We demonstrate 35 cases of retinal detachment in which the patients received treatment with xenogeneie (poreine)sclera as pressor material. All the patients improved with retinal replacement after initial operation. There are 5 relapsing cases in which 4 patients were reoperated and the retinas were reattaehed in 2 cases. So far the total curative percentage was 91.4 in this series. After a period of three year follow-up ,none of the patient showed apparent postoperative complication of rejection reaction,discharge,exposure and infection. These findings suggest that porcine sclera has excellent characteristic,similar to human sclera ,and may be used in ophtha[mologic surgery as a substitute of homologous(human)sclera. （Chin J Ocul Fundus Dis,1994,10:207-209）
Objective To evaluate the curative effects of vitreoctomy or simple scleral buckling on retinal multiple-tear detachment associated with tracted anterior flap. Methods The clinical data of 89 eyes in 89 patients with retinal multiple-tear detachment associated with tracted anterior flap diagnosed in Jan, 1999-Jan, 2002 were retrospectively analyzed. In the 89 patients, 41 had undergone vitreoctomy and 48 had undergone scleral buckling without vitrectomy. In the duration of 2- to 36-month follow-up with the mean of (11.02±7.90) months, visual acuity, retinal reattached rate and postoperative complication were examined and the results in the 2 groups were compared. Results In 41 eyes underwent vitreocotmy, successful reattachment was found in 38 (92.7% ); visual acuity increased in 33 (80.5%), didn′t change in 6 (14.6%), and decreased in 2 (4.9%); leakage of flocculent membrane in anterior chamber occured was found in 2 (4.9%), complicated cataract in 3 (7.3%),and severe proliferative vitreoretinopathy (PVR) in 3 (7.3%). In 48 eyes underwent scleral buckling, 41 (85.4%) had success reattachment; visual acuity increased in 36 (75.0%), didn′t change in 4 (8.3%), and decreased in 8 (16.7%); leakage of flocculent membrane in anterior chamber was found in 6 (12.5%), complicated cataract in 9 (18.8 %), and severe PVR in 8 (16.7%). Conclusion There isn′t any difference of the success rate of the surgery between vitrectomy and scleral buckling for retinal multiple-tear detachment associated with tracted anterior flap.The better visual acuity and less complications are found in the vitrectomy gro up than those in the scleral buckling group. (Chin J Ocul Fundus Dis，2004，20：209-211)
Objective To observe the hemodynamic changes in the retina and choroid after scleral buckling surgery in eyes with rhegmatogenous retinal detachment (RRD). MethodsA prospective clinical observational study. A total of 25 eyes of 25 patients with RRD who underwent scleral buckling surgery in Tianjin Eye Hospital from February to April 2024 were included in the study. Among them, 10 were male and 15 were female. Age was 17-68 years old. All cases were monocular. The surgical eye and the contralateral healthy eye were divided into the affected eye group and the contralateral healthy eye group respectively. Best corrected visual acuity (BCVA), scanning source optical coherence tomography angiography (SS-OCTA), and axial length (AL) measurements were performed 3 months after surgery. SS-OCTA examination of macular area was performed by VG200 of Visual Microimaging (Henan) Technology Co., LTD. Scanning range 21 mm×26 mm. According to the partitioning method of the early treatment group of glycosuria retinopathy, the retina within 21 mm of the macular fovea was divided into concentric circles with the macular fovea as the center and diameters of 1-3, 3-6, 6-12, 12-21 mm, respectively. The built-in software of the device was used to record the central area (12 mm×12 mm in the fovea of the macula) and the peripheral area (12-21 mm range) retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillaries (RPC) blood density and choroidal vascular index (CVI), choroidal vascular volume (CVV), and 1-3, 3-6, 6-12, 12-21 mm above concentric circles (S), nasal side (N), temporal side (T), and lower side (I) SCP, DCP, and RPC blood flow density. Quantitative data between the two groups were compared by independent sample t test or Wilcoxon signed rank test. The correlation between retinal and choroid blood flow parameters and postoperative BCVA was analyzed by Spearman correlation analysis. ResultsCompared with the opposite healthy eye group, SCP blood density in the central area (Z=−4.372), DCP blood density in the central area (Z=−2.829), and CVI in the peripheral area (Z=−2.138) were decreased in the affected eye group, and the differences were statistically significant (P＜0.05). SCP: in the affected eye group, the blood flow density in T3-6 mm, T6-12 mm, N6-12 mm and T12-21 mm regions decreased, while the blood flow density in I6-12 mm regions increased, with statistical significance (P＜0.05). DCP: blood flow density in S6-12 mm, I6-12 mm, S12-21 mm and I12-21 mm regions decreased significantly, and the differences were statistically significant (P＜0.05). RPC: blood flow density decreased significantly in T6-12 mm and I12-21 mm, and the differences were statistically significant (P＜0.05). CVI: T6-12 mm, S12-21 mm, T12-21 mm, I12-21 mm significantly decreased, and T1-3 mm, S12-21 mm significantly increased, the differences were statistically significant (P＜0.05). Correlation analysis showed that AL growth was positively correlated with CVV in central region (r=0.408, P=0.040) . The number of pad pressure was negatively correlated with the blood density of central DCP (r=−0.422, P=0.030). ConclusionsAfter scleral buckling operation, the blood flow density and choroidal blood flow parameters in RRD affected eyes are lower than those in contralateral healthy eyes in some areas. The increase of AL is positively correlated with CVV in the central region, and the wider the range of pad pressure, the worse the recovery of DCP blood density.
Objectivｅ To investigate the histopathologic charact eristic of the vitreous herniation out of sclerotomy site during vitrectomy. Methods Twenty specimens of tissues herniated at vitrectomy site were collected. The paraffin sections or fresh smears were stained with hematoxylineosin and examined under light microscope. The specimens were collected from the affected eyes with rhegmatogenous retinal detachment (9 cases), traumatic retinal detachment (1 case), miscellaneous vitreous hemorrhage (6 cases) and intraocular foreign body (4 cases). Results The herniated tissues were found to be retina in 4 cases, ciliary tissue in 1 case, retina and ciliary tissue in 1 case, uvea in 1 case, and hyaloid tissue in 13 cases. Conclusion There were not only vitreous, ciliary epithelial cells and pigment containe depithelia, but also ciliary body, retina and uvea in the prolapsed tissues of sclerotomy site, which might be related to the occurence of some clinical complications. (Chin J Ocul Fundus Dis,2001,17:99-101)