Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To evaluate the effects of surgical treatment for severe ocular rupture with blood staining of cornea and non-light perception , and analyze the relative factors. Methods Seven severely rup tured eyes of 7 patients with blood staining of cornea and non-light perception underwent second-stage penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis. All injured eyes had blood staining of cornea, hemorrhage in anterior chamber and vitreous, and choroidal and retinal detachment before the second-stage surgery. The average interval of the two surgical stages was 18 days (12-21 days). The preoperative visual acuity was non-light percept ion in all injured eyes with the mean intraocular pressure of 3 mm Hg (1 mm Hg =0.133 kPa) (2-5 mm Hg).The mean follow-up period was 12 months (6-30 months). Results The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity of light perception to 0.06. The retina was attached in 5 eyes (5/7). The mean postoperative intraocular pressure was 12 mm Hg(5-15 mm Hg)which was significantly higher than the preoperative one (Plt;0.05). Postoperative complications mainly included temporary intraocular hypertension (1 eye), corneal neovasculariza tion (4 eyes), cornea rejection (4 eyes), and ocular atrophy (2 eyes). Conclusion Penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis is a safe and effective method in treating severe ocular rupture with blood staining of cornea and non-light perception. (Chin J Ocul Fundus Dis，2004，20：212-214)
Objective To evaluate the influence factor of the prognosis of traumatic subretinal hemorrhage after vitreoretinal surgery. Methods The clinical data of 50 patients with traumatic subretinal hemorrhage who had undergone vitreoretinal surgery were retrospectively analyzed.All patients had ocular traumatic history and subretinal hemorrhage diagnosed by fundus and B-scan examination;the preoperative visual acuity was less than 0.1. According to different conditions, the traumatic eyes were treated with vitreo-retinal surgery, combined with lensectomy, retinotomy or silicone oil tamponade, respectively. The period of follow-up after surgery was 2-53 months, and the average period was 7.27 months. The corrected visual acuity and retinal reattachment at the last follow-up were observed. The visual acuity ge;0.1 was the standard of good prognosis; retinal reattachment was observed by indirect ophthalmoscope and color fundus photography.The prognostic factors mainly included type of injury,open or closed injury,the disease course, preoperative visual acuity, retinal detachment,hemorrhagic choroidal detachment,vitreous hemorrhage,the sites of submacular hemorrhage,methods of surgery.The relationships between those prognostic factors and visual acuity outcome or retinal reattachment were analyzed by chi;2test and logistic regression analysis. Results About 46.0% patients had good prognosis of the visualacuity. In the eyes with preoperative visual acuity of no light perception to hand moving and finger counting to 0.1, the rate of good visual acuitywas 34.2% and 83.3%, respectively; the difference between the two groups was significant (chi;2=8.860,P=0.003). In the eyes with or without preoperative retinal detachment,the rate of good visual acuity was 37.5% and 80.0%, respectively; the difference between the two groups was significant (chi;2=4.232,P=0.040). In the eyes with subretinal hemorrhage involving the macular fovea or not, the rate of good visual acuity was 34.4% and 66.7%,respectively; the difference between the two groups was significant (chi;2=4.836,P=0.028).All the other prognostic factors had no obvious effect on the retinal reattachment after the surgery. Conclusion Preoperative visual acuity、retinal detachment and submacular retinal hemorrhage were the important influence factors associated with prognostic visual acuity of eyes with traumatic subretinal hemorrhage after vitreoretinal surgery.
Objective To evaluate the clinical application value of ocular fundus photochromy and optical coherence tomography (OCT) in epimacular membrane of traumatic eyes following vitreorential surgery. Methods Ocular fundus photochromy and OCT were used to observe the morphological changes of macula in 139 consecutive patients with unilateral ocular trauma after vitreoretinal surgery between July 2003 and September 2004. Results At the 1st, 2nd, 3rd, 6th, and 12th month postoperatively, epimacular membranes were found in 5, 8, 17, 19, 20 patients, respectively by using photochromy; and in 7, 10, 20, 26, 27 patients, respectively by using OCT. There was no significant difference in epimacular membrane between photochromy and OCT(chi;2＝0.173，Pgt;0.05). The results of OCT showed that epimacular membranes completely adhered to the macular region in 8 patients（29.63%）, and retinal neurosensory layer swelled in 12 patients（44.44%）with the fovea thickness of (290.18plusmn;288.05) mu;m. Conclusion Ocular fundus photochromy and OCT are helpful in observing and discovering the epimacular membrane after virtreoretinal surgery of the patients with traumatic retinal detachment during the early and long-term follow-up period; and OCT can provide important information of the structue and position of these epimacular membranes hence to conduct to appropriate treatment. (Chin J Ocul Fundus Dis, 2006, 22: 236-238)
Objective To study the effects of neonatol rabbit Schwann cells(SC) on repair of optic contusion in adult rabbits. Methods 24 h after the adult rabbit optic nerves was contused,0.1 ml of SC suspension (group A) and saline water (group B) were injected into the vitreous of injured eyes respectively.All the animals were studied by retinal ganglion cell (RGC) and axon counting,flash visual evoked potential (FVEP) tests at various intervals after injury. Results At the 4th week after injury,the number of RGC was (19.89plusmn;3.79)/mm in group A and (12.67plusmn;4.12)/mm in group B,and the density of axons was (94.569plusmn;793)/mm2 in group A and (36.085plusmn;285)/mm2 in group B.There was dramatical difference between group A and B (Plt;0.01).The amplitude of FVEP wave of group A increased from 48% to 88% on the 3rd day after injury,and still dept 78% at the 8th week and group A was significantly higher than group B at various intervals (Plt;0.01). Conclusion SC are effective in promoting the repair of optic nerve contusion by increasing the survival rate of RGC,rescuing axons from degeneration,and dramatically promoting the function of the optic nerve. (Chin J Ocul Fundus Dis,2000,16:91-93)
Purpose To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion. Conclusion ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment. (Chin J Ocul Fundus Dis, 2001,17:122-124)