EVALUATING CLINICAL OUTCOMES OF AMNIOTIC MEMBRANE COVERAGE COMBINED WITH EARLY VITRECTOMY IN THE MANAGEMENT OF PERFORATING GLOBE INJURIES.

Abstract

To evaluate the anatomical and functional outcomes of a surgical approach combining amniotic membrane (AM) coverage with early vitrectomy under low perfusion pressure in patients with perforating globe injuries. 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. 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. The combination of AM coverage with early vitrectomy in the management of perforating globe injuries was associated with favorable anatomical outcomes, a low rate of postoperative PVR, and visual improvement in most patients. This approach represents a viable strategy for addressing the complex challenges in these severe ocular injuries.