Ocular endoscopy provides reliable prognosis, allows early intervention in ocular trauma patients

Ocular endoscopy yields significant vision improvement when used to manage ocular trauma and allows immediate prognostication, a recent study has found. This could lead to the early identification of patients with poor visual prognosis.

Researchers conducted a retrospective, consecutive, noncomparative case series of 58 eyes from 58 eligible patients (mean age 35.55±18.9 years, 82 percent men). Corneal oedema was the most common condition causing opaque media, while the most frequent indication for surgery was retinal detachment.

Endoscopic examination deemed 17 eyes to be inoperable due to closed funnel retinal detachment. Eleven eyes, on the other hand, were expected to have poor prognosis: five eyes had optic atrophy, three had necrotic retina, two with advanced disc cupping, and one with retinal ischaemia.

The remaining eyes (n=30) had fair prognosis, and after the surgery, 60 percent achieved a final vision of 20/400, as opposed to only 10 percent before the surgery (p=0.0001). In addition, 13.3 percent had a final vision of 20/40, compared with none in the preoperative period (p=0.03). Twenty-one of the eyes saw spontaneous clearance of corneal oedema.

“[T]his study proposes a definite role of endoscopic approach in cases with post-segment trauma and an opaque anterior media,” the researchers said. “The advantages of endoscopy in such cases include reliable prognostication, early intervention, preservation of resources by avoiding unnecessary extensive surgeries, and fair visual outcomes.

“[A] prospective study comparing endoscopic approach versus a conservative approach or a surgical approach using a temporary keratoprosthesis would help ascertain the advantages, or the absence of any, of endoscopy over the other two conventional approaches,” they added.