Characteristics, Mechanism and Surgical Outcomes of Funnel Shaped Retinal Detachment with Traumatic Vitreous Loss in Open Globe Injury.

Abstract

Purpose: To investigate the characteristics and mechanisms of funnel-shaped retinal detachment (FS-RD) with vitreous loss in open-globe injury (OGI) and assess the surgical outcomes after vitrectomy.

Methods: A total of 1026 patients with OGI were prospectively enrolled, of whom 37 eyes with diagnosed with FS-RD. Data were collected before and after vitrectomy. The characteristics and mechanisms of FS-RD were described, and one-year outcomes of the eyes were evaluated, including retinal reattachment rate, best corrected visual acuity (BCVA, in LogMAR), proportion of light perception (LP) recovery, and intraocular pressure (IOP). Group and subgroup comparisons were conducted using the chi-square test, paired t-test, or Wilcoxon signed-rank test according to data distribution, and a two-sided P < 0.05 was considered statistically significant.

Results: FS-RD occurred early after the injury, with 81.8% having wounds >10mm and 73% in zone II. All eyes had vitreous loss and 91.9% with total loss. Proliferative vitreoretinopathy (PVR) occurred in 32.4% eyes. Retinal reattachment was achieved in all eyes, while 86.5% of patients remained dependent on silicone oil. BCVA improved from 3.41 ± 0.66 preoperatively to 2.48 ± 0.86 at final follow-up (P < 0.05). NLP decreased from 54.1% preoperatively to 18.9%. IOP increased from 6.4 ± 3.9 mmHg preoperatively to 9.3 ± 3.6 mmHg.

Conclusions: FS-RD with traumatic vitreous loss in OGI differs from traditional FS-RD in eyes with chronic RD. A large anterior wound causing total or subtotal vitreous loss is the most prominent feature and the prerequisite of FS-RD. Anatomical and functional outcomes in this cohort were relatively good, however, larger multicenter studies are warranted to confirm these findings and their generalizability.