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Objective@#To observe the outcomes of 23G pars plana vitrectomy (PPV) and air tamponade for non-inferior rhegmatognous retinal detachment (RRD).@*Methods@#A prospective case series study. From August 2017 to April 2018, 39 consecutive RRD patients (39 eyes) in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. There were 20 males(20 eyes) and 19 females (19 eyes), 23 right eyes and 16 left eyes, with the mean age of 55±11 years. There were 30 eyes with lens and 9 eyes without lens or IOL. There were 21, 14 and 4 eyes with 1, 2 and equal or greater than 3 retinal tear respectively. All patients underwent 23G PPV which performed preretinal proliferative membranes and vitreous cortex removal, photocoagulation around the breaks with 3-5 rows, and filtered air tamponade. The follow-up was more than 2 months. The retinal reattachment, visual acuity and complications were observed. Pearson correlation analysis was used to analyze the correlation between BCVA and disease course. Chi-square test was performed for comparison among retinal reattachment rate and different clinical factors before operation.@*Results@#At 2 months after the PPV, 35 eyes' retina reattached, the rate of reattachment was 89.8%. In 2-3 weeks, 4 eyes were re-detached, all of them performed silicone oil tamponade. One eye was secondary to pre-macular membrane. The logMAR BCVA before and after PPV were 1.15±0.78 and 0.41±0.31, respectively (t=6.589, P=0.0001). Correlation analysis results showed that BCVA after surgery was positively correlated with BCVA before surgery(r=0.544, P=0.001). Twelve of 30 eyes with crystalline lens suffered cataract. The rate of reattachment vary in the number of the breaks (χ2=9.181, P=0.010).@*Conclusion@#PPV with air tamponade may be an optimal treatment of non-inferior RRD with better success rate and security.
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Objective@#To investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus.@*Methods@#A prospective case-controlled study was adopted. From April 2016 to January 2018, 290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. Among them, 146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with scleral incisions at 5.0 mm posterior to the limbus (5.0 mm group), and 144 patients(150 eyes) at 4.0 mm (4.0 mm group). No statistically significant difference was found in age, axial length(t=−1.324, 0.867; P=0.186, 0.387) and in gender, right/left eyes, proportion of indications (χ2=1.366, 2.615, 10.195; P=0.242, 0.106, 0.070) between the two groups. The incidence rate of complications between the two groups were comparatively observed, such as lens injury, retinal tears close to the scleral incision, retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Independent sample t test and χ2 test were performed for comparison between the two groups.@*Results@#Lens injury was observed in 4 eyes(2.67%) and 14 eyes (9.33%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=5.910, P=0.015). Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33%) and 6 eyes (4.00%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=0.094, P=0.759). The mean time of removing the vitreous base was 6.17±2.76 min and 10.03±5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599, P <0.01). No other surgical complications occurred in any group, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment, etc.@*Conclusion@#In primary 23G PPV, the safety of ora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm, but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 mm.
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Objective To observe the outcomes of 23G pars plana vitrectomy (PPV) and air tamponade for non-inferior rhegmatognous retinal detachment (RRD).Methods A prospective case series study.From August 2017 to April 2018,39 consecutive RRD patients (39 eyes) in Department of Ophthalmology of Subei People's Hospital Affiliated to Yangzhou University were enrolled in this study.There were 20 males (20 eyes) and 19 females (19 eyes),23 right eyes and 16 left eyes,with the mean age of 55 ± 11 years.There were 30 eyes with lens and 9 eyes without lens or IOL.There were 21,14 and 4 eyes with 1,2 and equal or greater than 3 retinal tear respectively.All patients underwent 23G PPV which performed preretinal proliferative membranes and vitreous cortex removal,photocoagulation around the breaks with 3-5 rows,and filtered air tamponade.The follow-up was more than 2 months.The retinal reattachment,visual acuity and complications were observed.Pearson correlation analysis was used to analyze the correlation between BCVA and disease course.Chi-square test was performed for comparison among retinal reattachment rate and different clinical factors before operation.Results At 2 months after the PPV,35 eyes' retina reattached,the rate of reattachment was 89.8％.In 2-3 weeks,4 eyes were re-detached,all of them performed silicone oil tamponade.One eye was secondary to pre-macular membrane.The logMAR BCVA before and after PPV were 1.15 ± 0.78 and 0.41 ± 0.31,respectively (t=6.589,P=0.0001).Correlation analysis results showed that BCVA after surgery was positively correlated with BCVA before surgery (r=0.544,P=0.001).Twelve of 30 eyes with crystalline lens suffered cataract.The rate of reattachment vary in the number of the breaks (x2=9.181,P=0.010).Conclusion PPV with air tamponade may be an optimal treatment of non-inferior RRD with better success rate and security.
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Objective To investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus.Methods A prospective case-controlled study was adopted.From April 2016 to January 2018,290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People's Hospital Affiliated to Yangzhou University were enrolled in this study.Among them,146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with seleral incisions at 5.0 mm posterior to the limbus (5.0 mm group),and 144 patients (150 eyes) at 4.0 mm (4.0 mm group).No statistically significant difference was found in age,axial length(t=-1.324,0.867;P=0.186,0.387) and in gender,right/left eyes,proportion of indications (x2=1.366,2.615,10.195;P=0.242,0.106,0.070) between the two groups.The incidence rate of complications between the two groups were comparatively observed,such as lens injury,retinal tears close to the scleral incision,retinal hemorrhage,supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment.Independent sample t test and x2 test were performed for comparison between the two groups.Results Lens injury was observed in 4 eyes (2.67％) and 14 eyes (9.33％) respectively in the 5.0 mm and 4.0 mm group during surgery (x2=5.910,P=0.015).Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33％) and 6 eyes (4.00％) respectively in the 5.0 mm and 4.0 mm group during surgery (2x2=0.094,P=0.759).The mean time of removing the vitreous base was 6.17 ± 2.76 min and 10.03 ± 5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599,P＜0.01).No other surgical complications occurred in any group,such as retinal hemorrhage,supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment,etc.Conclusion In primary 23G PPV,the safety ofora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm,but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 rnm.
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Objective To evaluate the safety to perform 23G vitrectomy with scleral incisions at 5.0 mm behind the limbus.Methods This is a prospective uncontrolled case study.The data of 140 consecutive primary 23G vitrectomy patients (145 eyes) were enrolled in this study.There were 56 males (59 eyes) and 84 females (86 eyes),with the mean age of (56.34 ± 9.98) years and axial length of (23.99± 2.57) mm.There were 139 phakic eye and 6 aphakic eyes.All the eyes received 23G pars plana vitrectomy with scleral incisions at 5.0 mm behind the limbus.To measure the normal Chinese adult parameters of anteroposterior axis of the eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex,the head CT scans of 105 patients without eye diseases in our hospital were studied during the same period of time for these vitrectomy surgeries.Pearson correlation analysis was used to analyze the relationship between age,anteroposterior axis of eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex.Results Surgical related complications included retinal tears close to the scleral incision sites (3/145 eyes,2.1％) and lens injury (3/121 eyes,2.5％).No other surgical complications occurred,such as retinal hemorrhage,supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment.Based on CT images,the average scleral distance from limbus to the plane passing through the lens posterior apex,anteroposterior axis of eyeball and lens thickness was (6.72± 0.81),(24.39± 0.97),(4.22 ± 0.47) mm,respectively.The results of Pearson correlation analysis showed that age and lens thickness had statistically significant correlation (r=0.328 9,P=0.000 6).Conclusion Primary 23G pars plana vitrectomy with incisions at 5.0 mm posterior to the limbus is safe.
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Idiopathic macular hole (IMH) is characterized by a central retinal defect without any ocular diseases.Internal limiting membrane peeling (ILMP) of the retina is proved to be beneficial to IMH.As a part of IMH treatment,ILMP can increase the closure rate of IMH and improve postoperative visual outcomes.This article reviewed advanced researches of the ILMP,including dying methods of ILM,intraocular tamponade agents,postoperative facedown posturing,healing process of IMH and postoperative effect of ILMP.
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Background Pars plana vitrectomy (PPV) is a main method of treating severe proliferative diabetic retinopathy (PDR) , but intraoperative bleeding often occurs, which affects the intraoperative process and final prognosis.Intravitreal injection of ranibizumab (IVR), a vascular endothelial growth factor (VEGF) monoclonal antibody,has been used in PPV,so the evaluation of therapeutic effect and safety of PPV associated by IVR is very important.Objective This study was to evaluate the effect of IVR-assisted 23G PPV on patients with severe PDR.Methods The clinical data of 82 eyes of 77 patients with severe PDR who received 23G PPV from August 2012 to December 2013 were respectively analyzed,including 49 eyes undergone IV R-assisted 23G PPV (IVR combined with PPV group) and 33 eyes undergone 23G PPV only (simple PPV group).IVR (0.5 mg/0.05 ml) was performed on the eyes 5-7 days before PPV in the IVR combined with PPV group,and only PPV was carried out in the simple PPV group.Operative duration, endodiathermy times, incidence of iatrogenic retinal holes, best corrected visual acuity (BCVA) (LogMAR), postoperative bleeding, re-operation rate, Ⅰ phase attached rate of retinas, occurrence rate of neovascular glaucoma and temporary ocular hypertension rate were compared between the two groups.Results The average operation duration was (71.90-± 26.42) minutes in the IVR combined with PPV group, which was significantly shorter than (96.76±25.15) minutes in the simple PPV group (t =-4.300, P＜0.05).Endodiathermy time in the IVR combined with PPV group was significantly less than that in the simple PPV group (0.76±0.14 versus 2.18±1.64) (x2 =-4.284,P＜0.01).The BCVA at postoperative 3 months was (0.70±0.50) and (0.74±0.50) in the IVR combined with PPV group and simple PPV group,which was significantly improved in comparison with before operation (1.73±0.50,1.70±0.470) respectively (t=-0.151,0.118,both at P＜0.01),but no significant difference in the postoperative BCVA between the two groups (t =-0.318, P =0.758).The incidence of iatrogenic retinal holes was significantly lower in the IVR combined with PPV group than that in the simple PPV group (6.12％ versus 21.20％) (x2 =4.193 ,P=0.041).In addition,the postoperative bleeding rate was also significantly different between the IVR combined with PPV group and the simple PPV group (2.04％ versus 15.15％) (x2=6.580, P=0.010).No significant differences were seen in the incidence of re-operation rate, I phase attached rate of retinas,occurrence rate of neovascular glaucoma and temporary ocular hypertension rate between two groups (all at P＞O.05).Conclusions IVR before 23G PPV can reduce the risk of intravitreal bleeding during operation and after surgery,shorten operation duration and lessen the incidence of iatrogenic retinal break.The BCVA after IVR-assisted PPV improves as good as simple PPV.
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Objective:To investigate the migration and odontogenesis of rat dental pulp cells transfected with adenovirus vector enco-ding cadherin-11.Methods:The dental pulp cells were cultured and transfected with pDC316-mCMV-EGFP-Cadherin-11.Cad-11 protein expression of the cells was examined by immunohistochemistry staining.The odontogenic differentiation of the cells was studied by alizarin red staining and ALP staining.The adhesion and migration of the cells were tested.Results:Transfection of pDC316-mC-MV-EGFP-Cadherin11 promoted Cad-11 protein expression and ALP activity,increased calcified nodule formation(P <0.05),adhe-sion and migration of rat dental pulp cells(P <0.05).Conclusion:Cadherin-11 may promote the odontoblast differentiation and mi-gration of rat dental pulp cells.
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Objective To investigate the effect of vacuum sealing drainage (VSD) technology on prevention and treatment of infection wound and to repair the infectious fracture wound in earthquake. Methods Twenty-two patients with limb fractures and open infection wound received VSD from May 12, 2008 to June 19, 2008 in West China Hospital of Sichuan University. Before the VSD, we debrided all wounds and gave effective systemic antibiotics. A -18 ～ - 14 kPa pressure was exerted to the wound, and the VSD was used for 8 ～ 10 days. We took a germiculture regularly. The capacity, color, and nature of negative pressure drainage, the regression of limb swelling, and systemic inflammatory responses were observed. Results There was no active bleeding wound or transparent film off in all patients. Three patients had drainage clogging, and were kept flowing freely using the sterile saline pipe to remove the blockage of necrotic tissues. During the VSD, granulation tissues grew well in the 13 patients with bone exposure of the wounded. Two patients whose symptom of inflammatory was not obviousy eased had another debridement to completely remove the necrosis, and the symptom was relieved. After 3-5 days of VSD, swelling and fever in the other 20 patients significantly subsided. Conclusion VSD can alleviate the wound inflammation, facilitate the growth of the fresh granulation tissue from the surrounding to the center, and reduce the flap transfer area for the Stage Ⅱ coverage of the exposed bone.