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Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points
BACKGROUND: The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less c...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310478/ https://www.ncbi.nlm.nih.gov/pubmed/35879788 http://dx.doi.org/10.1186/s40942-022-00399-9 |
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author | Chauhan, Muhammad Z. Georgiou, Michalis Al-Hindi, Hytham Uwaydat, Sami H. |
author_facet | Chauhan, Muhammad Z. Georgiou, Michalis Al-Hindi, Hytham Uwaydat, Sami H. |
author_sort | Chauhan, Muhammad Z. |
collection | PubMed |
description | BACKGROUND: The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less challenging as there is a lower risk of bleeding and posterior vitreous detachment induction is easier. The purpose of this work is to report the functional and anatomical outcomes following ocular traumatic injuries in a United States-based cohort, emphasizing the time of intervention. METHODS: This was a retrospective case series of 110 patients with traumatic ocular injuries who underwent PPV between 2008 to 2020. Patients were grouped into four timing categories: same day (0 days), early (1–7 days), delayed (8–14 days), and late (> 14 days). Multivariable regression models controlling for confounding were implemented to assess the impact of vitrectomy timing on anatomical and functional outcomes. Visual acuity (VA) at baseline and after surgery, proliferative vitreoretinopathy (PVR), and enucleation for each vitrectomy timing category were recorded. RESULTS: Patient demographics and severity of ocular trauma were comparable across timing categories. Final VA in LogMAR was found to have a stepwise worsening as the time of ocular trauma to vitrectomy was increased (p < 0.05). For every one-step increase in the vitrectomy timing category, there was an adjusted 0.24 (CI 0.04–0.44) increase in final VA. No patient in the same day vitrectomy group had an enucleation or PVR, while patients who had late vitrectomies had the largest number of both enucleations and PVR (44.4% and 52.0%, respectively). In adjusted analysis, there was 3.11 increased odds (CI 1.03–9.42) of developing PVR for a one-step increase in vitrectomy timing (p < 0.05). CONCLUSION: Vitrectomy on the same day of injury has the best final VA, and the lowest incidence rates of PVR and enucleation in comparison to other timing categories, regardless of etiology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-022-00399-9. |
format | Online Article Text |
id | pubmed-9310478 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-93104782022-07-26 Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points Chauhan, Muhammad Z. Georgiou, Michalis Al-Hindi, Hytham Uwaydat, Sami H. Int J Retina Vitreous Original Article BACKGROUND: The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less challenging as there is a lower risk of bleeding and posterior vitreous detachment induction is easier. The purpose of this work is to report the functional and anatomical outcomes following ocular traumatic injuries in a United States-based cohort, emphasizing the time of intervention. METHODS: This was a retrospective case series of 110 patients with traumatic ocular injuries who underwent PPV between 2008 to 2020. Patients were grouped into four timing categories: same day (0 days), early (1–7 days), delayed (8–14 days), and late (> 14 days). Multivariable regression models controlling for confounding were implemented to assess the impact of vitrectomy timing on anatomical and functional outcomes. Visual acuity (VA) at baseline and after surgery, proliferative vitreoretinopathy (PVR), and enucleation for each vitrectomy timing category were recorded. RESULTS: Patient demographics and severity of ocular trauma were comparable across timing categories. Final VA in LogMAR was found to have a stepwise worsening as the time of ocular trauma to vitrectomy was increased (p < 0.05). For every one-step increase in the vitrectomy timing category, there was an adjusted 0.24 (CI 0.04–0.44) increase in final VA. No patient in the same day vitrectomy group had an enucleation or PVR, while patients who had late vitrectomies had the largest number of both enucleations and PVR (44.4% and 52.0%, respectively). In adjusted analysis, there was 3.11 increased odds (CI 1.03–9.42) of developing PVR for a one-step increase in vitrectomy timing (p < 0.05). CONCLUSION: Vitrectomy on the same day of injury has the best final VA, and the lowest incidence rates of PVR and enucleation in comparison to other timing categories, regardless of etiology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-022-00399-9. BioMed Central 2022-07-25 /pmc/articles/PMC9310478/ /pubmed/35879788 http://dx.doi.org/10.1186/s40942-022-00399-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Article Chauhan, Muhammad Z. Georgiou, Michalis Al-Hindi, Hytham Uwaydat, Sami H. Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title | Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title_full | Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title_fullStr | Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title_full_unstemmed | Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title_short | Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
title_sort | outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310478/ https://www.ncbi.nlm.nih.gov/pubmed/35879788 http://dx.doi.org/10.1186/s40942-022-00399-9 |
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