Objective To approach the clinical characters and therapeutic methods of retinal detachment(RD) after extracapsular catarat extraction(ECCE)with posterior chamber intraocular lens(PCIOL). Methods Sixty eight cases(68 eyes) of RD after ECCE with PCIOL were treated with sclerel buckling,microvitreo retinal surgery and intraocular gas,silicone oil injection and were reviewed. Results The retinas were totally reattached in 65 eyes(95.59%) which dropped to 94.12% in 6-60 months postoperatively.The resultant rate of visual acuity of the eyes with 0.1 or better was 79.41%,with 0.3 or better was 26.47%. Conclusion The main causes of RD after ECCE with PCIOL are similar to those of general RD,and most cases of RD after ECCE with PCIOL can be cured by surgical treatment. (Chin J Ocul Fundus Dis,1998,14:167-169)
Objective To evaluate the visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment (DTRD). Methods 102 eyes of 86 consecutive patients with DTRD underwent vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via indirect ophthalmoscope and B ultrasonic scan after mydriasis. Followup duration varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity (BCVA) and anatomic success were observed postoperatively. The patients were divided into visual acuity improved group and didn't improved group. Ttest, Chisquare test and Multivariate Logistic regression analysis were performed to predict the prognosis of visual acuity. Results After primary vitreoretinal surgery, 87 eyes (85.3%) were anatomically reattached, 15 eyes (14.71%) needed reoperation because of the recurrence of retinal detachment (RD). Postoperative BCVA improved and better than 0.05 in 49 eyes (48.04%), reduced or increased but less than 0.05 in 53 eyes (51.96%). Comparing natural factors between these two groups, only combined cataract surgery and optic nerve atrophy were significant different (chi;2=5.266,9.274;P=0.022,0.002). Among post-operative complications only the RD recurrence was significant different (chi;2=12.059，P=0.000). Multivariate Logistic regression revealed recurrence of RD and optic nerve atrophy were two independent risk factors in the final BCVA (P=0.003,0.041;OR=33.518、4.079). Preoperative PRP was identified as the only protecting variable in the final BCVA(P=0.034，OR=0.270).Conclusion This study revealed recurrence of RD and optic nerve atrophy were two independent risk factors in final BCVA of DTRD patients.
Objective To invesligate the treatment of retinal de tachment(RD) after silicone oil tamponades(SOT)． Methods The records of a consecutive series of 32 eyes with redetachment of retina after SOT surgery between 1998 to 2000 were reviewed retrospectively． The surgical techniques used for these cases included remove of silicon oil,peeling of preretinal membrane, retinotomy, endolaser photocoagutation, secondary vitrectomy and C3 F8 tamponades． Results In 28 of 32 eyes the retina was reattached (87．6%)． The postoperative visual acuity was improved in 12 eyes, redused in 4 eyes and remained no change in 16 eyes． The postop erative complications in 6 eyes included secondary glaucoma(3 eyes), hypotony (1 eye) and hyphema (2 eyes)． Conclusion The techniques of preretinal membrane peeling, retinotomy, endophotocoagulation and C3 F8 tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery． (Chin J Ocul Fundus Dis,2001,17:214-215)
Objective To discuss the treatment of retinal detachment(RD) after posterior chamber intraocular lents(PCIOL) implantation. Methods Twenty eyes with RD after PCIOL inplantation which were treated with vitrectomy combined with scleral buckling and intraocular tamponade from March 1993 to June 1997 in this institute were analysed retrospctively. Results The retinas reattached completely in 16 eyes and partly in 2 eyes after RD operation.The postoperative visual acuity improved in 17 eyes,not improved in 2 eyes,and decreasde in 1 eyes.The PCIOL was taken off during RD operative in 6 eyes.Postoperative complications including displacement of the PCIOL in 2 eyes,hyphema and vitreous hemorrhage were found in this series of RD operation in 1 eyes. Conclusion Vitrectomy combined with scleral buckling and intraocular tamponade is one of the effective methods to treat the eyes with RD with PCIOL. (Chin J Ocul Fundus Dis,1998,14:165-166)
Objective To observe the effect of amniotic homogenate on closing holes in experimental rhegmatogenous retinal detachment and investigate its mechanism. Methods Forty rabbits were randomly divided into group A, B, C and D with 10 rabbits in each group. Group A and C were the treatment groups, and group B and D were the control groups. All eyes of rabbits underwent pars plana vitrectomy, retinectomy, and fluidair exchange. The surface of the breaks was treated with 01 ml amniotic homogenate in experimental groups and 0.1 ml PBS in control groups. At the end of operation, 20% SF6 was tamponaded and the retina reattaced. The animals were executed 14 (group A and B) and 28 days (group C and D) after the surgery. The tissue sections were observed by light microscope, electron microscope and immunocytochemistry method. Results Fourteen days after the surgery, the retina reattached in 6 eyes in group A (60%) and 2 eyes in group B (20%) （P=0.021）. Twenty-eight days after the surgery, the retina reattached in 8 eyes in group C (80%) and 3 eyes in group D (30%) (P=0.046). The difference of the rate of retinal reattachment among the 4 groups were statistical significant (Plt;0.05). Light postoperative inflammation of ocular anterior segment was observed, which was controlled 3-5 days after treated with topical steroids. The result of light microscopy showed that the eyes in treatment groups had multilayer of fibroblastlike cells around the retinal breaks, adhering to the choroid and retinal pigment epithelial cells. The proliferative cells around the retinal breaks obvious less in control groups than that in the treatment groups, and the retina could not adhere to the choroid. The results of electron microscopy were the same as that of light microscopy. Immunohistochemistry staining of the fibroblastlike cells revealed positve glial fibrillary acidic protein, which suggested that the proliferative cells around the retinal breaks were retinal glial cells. Conclusions Amniotic homogenate helps to seal retinal breaks and promote retinal reattachment by stimulating the proliferation of retinal glial cells around the breaks.
Objective To investigate the characteristics and risk factors of optic nerve atrophy in eyes with complicated retinal detachment after silicone oil tamponade during the procedure of vitreoretinal operation. Methods The clinical data of 97 patients with complicated retinal detachment who had optic nerve atrophy after silicone oil tamponade during the procedure of vitreoretinal operation were an alyzed retrospectively. Logistic regression analysis by SPSS statistical software was used to analyze the factors like age, disease history, primary diseases, preoperative ocular condition, complications in and after the operation, the time taking out the silicone oil, and emulsification of the silicone oil, and Ple;0.05 was considered to be the symbol of significant difference. Results All of the affected eyes had optic discs with clear border, including paler optic disc in 65 eyes, pale one in 21 eyes, and paler optic disc with enlargement of the cup/disc (ge; 0.6) in 11 eyes. The result of logistic regression analysis showed that the intraocular pressure (P=0.022) and the visual acuity (P=0.001) during the silicone oil removal were in the equation. Conclusion The risk factor of optic nerve atrophy is the chronic increase of intraocular pressure after silicone oil tamponade. (Chin J Ocul Fundus Dis, 2006, 22: 305-307)
ObjectiveTo investigate the therapeutic effects of vitrectomy for retinal detachment in patients with morning glory syndrome (MGS). MethodThe clinical data of 8 patients (8 eyes) who underwent vitrectomy for retinal detachment and MGS were retrospectively analyzed. Follow-up after treatment was performed for 8 months to 2 years. The visual acuity and retina reattachment were followed up. ResultsRetina was reattached in 5 eyes after vitrectomy. Retina was reattached in 2 eyes after second revision operation. Retina was not reattached in 1 eye after two operations. ConclusionsVitrectomy is effective in treating retinal detachment in patients with MGS.
Objective To investigate the response of retinal ganglion cells （RGC）in detached and reattached retina in adult rats, and the effect of IL-1beta antibody and IL-1Ra on the loss of RGC. Methods A total of 73 Sprague-Dawley (SD) rats were subretinally injected with healon GV（1.4% hyaluronate）and retrograde labeled with fluorogold (FG), and 10 ng IL-1 Ra and 500 ng IL-1beta antibody were injected into the subretinal space combined with healon GV. The retinal flakes were observed under the fluoroscope and the number of RGC was counted 2 hours, 1, 3, 5, 7, 10, 20, 50, and 90 days after deta chment; 10 days after detachment and 30 days after reattachement; 90 days after detachment and 20 days after reattachement, and 1 and 10 days after injection with IL-1beta antibody and IL-1Ra,respectively. And the control group was only developed an intraocular injection of the same valume of healon GV. Result Two hours after detachment, the RGC loss was found, reached the peak at first day, and decreased gradually. RGC loss was also found in the non-detached area. The reattachment 10 days after detachment (early reattachment) stopped the loss of RGC, and the reattachment 90 days after detachment (late reattachment) promoted the loss, which rested on a certain level. Subretinal space injection of IL-1Ra and IL-1beta antibody decreased the loss of RGCs in the detached retina. Conclusion The RGCs loss were found both in the detached and attached retina. Early reattachment may stop the loss of RGC, and late reattachment may promote the loss. Both IL-1beta antibody and IL-1Ra have neuro protective effect on RGC. (Chin J Ocul Fundus Dis，2004，20：233-236)