Vitrectomy in ocular trauma. Factors influencing final visual outcome.

The results of vitrectomy in 240 consecutive cases of ocular trauma were reviewed. Of these cases, 71.2% were war injuries. Intraocular foreign bodies were present in 155 eyes, of which 74.8% were metallic and 61.9% ferromagnetic. Multivariate analysis identified the prognostic factors predictive of poor visual outcome, which included: (1) presence of an afferent pupillary defect; (2) double perforating injuries; and (3) presence of intraocular foreign bodies. Association of vitreous hemorrhage with intraocular foreign bodies was predictive of a poor prognosis. Eyes with foreign bodies retained in the anterior segment and vitreous had a better prognosis than those with foreign bodies embedded in the retina. Timing of vitrectomy and type of trauma had no significant effect on the final visual results. Prophylactic scleral buckling reduced the incidence of retinal detachment after surgery. Injuries confined to the cornea had a better prognosis than scleral injuries.