Interval of injury, vitrectomy a risk factor for proliferative vitreoretinopathy

Due to the inherent variation of traumatic injuries, statistical analysis of large cohorts is valuable only to a point. It is difficult to extrapolate relevant data from such studies when evaluating an individual case in the clinical setting. That being said, this is a well-organized and well-written paper. The majority of the findings reinforce what we already know about PVR in the setting of trauma. First, it is bad and leads to poor visual outcomes. Second, it tends to occur in more severe injuries such as those with corneal-scleral rupture, those with vitreous hemorrhage and those with significant retinal detachment. Lastly, it tends to form more frequently and aggressively in younger patients. The most interesting finding in the study is the drastic increase in rates of PVR development with an increasing “interval of injury and vitrectomy.” This finding reinforces that attention to the timing of vitrectomy following primary repair is essential. Most interestingly, patients who were taken for vitrectomy less than 14 days from the time of their injury were 18.19 times less likely to develop PVR. Retinal surgeons often feel that it is best to wait at least 2 weeks for a posterior vitreous detachment to occur before performing a vitrectomy in the setting of trauma. This study forces us to question that practice.