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.
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.
ObjectiveTo evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.MethodsIt was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.ResultsThe mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant (F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation (F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant (F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation (r/rs=0.672, 0.385, 0.932; P＜0.05). There was no correlation between M value and BCVA (r/rs=0.503), EZ and ELM integrity (r/rs=0.497, 0.472), SRF (r/rs=0.416), CME (r/rs=0.821) and ERM (r/rs=0.632) after operation (P＞0.05).ConclusionsThe BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.
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）
Objective
To investigate the visionrelated quality of life (VRQoL) of patients with monocular rhegmatogenous retinal detachment (RRD) before and after relative surgery, and analyze its influencing factors.
Methods
A total of 92 patients with monocular RRD were asked to complete the Chinese-version low vision quality of life questionnaire (CLVQOL) preoperatively and at the end of the follow-up time.
Results
The Cronbach alpha; coefficient of the questionnaire was more than 0.7. The lowest scores were at the item of quot;adjustive abilityquot; before the surgery, and the scores of the questionnaires were significantly higher at the end of the follow-up time. The item whose score changed most caused by the surgery was quot;adjustive abilityquot;. The visual acuity in RRD eyes before the operation and the changes of the visual acuity was the chief independent risk factor of the questionnaire score before surgery and the changes of scores due to surgery, respectively.
Conclusions
CLVQOL can be used to assess the VRQoL of patients with monocular RRD after surgery. The qualities of life of patients with monocular RRD decrease sharply. VRQoL, especially the adjustive ability, improves obviously after operation, but the patient would be inconvenient for doing some precision work or daily house work. Improving the visual acuity of the RRD eye, giving early surgery and avoiding complications help to improve the VRQoL of the patients with monocular RRD.
(Chin J Ocul Fundus Dis, 2006, 22: 106-109)
ObjectiveTo observe the changes of multifocal electroretinogram(mfERG)and central visual field before and after surgery in patients with rhegmatogenous retinal detachment (RRD) involving the macular area.
MethodsThis is a retrospective study. Sixteen patients (16 eyes) with RRD involving the macular area (RRD group) and age-matched normal 20 cases (20 eyes, normal control group) were enrolled in the study. All patients in RRD group underwent scleral buckling surgery. Before surgery and 1, 3, 6 months after surgery, RRD eyes and normal eyes were checked by using mfERG and central visual field examination, and macular reaction wave amplitude density, incubation period and 4° visual field mean sensitivity (MS) were observed. The correlation between amplitude density, incubation period and MS in RRD group and the consistency between mfERG and central visual field examination in normal control group and RRD group were analyzed.
ResultsCompared with the normal control group, in RRD group before surgery the macular reaction wave N1 and P1 amplitude density reduced, the incubation period prolonged, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density improved, the incubation period reduced than before surgery, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density reduced, the incubation period prolonged compared with the normal control group, the differences were statistically significant (P < 0.05). Compared with the normal control group, 4° visual field MS significantly reduced in RRD group before surgery reduced, the differences were statistically significant (t=49.752, P < 0.05). Postoperative 1, 3, 6 months, 4° visual field MS significantly increased compared with the preoperative value, the differences were statistically significant (t=-9.580, -16.533, -19.580; P < 0.05); but were lower than that of the normal control group, the differences were statistically significant (t=-6.286, -7.493, -6.366; P < 0.05). Postoperative 1, 3, 6 months, macular reaction wave amplitude density and MS in RRD group showed positive correlation (P < 0.05), and there was no correlation between incubation period and MS (P > 0.05). mfERG and vision consistency in normal control group and RRD group showed good agreement(K=0.886, P < 0.05).
ConclusionsCompared with normal control eyes, in RRD eyes involving the macula area before and after surgery, macular reaction wave amplitude density reduced, the incubation period prolonged and MS values reduced; compared with the preoperative mfERG and central visual field, macular reaction wave amplitude density improved, the incubation period reduced and MS values increased.
ObjectiveTo investigate the clinical characteristics and surgical management of the familial exudative vitreoretinopathy (FEVR)-associated rhegmatogenous retinal detachment (RRD).
MethodsRetrospective noncomparative case series. Thirty-three eye of 32 patients were diagnosed FEVR-associated RRD by Fluorescein fundus angiography. There were 26 males and 6 females. The male to female ratio is 4.3:1 with an average age of 19.35±8.83 years. The detection of best corrected visual acuity (BCVA), refraction status, fundus photograph and fluorescein fundus angiography(FFA)were underwent in all patients. FEVR was confirmedby FFA and positive family history. The BCVA, refraction status, morphology of retinal detachment, location, size and shape of retinal hole, presence and grade of proliferative vitreoretinopathy (PVR), and subretinal proliferation were recorded.
ResultsAs for the refractive status, the scope of refraction was +2.0 D to-13.0 D andthe BCVA were range from light perception to 0.7. Atrophy holes which located at the temporal half were responsible for retinal detachment in all cases. Besides, horseshoe tears were noted in 6 eyes (18.18%), while macular tears were noted in 2 eyes of RRD (6.06%). The PVR greater than stage C2 was noticed in 10 eyes (30.30%), while subretinal proliferation was presented in 23 eyes (69.70%).
ConclusionsMale predominance, juvenile onset and associated with moderate to high myopia are the main characteristics in FEVR-associated RRD. Atrophy holes at the temporal half and the subretinal proliferations were most commonly in FEVR-associated RRD. Detailed fuduns and FFA examination of the fellow eye should be undergone to avoid misdiagnosis.
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 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)
OBJECTIVE:To investigate the transporting function of subretinal fluid in retinal pigment epithelium(RPE) of experimental retinal detachment (RD).
METHODS: Twenty-seven pigmented rabbits with one eye as retinal detachment model and the other eye as control were divided into 4 groups ,ic. 7 rabbits in each group at random. The Na十-K+-ATPase activity in RPE-choroidal tissue at the detached region in both experimental and control eyes was determined at the lst,2nd,3rd and 4th week after retinal detachment,and also the ultrastructure of the RPE-choroidal tissues observed. RESULTS:The
activity of Na十-K+-ATPase of experimental eyesE[(2.16士1.26)/mu;mol(mgmiddot;h)]was significantly lower than that of the controis[(4.84plusmn;1.59)mu;mol/(mgmiddot;h)]. The degree of decreasing activity was relieving along with increasing of the course of RD. The inward pinocytosis in RPE cells under electron-microscope was found from the 2nd week samples afterwards and becoming obvious along with increasing of the disease course.
CONCLUSIONS:The outward transporting function of RPE was increased after RD,it became decreased along with increasing of the course df RD and the inward transporting function then developed.
