AMNIOTIC MEMBRANE COVERAGE COMBINED WITH EARLY VITRECTOMY IN THE MANAGEMENT OF PERFORATING GLOBE INJURIES: A NOVEL SURGICAL TECHNIQUE
Huan Xu, Liangliang Niu, Chunhui Jiang, Rui JiangPurpose:
This study aims to assess the effectiveness of a novel surgical approach that combines amniotic membrane (AM) coverage with early vitrectomy performed under low perfusion pressure for the treatment of perforating globe injuries. The objective is to mitigate the risk of proliferative vitreoretinopathy (PVR) and enhance patient outcomes.
Methods:
The study involved nineteen patients who presented with zone 3 exit wounds of globe injuries. The surgical procedures included the administration of rt-PA for hemorrhage clearance, pars plana vitrectomy, internal limiting membrane peeling or retinectomy depending on the presence of PVR, application of AM over the exit wound, and intraocular tamponade injection. The postoperative follow-up period extended over six months.
Results:
Anatomical success, defined as retinal reattachment, was achieved in 89.5% of cases, with a 100% rate of globe survival. The incidence of postoperative PVR was 10.5%. Best-corrected visual acuity improved in 89.47% of patients.
Conclusion:
The combination of AM coverage with early vitrectomy appears to reduce the risk of PVR, improve anatomical outcomes, and enhance visual acuity in cases of perforating globe injuries. This approach shows considerable promise for optimizing surgical outcomes.