ABSTRACT
Objective To observe the incidence of ciliary detachment and its relationship with intraocular hypotension soon after vitrectomy.Methods A total of 46 eyes of 46 patients who underwent vitrectomy were examined by ultrasound biomicroscope (UBM).The patients were divided into three groups according to different tamponade: gas group (11 eyes),silicone oil group (8 eyes) and balanced saline solution (BSS) group (27 eyes).Basing on the postoperative intraocular pressure (IOP),the patients were divided into two groups: IOP<10 mm Hg (25 eyes) and IOP≥10 mm Hg (21 eyes).UBM was applied to determine the tomographic features of the ciliary body 3 days after the surgery.IOP were monitored by non-contact tonometer daily after the surgery.The eyes with ciliary detachment were then examined once a week till the ciliary detachment reattached.The follow-up period was from 14 to 35 days.Results After vitrectomy,ciliary detachment was observed in 20 eyes of 46 eyes (43.5%),The incidence of ciliary detachment was 27.3% in gas group,25.0% in silicone oil group,and 55.6% in BSS group.The average IOP in eyes with ciliary detachment [(6.47±4.49) mm Hg (1 mm Hg=0.133 kPa)] was significantly lower than that in the eyes without ciliary detaehmen [(15.61±7.72) mm Hg] (t=8.031,P<0.001).The incidence of ciliary detachment was higher in eyes with postoperative IOP <10 mm Hg (68.0%) than that in the eyes with postoperative IOP≥10 mm Hg (14.3%) (χ2=15.60,P<0.001).All eyes with postoperative ciliary detachment got spontaneous reattaehment within 30 days after the surgery except that one eye had optic disc edema due to severe intraocular hypotension.Conelusions Early postoperative ciliary detachment is a common complication after vitrectomy.Eyes filled with BSS have the highest incidence of postoperative ciliary detachment.Most of the patients with ciliary detachment may get spontaneous reattahment within 30 days after the surgery.
ABSTRACT
Objective To compare the anatomic and functional results of ocular intensive and systemic corticosteroid administration prior to vitrectomy for primary rhegmatogenous retinal detachment with choroidal detachment.Methods A retrospective,clinical pilot study.Results Of 38 cases of primary rhegmatogenous retinal detachment with choroidal detachment,11 cases received intensive 1% prednisolone acetate eyedrops once each hour,totally 16 times a day(Group A)for(4.91?1.51)days and 27 cases received systemic corticosteroid treatment which is performed as intravenous injection of 15 mg Dexamethasone for 3 d and then taped down for(5.67?1.88)days prior to vitrectomy(Group B).The rate of anatomic reattachment by one operation was 54.5% for Group A and 63.0% for Group B;The rate of reattachment by reoperation was 80% for Group A and 100% for Group B.The functional result was the same in the two groups,with the vision improvement in 70% cases of Group A and 68% cases of Group B.The minimal follow-up period was 3 months after final operation.Conclusion There is an obvious tendence of lower rate of anatomic reattachment in intensive steroid eyedrops treatment group than in systemic corticosteroid treatment group.However,the functional result is almost the same in the two groups.
ABSTRACT
Objective To compare the efficacy of pneumatic retinopexy and subretinal drainage in the treatment of primary rhegmatogenous retinal detachment(RD) in scleral buckling procedure.Methods Pneumatic retinopexy or subretinal drainage was applied during the scleral buckling procedure when lots of subretinal fluid existed.Results Twenty-three of 26 eyes(88.5%) were successfully reattached by pneumatic retinopexy during scleral buckling procedure for the repair of primary retinal detachment.New hole formation was the major complication for the surgical failure.One eye was fixed by another buckling procedure and the other two were treated by vitrectomy.Eleven of 12 eyes(91.7%) with primary RD were successfully managed by scleral buckling procedure and subretinal fluid drainage.Subretinal hemorrhage occurred in one eye after subretinal drainage.Conclusion Pneumatic retinopexy can substitute subretinal drainage in the repair of primary rhegmatogenous retinal detachment when plenty of subretinal fluid exists.