Vitreous management in penetrating trauma: primary repair and secondary intervention

Ocular trauma involving the vitreous produces a very wide range of pathology, the treatment of which can confuse. In the past, the prognosis for vision following such injuries was poor. Modern closed intraocular surgical techniques have transformed the management of penetrating trauma and allowed salvage of vision in many previously hopeless cases. However, many controversies remain, including the timing of surgical intervention, the use of encircling buckles, and the type of internal tamponade. This article will discuss those controversies, and make some practical recommendations for the management of penetrating and perforating trauma involving the vitreous.