Objective To observe the clinical effect of conventional vitrectomy using transconjunctival sutureless 20 Gauge (20G) trocar. Methods The clinical data of 62 patients (63 eyes) who had undergone vitrectomy were retrospectively analyzed. The patients were divided into 2 groups according to the surgery methods. Group A: conventional vitrectomy using transconjunctival sutureless 20G trocar were performed on 33 cases (34 eyes) including 19 males (20 eyes) and 14 females (14 eyes). The patients aged from 17 to 75 years with the average age of 52.3 years. The average visual acuity was 0.04 and the average intraocular pressure was 18.25 mm Hg (1 mm Hg=0.133 kPa). Included were 13 cases of diabetic retinopathy, 9 cases of vitreous hemorrhage, 2 cases of silicone oil removal and tearing membrane off, 9 cases of complex retinal detachment, and 1 case of tearing epiretinal macular membrane. Group B: 20G conventional incision vitrectomy was performed on 29 cases (29 eyes) including 13 males (13 eyes) and 16 females (16 eyes) aged from 24 to 69 years with the average age of 49.5 years. The average visual acuity was 0.02 and the average intraocular pressure was 17.50 mm Hg. Included were 10 cases of diabetic retinopathy, 8 cases of vitreous hemorrhage, 5 cases of retinal detachment, 2 cases of longstanding retinal detachment performed with vitrectomy and scleral buckling, and 4 cases of silicone oil removal and tearing membrane off and intravitreal injection of expanding gases. Within group A, 21 eyes were treated with intraocular laser photocoagulation, 9 eyes were treated with scleral cryosurgery to block the hole, 3 eyes were treated with intravitreal injection of expanding gases, and 15 eyes were injected with silicone oil. Leakage of incision, incidence of iatrogenic holes and comfort of patients after operation were recorded and analyzed. All data were analyzed by chi;2 test statistical analysis. Results In group A, 31 eyes had a good degree of comfort without incision leakage and did not need special treatment; 3 eyes filled with inert gas needed suppression for 3 to 5 minutes, and had gas spill from the temporal incision, which needed to be sutured once. In group B, all incisions were sutured with 8.0 silk suture without any incision leakage, whileforeign body sensation and irritation was apparent. Difference on the degree of comfort in the two groups was statistically significant (chi;2 =50.56,Plt;0.01). No eyes in group A generated iatrogenic hole, while 2 eyes in group B generated ora serrata slit pores next to the puncture. Compared with each other, there was a significant statistical difference (chi;2=4.15,Plt;0.05). Conclusion Conventional vitrectomy using transconjunctival sutureless 20G trocar made the vitrectomy simpler and quicker and can reduce the incidence of iatrogenic hole significantly.
Objective To probe the clinical feature and complications of extraction of silicon oil after operation of simple rhegmatogenous retinal detachment in child patients. Methods The clinical materials of 22 patients (22 eyes) of child patients (5~14 years old) and 11 cases (11 eyes) of adult patients with simple rhegmatogenous retinal detachment undergone surgical treatment and subsequent retraction of silicon oil tampon, were reviewed and analyzed retrospectively. The reasons of extraction silicon tampon, ocular complications of intrao cular silicon tamponade and the changes of visual acuity pre- and post-extraction of silicon tamponade in above 2 groups were explored. Results The main reason for the extraction and complications of silicon oil tamponade were similar in both groups. The rate of occurrence of the complications in either group rose as time went on . There was no significant difference in change of visual acuity between two groups after the extraction of silicon oil tampon. Conclusion The responses to silicon oil after the operation for simple rhegmatogenous retinal detachment is quite similar in either children or adult patients,and there is no obvious difference between child and adult patients in the results of silicon oil extraction. (Chin J Ocul Fundus Dis，2000，16：139-212)
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）
Seventen eyeswith complicated retinal detachment were repaired with vitrectomy,retinotomy,retinectomy or retinal suture combined with gas/fluid exchange,scleral buckle and cryotherapy.These cases include giant retinal tear with inverted retinal flap(6 eyes),severe traumatic retinal detachment(4 eyes),proliferative diabetic retinopathy(2 eyes),recurrent retinal detachmeng(3 eyes)and anterior proliferative vitreoretinopathy(2 eyes).The duration of follow up in 16 eyes was from 3 to 42 months.The retinal reattachment was in 10 eyes(62.5%),and visual acuity better than0.05 in 8 eyes(50.0%).Four eyes(25.0%)resulted in hypotony. （Chin J Ocul Fundus Dis,1996,12:7-9）
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 surgical outcomes and influencing factors of retinal detachment (RD) after phacoemulsification cataract extraction and intraocular lens (IOL) implantation. Methods The clinical data of 38 patients who underwent retinal detachment after phacoemulsification cataract extraction and intraocular lens implantation were retrospectively analyzed. All patients diagnosed via visual acuity, slit-lamp microscopy, direct or indirect ophthalmoscopy, A or Bscan ultrasonography and optical coherence tomography (OCT). There were 21 males (21 eyes) and 17 female (18 eyes). The age was from 42 to 83 years, with the mean of (57.4±11.2) years. There were nine patients (10 eyes) with simple macular hole RD (MHRD). Vitrectomy or scleral buckling or combined vitrectomy and scleral surgery were implemented according to RD range, the hole location and size, proliferative vitreoretinopathy (PVR) grading; simple MHRD eyes were treated posterior scleral reinforcement surgery. The followup was ranged from 3 to 12 months, with a mean of (11.9±6.8) months. Results The retina was reattached successfully through one operation in 36 eyes (92.3%), two eyes failed because of a relapse after surgery, and one eye finally succeeded by the third times of surgery. There were two eyes (5.1%) with improved vision, one eye (2.6%) with stable vision, and 36 eyes (92.3%) with decreased vision. Conclusion The ratio of the reattachment by one operation for RD after phacoemulsification cataract extraction and intraocular lens implantation is high, but the final visual prognosis remains poorly.
Objective To investigate the clinical characteristics of retinal degeneration (RD) with retinal holes and the therapeutic effect of argon laser therapy. Methods The data of argon laser therapy in 210 RD patients (224 eyes) with retinal holes who underwent the treatment in our department were retrospectively analyzed, which was compared with the data of argon laser therapy in 173 RD patients (198 eyes) without retinal holes. Results In RD patients with retinal holes, 89.7% of the patients were less than 60 years old (53.3% males and 46.7% females). Grid-like degeneration was found in 65.6% of the patients in whom 87.5% had the range of degeneration less than 1 quardrant. There were oval-shaped holes in 60.7% of the patients and accompanied with limited rhegmatogenous retinal detachment (LRRD) in 23.7%. Compared with RD patients without retinal holes, the ratio of patients with the age ofge;35 years, cystic degeneration, retinal lengthways small plica, and subjective symptoms was higher in RD patients with retinal holes; while the therapeutic effect of argon laser therapy on patients with LRRD was obviously less than whom without retinal holes (Plt;0.01 ). Conclusions RD with retinal holes often occurs in youth, most of whom have grid-like degeneration with the range of le;1 qua drant. The major types of retinal holes are oval-shaped degeneration without retinal detachment. There was no sex difference in RD patients with retinal holes and most of the patients have no subjective symptoms. The therapeutic effect of prophylactic argon laser therapy on RD patients with retinal holes but no retinal detachment is satisfying. (Chin J Ocul Fundus Dis, 2006, 22: 39-41)
ObjectiveTo invesitigate the relationship between the macular histomorphological changes and the prognosis of the visual acuity (VA) in eyes with rhegmatogenous retinal detachment (RRD).MethodsOptical coherence tomography (OCT) was performed on 39 patients (39 eyes) with rhegmatogenous retinal detachment. According to the macular neurepithelial configuration displayed by OCT, the patients were divided into 3 groups: neurepithelial edema group, neurepithelial detachment group, and neurepithelial cystoid degeneration group. The time of retinal detachment, pre- and post-operative VA, and macular neurepithelial thickness OCT images were observed and analyzed statistically.ResultsThere was no difference of pre-operative VA among the three groups (P＞0.05). Significant differences of post-operative VA, time of retinal detachment, and neurepithelial thickness were found (P＜0.05). The differences of time of retinal detachment and neurepithelial thickness between neurepithelial degeneration group and cystoid degeneration group were significant (P＜0.05) except the postoperative VA (P＞0.05).ConclusionsThe time of retinal detachment and post-operative VA in patients with retinal detachment relate to the neurepithelial thickness detected by OCT. When the duration of retinal detachment becomes longer, the macular neurepithelium becomes thicker, the histomorphological changes increase, and the post-operative VA decreases. (Chin J Ocul Fundus Dis, 2005,21:83-85)
Objective To explore the therapeutic value and effects of relaxing retinotomy for perforating traction retinal detachment(PTRD). Method A retrospective survey was done in 21 patinets (21 eyes) with PTRD who underwent vitrectomy combined with relaxing retinotomy in our hospital from 1998 to 2001.Results The retinae were completely reattached in all 21 cases. The visual acuity of 12 patients (57%) was counting finger, and the best visual acuity was 0.05. Among the 18 patients who were followed up for 6 to 25 months, 14(77.8%) remained retinal reattachment. Conclusions Relaxing retinotomy is effective for anatomic reattachment of PTRD, especially to the patients with retinal incarceration and severe proliferative vitreoretinopathy. (Chin J Ocul Fundus Dis，2003，19：5-7)
Objective To explore the changes of multifocal electroret inogram (mERG) before and after retinal detachment surgery and its clinical significance. Methods Eighteen patients suffered from rhegmatogen ous retinal detachment underwent mERG before and after surgery using VERIS ScienceTM 4.0. The mERG at different area was compared between preoperative and postope rative surgery. Results Preoperatively, the latencies of a wave and b wave in detached area were statistically longer than in attached area (t=4.541 and 6.784, Plt;0.01). The amplitude densities of a wave and b wave were statistically smaller in detached area than in attached area (t=3.680 and 4.257, Plt;0.01). Postoperatively, the amplitude densities of a wave and b wave at fovea, macula, perimacular area and whole tested area significantly improved. Statistical difference was found before and after surgery, but no statistical difference was found in the latencies of a wave and b wave. The amplitude densities of a wave and b wave in the preoperative detached area were statistically larger after surgery than before surgery (Plt;0.05). Conclusions After retinal detachment surgery, the responses of mERG improve to some degree. mERG was a promising tool to evaluate the recovery of retinal function after surgery . The amplitude densities are more sensitive than the latencies to evaluation of retinal function. (Chin J Ocul Fundus Dis, 2001,17:264-267)