Primární pars plana vitrektomiev léčbě penetrujícího poranění okazasahujícího do sklivce s nitroočnímcizím tělískem

Primary Pars Plana Vitrectomy in the Treatment of Penetrating Eye InjuriesAffecting the Vitreous Body with an Intraocular Foreign Body

The method of choice in the treatment of penetrating eye injuries affecting thevitreous body with an intraocular foreign body is in the majority of patientsprimary pars plana vitrectomy with transvitreal extraction of the foreign body(FB). During the period from April 1999 till September 2000 the authors treatedthus at the Ophthalmological Clinic of the General Faculty Hospital and 1stMedical Faculty Charles University Prague 26 eyes of 26 young men with anaverage age of 34 years. The mean interval between the injury and primary PPVwas 8.5 days. The patients were followed up on average for 23.5 months. Theentrance of the penetrating injury was in 17 eyes in the cornea or limbus, in 9 eyesin the sclera. In two eyes posttraumatic endophthalmitis developed. The intraocularFB was 6 mm2 in size in 16 eyes and 6-20 mm2 in 10 eyes. In primary PPV weindicated in 14 eyes internal tamponade with gas or silicone oil. On account oflate retinal complications which developed as a result of proliferative vitreoretinopathywe indicated in eight eyes PPV reoperation.At the endof the investigation period in 3 eyes inoperable detachment of the retinadeveloped. As the main negative prognostic factor for final visual acuity theauthors evaluated a size of the FB greater than 6 mm2, other negative prognosticfactors are the scleral entrance injury, complications of the entrance injury (prolapse of the iris, vitreous body, haemophthalmus) and the development ofposttraumatic exogenous endophthalmitis.

Key words:
intraocular foreign body - pars plana vitrectomy