Association of early vitrectomy with improved outcomes in open globe injuries: a systematic review and meta-analysis

To compare the efficacy and safety of early (≤ 7 days) versus delayed (> 7 days) vitrectomy for open globe injury (OGI). We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, CNKI, and Wanfang Database until Dec 30, 2025. Two reviewers independently selected studies, extracted data, and assessed bias. Meta-analysis used RevMan 5.3 and Stata 18, with RR, OR, and MD as effect measures. Twelve studies (10 cohorts, 2 RCTs) were included. Early vitrectomy was associated with a significantly higher surgical success rate (RR = 1.24, 95% CI:1.12–1.37, P < 0.0001) and greater visual acuity improvement (MD=-0.44, 95% CI:-0.72 to -0.15, P = 0.002) compared to delayed surgery. The odds of marked visual improvement were 2.30-fold and 7.82-fold higher with early surgery using five-tier and six-tier criteria, respectively. Early surgery also significantly reduced risks of PVR (RR = 0.24), recurrent vitreous hemorrhage (RR = 0.35), recurrent retinal detachment (RR = 0.43), secondary glaucoma (RR = 0.25), and silicone oil-dependency (RR = 0.23) (all P < 0.01). In this meta-analysis of predominantly observational studies, vitrectomy within 7 days of OGI was associated with superior surgical success, better visual outcomes, and lower complication risks compared to delayed intervention. These findings should be interpreted as associations rather than causal effects, and further high-quality RCTs are needed to confirm these results.