Objective To investigate the causes of visual loss and failure of treatment after intraocular silicone oil removal. Methods Retrospective clinical analysis of the causes of loss of visual acuity of 15 eyes after silicone oil removal in patients with complicated retinal detachment which were successfully treated with vitreous and retinal microsurgery. Results Among the 15 eyes,retina failed to reattach in 11 eyes,secondary glaucoma occurred in 2 eyes and corneal opacity appeared in another two eyes.All of them were resulted in total loss of vision. Conclusion Retinal redetachment was the leading cause of final visual loss in the failing 15 cases(15 eyes) after intraocular silicone oil removal,and secondary glaucoma and corneal decompensation may also be the causes of visual loss. (Chin J Ocul Fundus Dis, 1999, 15: 230-231)
Objective To observe the efficacy and safety of micro-invasive vitrectomy for retinal detachment associated with choroidal detachment. Methods A total of 35 patients (36 eyes) with retinal detachment associated with choroidal detachment were enrolled in this study. The patients included 22 males and 13 females, with a mean age of (51.32 plusmn;17.34) years. Visual acuity was light perception in six eyes, hand movement in 12 eyes, finger counting in nine eyes, 0.01-0.1 in eight eyes, and 0.2 - 0.3 in one eye. The median LogMAR visual acuity was (2.13plusmn;0.50). The median intraocular pressure was (7.08plusmn;2.62) mm Hg (1 mm Hg=0.133 kPa). All the patients were received vitrectomy using 23-gauge instrumentation combined with 25-gauge infusion. Tamponade with silicone oil (35 eyes) or C3F8 gas (one eye) were performed. The median follow-up time was (6.23plusmn;3.07) months. The pre- and post-operative visual acuity, intraocular pressure, the rate of retinal reattachment, the rate of recurrent retinal detachment and complications were comparatively analyzed.Results Retinal reattachment was attained in 36 eyes (100%) at the first day after vitrectomy. Retinal reattachment was attained in 33 eyes (91.7%) and recurrent retinal local detachment was attained in three eyes (8.3%) at one months after vitrectomy. The rate of retinal reattachment was 83.3% (30 eyes) at three months after vitrectomy. One day, one and three months after treatment, the mean LogMAR visual acuity were 1.77plusmn;0.66, 1.53plusmn;0.72, 1.31plusmn;0.77 respectively. The differences of the visual acuity was statistically significant between before and after vitrectomy (F=62.61,P＜0.05). One day, one and three months after treatment, the mean intraocular pressure were (12.47plusmn;7.28), (15.51plusmn;6.86), (15.82plusmn;7.60) mm Hg respectively. The differences of the intraocular pressure was statistically significant between before and after vitrectomy (F=6.88,P＜0.05).Secondary glaucoma occurred in one eye at three months after vitrectomy. Except this, there was no other complication related to treatment. Conclusion Micro-invasive vitrectomy is a feasible and safe treatment for retinal detachment with choroidal detachment.
ObjectiveTo investigate the therapeutic effects of scleral buckling operations on treating longstanding retinal detachment with subretinal proliferation.MethodsThe clinical data of 36 patients (40 eyes) with long-standing retinal detachment with subretinal proliferation who had undergone scleral buckling operation were retrospectively analyzed, and the clinical features, therapeutic methods and curative effects were summarized.ResultsThe diagnosis of long-standing retinal detachment mainly based on the examination of ocular fundus. The features of the affected eyes were: flat retinal detachment, thin and transparent retina, and formation of subretinal cords. In 40 eyes undergone scleral encircling and buclking, 36 (90%) had one-off successful operation, and the visual acuities over 0.05 were found in 77.5% of the whole eyes.ConclusionsScleral encircling and buckling procedures can be used to treat long-standing retinal detachment with subretinal proliferation with fairish cured rate. (Chin J Ocul Fundus Dis, 2005,21:150-152)
Purpose To investigate the therapeutic effect and complications of vitreous surgery in conjunction with laser treatment for high myopic retinal detachment with macular hole． Methods Thirtyfive consecutive cases(38 eyes) of high myopic retinal detachment with macular hole in our institute from January 1994 to August 1997 were analysed retrospectively.Among them,11 cases(12 eyes)were treated with vitreous operation and 24 cases (26 eyes)with vitreous operation combined with argon laser photocoagulation of the macular holes.All of the eyes operated on were followed up for more than 6 months,and with an average period of 21.7 months. Results In the 12 nonlaser treated eyes the macular hole recured in 5 eyes (41.7%),and the visual acuity was 20/200 or more in 6 eye(50.0%).In the 26 laser treated eyes,the macular hole recurred in 2 eyes(7.7%),new retinal tear appearred in 1 eye, and the visual acuity was 20/200 or more in 13 eyes(50.0%).The probability of recurrence of the macular hole between nonlaser and laser treated eyes was 0.024,and of retinal probability redetachment between them was 0.0487.There was no significant difference in between pre and postoperative visaul acuity. Conclusion Vitreous surgery in conjunction with laser photocoagulation for high myopic retinal detachment with macular hole might be helpful in improving the operative successful rate. (Chin J Ocul Fundus Dis,1998,14:199-201)
The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis. Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy. The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound, and the emphasis should be put on retinal reattchment and stable repairment.
Objective To evaluate the therapeutic effect of encircling scleral buckling surgery in rhegmatogenous retinal detachement (RRD) with vitrectomy. Methods The records of a series of 118 consecutive patients with RRD undergone encircling scleral buckling surgery and vitrectomy between 1995-1999 were reviewed. All of the patients underwent an onece vitrectomy, and they consisted of with encircling scleral buckling group and without encircling scleral buckling group. The difference of rate of retinal reattachment, and the relationship between the reattachment rate and the grade of PVR, position of retinal tear and the different intraocular tamponade substitute in both groups were analysed and compared. The average follow-up period was 6.5 mons (1.5 mons-3 ys). Results The rate of retinal reattachment in this series of 118 cases was 81.4% (96/118) in which the encircling scleral buckling group accounted for 44.7% and the group without encircling scleral buckling accounted for 55.3%. There was no statistical difference of rate of retinal reattachment between both groups with PVR C, different intraocular tamponade and various positions of retinal tears, while the rate of retinal reattachment in cases of PVR D and retinal tears posterior to equator in group without encircling scleral buckling was significanthy higher than that in encircling scleral buckling group (Plt;0.05). Conclusion The encircling scleral buckling procedure may be unprofitable in increasing the rate of retinal reattachment in vitrectomy for RRD. (Chin J Ocul Fundus Dis, 2002, 18: 212-214)
Objective To investigate the therapeutic effects of vitre ctomy for primary retinal detachment due to macular hole in high myopic eyes. Methods Consecutive patients with primary retinal detachment due to macular hole who went to our hospital from March 1996 to March 2004 were retrospectively analyzed. The condition of the patients must accord with the previous refractive error of ge;6.00 D or the axial length of ge;26 mm without peripheral retinal hole; and with primary retinal detachment due to macular hole which had undergone vitrectomy. Results In 83 patients (85 eyes) including 63 females and 20 males with an average age of 54.1 years, preoperative visual acuity was light perception to counting finger in 49 eyes, 0.01-0.1 in 33, and 0.12-0.2 in 3 eyes; the extent of retinal detachment was only in the macular area in 15 eyes, in 1-2 quadrants in 11 eyes, and in 3-4 quadrants in 59 eyes; extraction of the lens or phako fragmentation was simultaneously performed during the operation in 62 eyes (72.9%), macular epiretinal membrane was removed in 37 eyes, and C3F8 or silicone oil was injected intravitreously in 29 (34.1%) and 56 (65.9%) eyes, respectively; the retina was reattached postop eratively in 77 eyes (90.6%) and failed to reattach in 8; visual acuity improved in 47 eyes (55.3%), remained unchanged in 25 (29.4%), and decreased in 13 (15.3%) after operation. Conclusions Primary retinal detachment due to macular hole often occurs in elder female patients with high myopic eyes.Simultaneous vitrectomy procedures including removal of posterior vitreous cortex, macular epiretinal membrane, cataractous lens and internal tamponade may usu ally beneficial to improve or preserve. The visual acuity improves or remains still in most of the affected eyes after the surgery. （Chin J Ocul Fundus Dis, 2006, 22: 287-290)
Objective To detect the prognosis of visual acuity, operation timing and medical management of peri-operation in patients who had undergone pars plana vitrectomy for uveitis associated with tractive retinal detachment. Methods The clinical data of 15 eyes (13 patients) with tractive retinal detachment associated with uveitis who had undergone pars plana vitrectomy from our Department were retrospectively analyzed. The patients, 6 males and 7 females, aged from 19.0 to 70.0 years, with the average of 42.8 years. The duration of the disease history was 3-15 years with the average of 7 years. In the 15 affected eyes, the visual acuity was le;hand moving before the eye in 7 eyes, 0.01-0.1 in 7, and 0.2 in 1. Vitreous opacity, proliferative vitreoretinopathy, and tractive retinal detachment were found in all of the affected eyes. All the patients had been treated with oral and topical steroid. In addition, 3 of them received oral azathioprine meanwhile. Eye drops of 1% prednisolone acetate, 1% atropine, and tropicamide were used. The inactive duration of inflammation of uveitis was 0.5-4.5 months with the average of 2.0 months. After the inflammation became inactive, pars plana vitrectomy with membrane peeling, intraocular photocoagulati,filling with C3F8 or silicon oil were performed, including 7 eyes underwent lens excision. Glucocorticoid was given to the patients orally before the operation, and systemic and ocular medication of glucocorticoid were given continuously after the operation, in whom 3 were treated with oral azathioprine meanwhile. The postoperative follow-up duration ranged from 3 to 146 months with the average of 26 months. Results No recrudescence of uveitis, inflammation of ocular anterior segment, or vitreous inflammation was fund in the 15 eyes. The retina reattached successfully and the visual acuity improvement in 13 eyes (86.7%), inluding 2 eyes achieved the visual acuity increased from 0.2 to 0.8 and 0.03 to 0.6, 1 eye had unchanged visual acuity (6.7%)，and 1 eye decreased from hand moving to light perception (6.7%). In the follow-up duration, 4 eyes had cataract formation and underwent cataract extraction and intraocular lens (IOL) implantation, and the visual acuity improved after the operation. Iris neovascularization and secondary hyphema were found in 1 eye. Organization membrane on the surface of rtina and tractive retinal detachment recurred in another eye. Conclusion Pars plana vitrectomy is effective on uveitis associated with tractive retinal detachment. Operation timing and perioperational reasonable glucocorticoid application are essential for surgery success. (Chin J Ocul Fundus Dis, 2007, 23: 108-111)
Objective To investigate the technique of drain-air, cryotherapy, and explant (DACE) of operation for superior bullous retinal detachment (SBRD).Methods In the DACE procedure, drainage and air or balanced salt soultion (BSS) injection were carried out first, with the intention of flattening the retina before localization of retinal hole, cryotherapy out of choroid and scleral buckling.Results In 42 SBRD eyes, 40 underwent the operation with DACE technique. In 23 eyes injected with BSS instead of air, 5 should be injected air due to no avail for flattening deeply retinal detachment, and 1 needed scleral buckling due to new retinal tear after DACE procedure two weeks. During the follow-up, all retinae attached. Conclusions The DACE technique is very useful and effective in upper ballooned retinal detachment due to single hole or breaks localized in small area between the 10 and 2 o′clock meridiant. BSS instead of air injection can eliminate the difficulty of observation of retinal breaks from the presence of air in some cases. (Chin J Ocul Fundus Dis，2003，19：11-13)
Objective To evaluate the therapeutic effects of vitrectomy with internal limiting membrane (ILM) peeling on retinal detachment in eyes with high myopia. Methods The clinical data of 25 high myopia patients (25 eyes) with retinal detachment and macular hole were retrospectively analyzed. The patients were divided into two groups according to the treatment:13 patients in group A had undergone conventional vitrectomy;12 patients in group B had undergone vitrectomy and ILM peeling.All patients had been tamponaded by inert gas and kept in a facedown position for 7-15 days after the operation. The followup period was 6-18 months (average 10 months).LogMAR visual acuity, ocular fundus, B-scan ultrasonography and optical coherence tomography had been followed up.Results Retinal reattachment was found in 7 eyes (53.8%) in group A and 11 eyes in group B (91.7%), the difference was significant(chi;2=4.427, P=0.046).The macular hole closed in 6 eyes (46.2%) in group A, and 11 eyes (91.7%) in group B; the difference was significant between those two groups (chi;2=5.940，P=0.020). The postoperative visual acuity increased significantly in both groups(Z=-2.045,2.481;P=0.041,0.012), the difference of vision improvement was not significant between those two groups (MannWhitnay U＝51.5，P=0.16). Conclusions By completely releasing the macular traction and increasing retinal flexibility, vitrectomy with ILM peeling can significantly increase the rate of retinal reattachment and closure of macular hole in eyes with high myopia.