries(OGIs)is an important public health problem,which has adverse consequences for both in the individual and in society.OGIs is a kind of ocular trauma which is destroyed by the continuity of the eyeball wall,which have the characteristics of diversity,individual difference,poorer prognosis and intractable treatment.According to the different types of trauma the treatments and means are not the same.According to the Ocular Trauma Classification Group system,the main contents of this study were to explore the timing of vitrectomy for severe open globe injuries.This topic proposed inclusion of severe open ocular trauma patients,which is exclusion of IOFB and endophthalmitis,through prospective cohort study the different time of vitrectomy to determine the safety of emergency vitrectomy in 48 hours.By retrospective analysis to explore the clinical outcomes of early vitrectomy in intraocular foreign bodies(c),evaluate its safety and effectiveness.Purpose: To observe the outcome of the two types of OGIs.Determined the safety and prognosis about different time of vitrectomy for the different types of OGIs.Methods: This research is divided into two parts,the first part:severe OGIs patients were inclued,which is exclusion of IOFB and endophthalmitis,treated with vitrectomy in different time(in 48 hours versus 7-28 d).Evaluate the clinical effect and safety between the two groups.The second part:To observe the different vitrectomy of OGIs,evaluate difference prognosis of two kinds of vitrectomy time,in order to guide the basis of operation time for ocular trauma.Results: the first part:(1)Research results shows:compared emergency vitrectomy in 48 hours with 7~28d after ocular trauma was not statistically significant in the preoperative injury,intraoperative retinal incision,failed surgery,disposable retinal reattachment ratet,TPVR,eyeball preservation rate,visual acuity,intraocular pressure.(2)Because of the small number of cases,the patients with severe ocular trauma exclusion of IOFB and endophthalmitis,the safety of the patients undergoing vitrectomy in 48 hours is not clear.The second part:(1)Increase the risk of endophthalmitis if delayed the time of vitrectomy in patients with IOFB.The incidence of endophthalmitis about the vitrectomy in 24~48 hours was significantly higher than that in 24 hours.(2)Early vitrectomy is an safety and effective means for IOFB.Conclusions: In order to prevent the occurrence of endophthalmitis in patients with IOFB,should be performed vitrectomy as early as possible.Due to the inclusion fewer cases of the severe ocular trauma,which was exclusion of IOFB and endophthalmitis.So the safety of emergency vitrectomy in 48 hours remains to be studied.