Radical vitrectomy with silicone oil injection for severe traumatic endophthalmitis in paediatric patients

Session Details

Session Title: Free Paper Session 20: Vitreoretinal Surgery V

Session Date/Time: Sunday 10/09/2017 | 08:00-09:30

Paper Time: 08:06

Venue: Room 117

First Author: : A.Grover INDIA

Co Author(s): :    A. Sen   A. Khanna                          

Abstract Details

Purpose:

To determine the anatomical outcome of pars plana vitrectomy combined with silicone oil injection in paediatric patients presenting with severe endophthalmitis following open globe injury, and to analyse the associated factors.

Setting:

Department of Vitreo retina, Sadguru Netra Chikitsalaya in Chitrakoot, Satna, Madhya Pradesh, India

Methods:

A case series of 17 paediatric patients (aged 2-13 years, mean age 5.68 ± 3.24 years), who presented with severe endopthalmitis (severe vitritis with poor fundus glow and no view of the optic disc) following open globe injury, and underwent pars plana vitrectomy with silicone oil injection in the affected eye after primary repair of the corneoscleral tear. A thorough removal of the vitreous with shaving of the peripheral vitreous base was carried out. The patients with a minimum follow up of 6 months were included. The anatomical outcomes, as well as the associated complications were assessed.

Results:

The time of presentation following trauma varied from 1 to 15 days (mean duration 5.35 ± 4.47 days). The globe was preserved in all 17 eyes at the final follow up visit, with resolution of active infection. 5 of the 17 eyes underwent silicone oil removal with reinjection of silicone oil within 6 months of follow up. 11 of the 17 eyes had good media clarity with attached retina, while 2 eyes had a detached retina on the last follow up visit. 4 eyes had a hazy media with a pupillary membrane/occlusio pupillae. 3 eyes developed hypotony (IOP<6 mmHg), and band shaped keratopathy was found in 5 of the 17 eyes.

Conclusions:

Pars plana vitrectomy with silicone oil injection can be used as a primary treatment option in severe cases of post traumatic endophthalmitis in paediatric patients. Silicone oil injection allows control of infection and inflammation, and also preserves the shape of the eyeball in such cases with an otherwise poor prognosis.

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