ABSTRACT
Objective:To investigate the ultrastructural and biomechanical properties of the internal limiting membrane (ILM) in high myopic macular hole (HM-MH) eyes.Methods:ILM specimens were peeled from 14 eyes with HM-MH from August to December in 2017, and 16 eyes with idiopathic macular hole (IMH) in the same period were served as a control.Specimens were detected by immunefluorescence, transmission electron microscopy (TEM) and atomic force microscopy (AFM). This study followed the Declaration of Helsinki, and was approved by the Ethics Committee of Zhongshan Ophthalmic Center.Results:The immunofluorescence staining results showed that collagen Ⅳ was mainly distributed on the vitreal side and laminin on the retinal side of ILM in both groups.TEM findings revealed that the thickness of ILMs in the HM-MH group was (1.01±0.17)μm, which was significantly decreased compared with (1.92±0.21)μm in the IMH group ( t=12.880, P<0.001). The stiffness of the ILMs in the HM-MH group was (2.86±0.33)MPa, which was significantly higher than (0.88±0.23)MPa in the IMH group ( t=-12.650, P<0.001). The stiffness of the ILMs in the HM-MH group was positively correlated with the axial length ( r=0.832, P<0.001). Conclusions:Compared with IMH, the thickness of ILMs from HM-MH patients is thinner and the stiffness is higher, which contribute to a deep understanding of the pathogenesis of HM-MH.
ABSTRACT
Objective To evaluate the efficacy and safety of 27-gauge sutureless vitrectomy with air tamponade for rhegmatogenous retinal detachment (RRD).Methods The clinical data of 35 consecutive eyes with primary RRD from 35 patients who received 27-gauge vitrectomy with intraocular air tamponade in Zhongshan Eye Center from April 2016 to January 2017 were retrospectively analyzed.The mean follow-up duration was 8.6 months.Best corrected visual acuity (BCVA) (LogMAR) and intraocular pressure (IOP) were examined before surgery,1 week and 3 months after surgery.The operative duration,sclerotomy sites,retinal reattachment rate,intraoperative and postoperative complications were recorded.Results The mean duration of vitreous removal was (15.3 ± 3.6) minutes,and the mean duration of operation was (34.5 ± 4.8) minutes.No suturing process was performed at sclerotomy sites in all eyes.The retinal reattachment rate following a single procedure was 100％.The mean BCVA was significantly different among before surgery,1 week and 3 months after surgery (F =64.12,P＜0.01),and the BCVA at 1 week and 3 months after surgery was evidently improved in comparison with before surgery (0.82±0.31 vs.1.01 ±0.40;0.68±0.30 vs.1.01 ±0.40) (both at P＜0.05).The mean IOP was (14.69±3.66),(17.37±2.32) and (16.69±2.45) mmHg (1 mmHg =0.133 kPa) before surgery,1 week and 3 months after surgery,showing a significant difference among them (F=14.82,P＜0.01),and the IOP 1 week and 3 months after surgery was evidently higher than that before surgery (both at P＜0.05).The complications included intraoperative iatrogenic retinal breaks in 2 eyes,postoperative hypotony in 1 eye and hypertension in 5 eyes.These complications were curable.Conclusions 27-Gauge vitrectomy and air tamponade for RRD is an effective and safe approach.