Improvements in ocular microsurgery and a new understanding in the intraocular posttraumatic development induced by an injury, new surgical concepts have been developed to reach a much better functional rehabilitation than a few years ago could be imagined (tertiary prevention).
From the mechanism of wound healing the strategical approach of early vitrectomy for severe ocular trauma is derived.
Effectiveness / Safety:
The effectiveness of this concept has been proven in retrospective and prospective studies.
Take home message:
New strategies in trauma surgery help to improve the outcome of severe ocular trauma (tertiary prevention). However, as 90% of ocular trauma is avoidable, primary and secondary prevention is at least as effective. Safer working conditions contributed to a decrease of the percentage of work related injuries from 70% to less than 30% of ocular injuries (primary prevention). Also, the safety of the environment in cars has been improved to avoid the formerly common windshield injuries (primary prevention). When it is not possible to improve the setting, the person at risk should be advised to wear eye protection as in sports or to prevent war injuries (secondary prevention).