Observation Without Vitrectomy in Penetrating Open-Globe Injury With Retinal Strike Sites in Young Patients

The aim of this study was to describe outcomes of non-operative management of retinal strike sites in penetrating open-globe injury with formed vitreous. A retrospective series of patients with open-globe injuries with retinal strike sites and without retained foreign body. Primary repair and follow-up were conducted at Mass Eye and Ear with examination, fundus photographs, and B-scan ultrasonography as indicated by the clinical course. Patients did not undergo secondary vitrectomy for management of retinal strike sites. A total of three cases were included. Two patients were managed by observation; one received laser retinopexy. Retinal detachment did not develop in any patient with follow-ups of 2 years, 3 years, and 18 months, respectively. Two patients, one of whom received laser retinopexy, developed mild, non-progressive vitreous traction adjacent to the strike site. Two patients achieved final visual acuity of 20/20; one patient had final visual acuity of 20/40 due to corneal astigmatism. All patients were younger than 25 years of age and did not have posterior vitreous detachment (PVD) through at least 18 months follow-up. In three cases of penetrating injury into vitreous with a retinal strike site, young patients without a PVD maintained good anatomic and visual outcomes without vitrectomy. Future work should evaluate how age and vitreous status might influence indications for vitrectomy.