Objective To evaluate the efficacy and its affecting factors of silicone oil as an introocular tamponade for copmlicated retinal detachments in children(le;14 years). Methods We analysed retrospectively 34 cases(36 eyes) of complicated retinal detachments in children, who were performed with pars plana vitrectomy combined with silicone oil tamponade from June 1993 to November 1997. Results After 3-21 months of follow-up, the detached retinas in 19 eyes(52.7%) were reattached, in 10 eyes(27.8%) partially reattached and in 6 eyes (16.7%) redetached, 1 eye(2.8) had a media opacity that precluded evaluation of the retina. Postoperative visual acuity was less than 0.05 in 12 eyes(33.3%), and 0.05-0.2 in 20 eyes(55.6%), 2 cases(4 eyes) could not tell their visions(11.1%). Conclusion Silicone oil tamponade is an effctive therapy for complicated retinal detachments in children. The major cause of surgical fai;ure was development of recurrent proliferative vetrioretinopathy. (Chin J Ocul Fundus Dis,1999,15:7-8)
PURPOSE:To evaluate the ability Of retinoic acid(RA) in silicon oil(SiO)to inhibit the proliferation of injected intraocular fibroblast cells. METHODS:Thirty New Zealand white rabbits (58 eyes)were divided into three groups. In control group ,only SiO(10 eyes)or BSS(10 eyes)were injected intravitreally and 5mu;g/ml (18 eyes)or 10mu;g/ml (20 eyes)RA in SiO were injected into other lwo groups respectively. Three days after gas-compression vitrectomy, 2 times;105 fibroblasts and Sio(0.5ml)or BSS(0.5ml)were injected in all eyes sequentially.The morbidity of tractional retinal detachment (TRD) were observed by ophthalmoscope until 4 weeks. RESULTS:After 4 weeks,in control ,5mu;g/ml RA in SiO and 10mu;g/ml RA in SiO group,80. 00%,44.44%,and 30.00% eyes developed TRD respectively. Significant statistical differences were found between the control group and the two treated groups (P＜0.05). CONCLUSIONS:5mu;g/ml or 10mu;g/ml RA in SiO can inhibit the occurrence of TRD effectively. （Chin J Ocul Fundus Dis,1997,13:174-176）
Objective To observe the therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia.Methods The clinical data of 48 high myopia patients (48 eyes) with macular hole retinal detachment were retrospectively analyzed. Retinal detachment was mainly at the posterior pole; macular hole was confirmed by noncontact Hruby lens and optical coherence tomography (OCT). Phacoemulsification combined with pars plana vitrectomy and silicon oil tamponade were performed to all patients, of which 41 had undergone internal limiting membrane peeling, and 23 had intraocular lens implanting. The oil had been removed 3.5-48.0 months after the first surgery and OCT had been performed before the removal. The followup period after the removal of the silicon oil was more than 1 year.Results The edge of the macular hole could not be seen under the noncontact Hruby lens 1 week after the surgery in all but 5 patients, and the visual acuity improved. The silicon oil had been removed in all of the 48 patients; the OCT scan before the removal showed that the closed macular holes can be in U shape (8 eyes), V shape (6 eyes) or W shape (23 eyes). About 1338 months after the oil removal, retinal detachment recurred in 2 patients with the Wshaped holes. At the end of the followup period, 16 patients (33.3%) had U or Vshaped macular holes, and 32 patients (66.7%) had Wshaped macular holes. The rate of retinal reattachment was 100%.Conclusion Combined surgery of anterior and posterior segment and silicon oil tamponade is effective on macular hole retinal detachment in eyes with high myopia.
Objective To evaluate the effect of vitreoretinal surgery with lens-sparing technique in treating the detachment with giant retinal tear(GRT) associated with proliferative vitreoretinopathy(PVR). Methods Thirty-one consecutive eyes with GRT unde rwent vitrectomy were analysed retrospectively. Operative techniques included peeling of pre-retinal membrane， injection of perfluorodecalin liquid， retinotomy and retinectomy，endolaser，and silicon oil or C2F6 gas tamponade. Lens-sparing vitrectomy was performed in 28 phakic eyes. Follow-up period ranged from 11 to 34 months. Results Anatomic retina l attachment was achieved intraoeratively in 29 eyes. In 16 eyes of 28 eyes with postoperative cataract formation,3 eyes underwent cataract surgery with or without intraocular lens implantation. The corrected final visual acuity ran ged from 0.4 to 0.01. Conclusion Most phakic eyes of retinal detachment with GRT PVR can be successfully operated on with an out come of improving the visual acuity by using techniques of lens-sparing vitrectomy, perfluorodecalin liquid and silcone oil tamponade. (Chin J Ocul Fundus Dis, 2001,17:93-95)
Objective To observe the effects of vitrectomy combined with endotamponade on severe endophthalmitis. Methods The clinical data of 44 patients (44 eyes) of posttraumatic and 22 patients (22 eyes) of postoperative severe endophthalmitis were retrospectively analyzed. All patients were treated by vitrectomy and endotamponade. Intraocular foreign body removal (19 eyes), lens extraction (25 eyes), intraocular lens removal (six eyes) and scleral buckling (16 eyes) were performed. Tamponade with silicone oil (52 eyes) or C3F8 gas (14 eyes) was also performed. Postoperative follow-up ranged from two to 25 months, with the mean of 7-9 months. The visual acuity（VA）and intraocular pressure before and after surgery were comparatively analyzed. Results Inflammation of all the patients were controlled，the effective rate was 5.10%. There was no recurrence and retinal detachment. Among the 66 eyes, postoperative VA of 58 eyes (87.90%) increased,five eyes（7.60%）didn't change and three eyes（4.55%）decreased, the difference was statistically significant（chi;2=45.27，P＜0.05）. The postoperative intraocular pressure was higher than that before surgery，the difference was statistically significant（t=-3.23，P＜0.05）. Conclusions Vitrectomy combined with endotamponade is an effective way to cure severe endophthalmitis. It can improve the visual acuity and intraocular pressure.
We uesd domestic perfluorotributylamine to treat 21 eyes with giant retinal tears,including 5 rhegmatogenous retinal detachment with folded and fixed flap and 16 giant retinal tears resulting from retinotomy and retinectomy due to complicated retinal detachment.The success rate of retinal reattachment was over 95%,with no serious side effects.The activities and complications of perfluorotributylamine in the mangement of giant retinal tears were discussed. （Chin J Ocul Fundus Dis,1996,12: 22-24）
ObjectiveTo observe the changes in physical properties of silicone oil after intraocular tamponade. MethodsThe silicone oil was removed from 99 patients (99 eyes) of primary retinal detachment with 23G vitreous cutter system. The upper silicone oil was collected after put the vitrectomy samples at room temperature for 3 days. According to the time of intraocular tamponade, the silicone oil samples were divide into six groups including group A (1 month, 12 samples), group B (2 months, 15 samples), group C (3 months, 25 samples), group D (6 months, 22 samples), group E (1-2 years, 13 samples) and group F (above 2 years, 12 sample). Fresh unused silicone oil was set as blank control group. Then the emulsion particles, kinematic viscosity, surface tension, density, transmittance and refractive index were measured. ResultsThe difference between group A-F and the control was statistical significant (P<0.05) in emulsion particles (F=89.337), kinematic viscosity (F=10.660), surface tension (F=11.810), density (F=13.497), transmittance of wavelengths (F=455.496, 566.105, 525.102, 767.573, 622.961, 601.539), but not statistical significant at refractive index (F=2.936, P>0.05). The number of silicone oil emulsion particles has no statistical difference between group A and the control (P>0.05), but was significantly different between group B-F (P<0.05). The kinematic viscosity of silicone oil has no statistical difference between group A, B and the control (P>0.05), but was significantly different between group C-F (P<0.05). The surface tension of silicone oil has no statistical difference between group A-D and the control (P>0.05), but is significantly different between group E and F (P<0.05). The density of silicone oil has no statistical difference between group A-D and the control (P>0.05), but was significantly different between group E and F (P<0.05). The transmittance of silicone oil has statistical difference between group A-F and the control(P<0.05). The refractive index of silicone oil has no statistical difference between all the groups and the controls significantly (P>0.05). ConclusionsThe physical properties of silicone oil will change during the intraocular tamponade. The emulsion particles number will increase and the transmittance will decrease after 2 months, the kinematic viscosity of silicone oil will decrease significantly after 3 months, and the density and surface tension will change significantly after 1 year of tamponade.
Objective To investigate the effect of prophylactic 360°laser retinopexy on retinal redetachment after silicone oil removal. Methods The clinical data of 181 vitreoretinal patients after silicone oil removal were retrospectively analyzed. In 88 patients (photocoagulation group) was taken prophylactic 360-degree laser retinopexy before silicone oil removal; in 93 patients (control group) without prophylactic laser retinopexy. The incidence, time, the cause of retinal redetachment and the complications of laser retinopexy after silicone oil removal in two groups were observed. Results The duration of silicone oil tamponade is 4~72 weeks, averaging 13.7±2.4 weeks. 20 cases of retinal redetachment were recorded after silicone oil removal, including 5 cases (5.7%) in photocoagulation group and 15 cases (16.1%) in control group. The difference between two groups is statistically significant (Plt;0.05). Among these 20 patients with retinal redetachment, 10 occured during the first 3 days after the operation, 6 during 4~7 days, 3 during 8~14 days. 1 case occured 2 months after the operation. 11 cases of redetachment result from the omission of small retinal breaks located in ora serrata or behind the photocoagulation zone, or the reopening of primary retinal breaks because of insufficient photocoagulation and freezing during the operation. 1 case result from the hole that come from laser photocoagulation scar tracted by nearby proliferative tissue. 7 cases result from the formation of new breaks from the proliferative vitreoretinopathy(PVR) or proliferation of residual vitreous. There are 52 cases of burning of pupillary border, with the incidence of 59%. Conclusions Prophylactic 360-degree laser retinopexy is associated with a decrease of the incidence of retinal redetachment after removal of silicone oil. （Chin J Ocul Fundus Dis，2008，24：283-285）
Objective To observe the effect of preservation of an terior lens capsule on the incidence of complications associated with silicone oil. Methods Eighty-two patients(82 eyes)accepted trans pars plana vitrectomy combined with lensectomy,30 eyes with preservation of an terior lens capsule (PAC) and 52 eyes with no preservation of anterior capsule(N PAC)were observed.The incidence of complications was analysed to investigate whe ther PAC could reduce the complications associated with the usage of tamponade of silicone oil. Results The incidence was 50.0% in NP AC group,and 23.3% in PAC group(0.010lt; Plt; 0.025).There were secondary glaucoma(21.1%),band keratopathy(13.5%)and corneal decompensation(9.6%)in NPAC group,while there was none of them in PAC group. Conclusion Preservation of anterior lens capsule is an effective measure to reduce the complicaltons associated with the tamponade of silicone oil. (Chin J Ocul Fundus Dis, 2001,17:41-43)
ObjectiveTo compare the clinical characteristics and analyze the factors affecting vision prognosis of idiopathic macular hole (IMH) or myopic macular hole (MMH). MethodsA cross-sectional study. From October 2012 to October 2020, 336 patients with 346 eyes of IMH and MMH who were diagnosed in Shanxi Provincial Eye Hospital with continuous follow-up data after surgery were included. There were 346 eyes (336 cases), including IMH with 247 cases (255 eyes) and MMH with 89 cases (91 eyes), which were divided into IMH group and MMH group. Best corrected visual acuity (BCVA) and optical coherence tomography were performed in all eyes. The BCVA examination used the standard logarithmic visual acuity chart, which was converted into logarithmic minimum angle of resolution (logMAR) visual acuity. The age of outset in IMH and MMH was 64.8±6.6 and 59.2±8.1 years, the logMAR BCVA was 1.11±0.50 and 1.80±0.78, respectively. There were significant differences in age (Wald=34.507) and logMAR BCVA (Z=－7.703) between two groups (P＜0.05). All eyes were performed inner limiting membrane (ILM) peeling or partial inverted ILM covering hole operation. After the operation, the vitreous cavity was filled with air, C3F8 and silicone oil, including 73, 102, 83 eyes in IMH group and 9, 10, 72 eyes in MMH group, respectively. Follow-up time after surgery was more than 2 months. The optimal BCVA and macular hole closure of the two groups were observed. If the quantitative data conformed to the normal distribution, the generalized estimating equation was used, otherwise, the Mann-Whitney U test or Kruskal-wallis test was used, the χ2 test was used for the comparison of categorical variables. Generalized estimating equation logistic regression analyzed the influencing factors of optimal BCVA after surgery and visual acuity success. ResultsIn IMH and MMH, the optimal logMAR BCVA were 0.71±0.36, 1.10±0.51 respectively, and 147 (57.6%, 147/255) eyes, 63 (69.2%, 63/91) eyes achieved visual success respectively. There was a significant difference in the optimal logMAR BCVA (Z=－6.803, P＜0.005), but no difference in visual success rate (χ2=3.772) between the two groups. The visual success rate of IMH at the same baseline BCVA level was higher than that of MMH, and the difference was statistically significant (χ2=14.500, P=0.001). Logistic regression analysis showed that the influencing factors predicting poor optimal visual acuity after surgery were: IMH, baseline BCVA [odds ratio (OR)=2.941, 95% confidence interval (CI) 1.341-6.447, P＜0.05], MH diameter (OR=1.003, 95%CI 1.001-1.005, P＜0.05), silicon oil filling (OR=3.481, 95%CI 1.594-7.605, P＜0.05); MMH, baseline BCVA (OR=2.549, 95%CI 1.344-4.834, P＜0.05), C3F8 filling (OR=18.131, 95%CI 1.505-218.365, P＜0.05) and silicon oil filling (OR=7.796, 95%CI 0.997-60.944, P＜0.05). The factors leading to a lower likelihood of achieving visual success: IMH, baseline BCVA (OR=213.329, 95%CI 46.123-986.694, P＜0.05), MH diameter (OR=0.995, 95%CI 0.992-0.997, P＜0.05), silicon oil filling (OR=0.326, 95%CI 0.115-0.926, P＜0.05) and duration (OR=1.036, 95%CI 1.005-1.067, P＜0.05); MMH, baseline BCVA (OR=13.316, 95%CI 2.513-70.565, P＜0.05) and duration (OR=1.022, 95%CI 1.001-1.044, P＜0.05). ConclusionsMMH was earlier than IMH in age of outset. Baseline vision significantly affected vision prognosis in IMH and MMH. Silicone oil should be avoided as much as possible under the premise of hole closure.