Surgery of eye injuries in an eight-year period

Background. Eye injuries constitute a leading problem in eye surgery worldwide, as well as at our department. Their treatment is very complex, and requires a wide surgical knowledge and surgical skills supported by the material and the equipment. Aim. To analyze the results of vitreoretinal surgery on 647 patients with severe penetrating eye injuries in the period from 1991 to 1998. Methods. The study included a retrospective analysis of the treatment of 647 injuries, out of which 500 were penetrating, and 147 were severe contusion injuries. Attention was payed to the penetrating injuries with intraocular foreign body (IOFB), to the number of the performed pars plana vitrectomies (VPP), to the number of the extirpated foreign bodies, as well as to the number of the conventional retinal ablation surgeries. Also significant proved the consequences of contusion injuries, and the method of their complete surgical management - the surgery combined with the implantation of intraocular lens, as well as their functional results. Results. Inside the said period, 558 VPPs were performed, 60 conventional retinal ablation surgeries, and 29 combined anterior/posterior segment surgeries. VPP was applied in 286 (51.3%) of the cases with penetrating injuries with IOFB, and in 58 (10.4%) of the cases with contusion injuries. VPP in one eye was applied in 464 (83%) of the cases, in both eyes in 65 (11.8%) of the cases, and in a single eye in 29 (5.2%) of the cases. Following VPP, silicone oil tamponade was done in 352 (63%) of the cases, air tamponade in 123 (22%) of the cases, and Ringer-BSS tamponade in 83 (15%) of the cases. Laser photocoagulation (LFC) was performed in 484 (87%) of the cases, cryocoagulation in 45 (8%), while neither of them was done in 29 (5%) of the cases. In all of the cases of the conventional retinal ablation (n = 60), a placement of a serclage was applied and exocryocoagulation was performed, while in the 52 cases a placement of a scleral flap was applied. Combined surgery - lensectomy, VPP, and an anterior chamber intraocular lens (AC IOL), was applied in 16 of the cases, and phacoemulsification, VPP and a posterior chamber intraocular lens (PC IOL) in 13 of the cases. Conclusion. Vitrectomy was the most frequently applied surgery in solving the complex eye injuries. The eye injuries treated in our department were with the IOFB, and the retinal ablation. The IOFBs in our patients were almost completely extirpated. The applied combined anterior/posterior segment surgeries had the potential to safely and successfully condense those separate procedures in one surgery. A relatively high incidence of endophthalmitis was recorded in the injuries treated in our department.