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AIM: To discuss the clinical effect of 23-gauge pas plana vitrectomy ( PPV) for delay-onset endophthalmitis following cataract surgery.? METHODS: This retrospective chart review study included patients with delay-onset endophthalmitis that was present 6wk or more after cataract surgery, who underwent 23-gauge PPV from January 2010 to January 2016 at Renmin Hospital of Wuhan University. The diagnosis was made according to clinical symptoms and signs. The postoperative follow - up results were recorded, including anterior segment examinations, fundus examinations, and best-corrected visual acuity.?RESULTS:Totally 15 patients (15 eyes) were included. The average time between cataract surgery and their eye symptoms of endophthalmitis was 5. 13 ± 2. 41mo. The culture isolates revealed that 9 eyes ( 60％) were cultured positive, anaerobes in 4 eyes (44％), fungal infections in 3 eyes ( 33％) , aerobes in 2 eyes ( 22％) . The mean follow-up period was 12mo. The final visual outcomes were as follows:11 eyes ( 73％) achieved a better vision with PPV; 3 eyes ( 20％) achieved a better vision with PPV, total capsulectomy ( TC ) and IOL removal; 1 eye ( 7％) with PPV, silicone oil tamponade, total capsulectomy ( TC ) and IOL removal was enucleated because of uncontrolled inflammation.?CONCLUSION: The 23-gauge PPV is safe and effective for the management of delay - onset endophthalmitis following cataract surgery. Recurrence rate might be decreased with total capsulectomy and IOL removal.
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@#AIM: To evaluate the efficacy of surgery in eyes with vitreous hemorrhage secondary to central retinal vein occlusion complicated with primary hypertension. <p>METHODS: Totally 83 eyes of 83 consecutive primary hypertension patients with vitreous hemorrhage underwent vitrectomy were included. In 28 eyes of 28 patients, vitreous hemorrhage was caused by central retinal vein occlusion. All patients were followed up for 9-36mo, meanly 22.4mo. Main outcome measures included the best corrected visual acuity, intraoperative and postoperative complications,and the data were statistically analyzed and compared. <p>RESULTS: The incidence of vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion was 33.7%. The best corrected visual acuity increased in 24 eyes(86%), unchanged in 4 eyes(14%), there was a significant statistical difference between pre-operation and post-operation(<i>P</i><0.05). There were 5 eyes(18%)with macular edema after the surgery.There were no serious complications in and after the surgery in all 28 eyes. <p>CONCLUSION: Vitrectomy is a safe and effective treatment for vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion.
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Late intraocular lens dislocation is one of the most severe late complications after phacoemulsification.It often occurs 3mo after the surgery.Different from early intraocular lens dislocation, late intraocular lens dislocation is caused by zonular dehiscence and contraction of the capsular bag many years after phacoemulsification.In recent years, the incidence of late intraocular lens dislocation gradually increases, having a risk of 0.1% after 10a and 1.7% after 25a.In the long-term follow-up patients who underwent cataract surgery, 90% had zonular insufficiency and capsular contraction.Among the multiple factors which may contribute to zonular weakness and capsular contraction, pseudoexfoliation is the most common cause, accounting for 50% of all the cases.Other risk factors include aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders.The understanding of these predisposing factors will suggest necessary preventions for high-risk patients in the future.
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AIM:To study the efficacy and safety of Toric implantable contact lens (TICL) implantation in the treatment of patients with high myopia and astigmatism.METHODS: Totally 90 patients (178 eyes) diagnosed as this disease were selected in our hospital during September 2012 to September 2016 by the method of random.The UCVA, BCVA, refraction, astigmatism coefficient, corneal endothelial cell, intraocular pressure, manifest refraction examination were accessed and compared before and after 3 and 9mo of surgery.RESULTS: After 3 and 9mo of the surgery, the UCVA and BCVA were much higher than those before treatment, which the difference was statistically significant (P0.05).The corneal endothelial cells at 3 and 9mo after operation were compared with those of before treatment, and we found that the differences were statistically significant (P0.05).CONCLUSION: TICL implantation in the treatment of patients with high myopia and myopic astigmatism has a more obvious clinical efficacy and safety and reliability.
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AIM:To investigate the changes of subfoveal choroidal thickness ( SFCT ) in central serous chorioretinopathy ( CSCR) eyes and to compare them with normal control eyes. METHODS: This was a case-control study and a Meta-analysis. Forty - six CSCR patients diagnosed by the fundus pre - set lens, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. Sixty two age-, sex-, diopter- and axial length-matched 62 normal subjects ( 62 eyes ) were enrolled in this study as the control group. Using enhanced depth imaging optical coherence tomography ( EDI-OCT) , SFCT of CSCR eyes and normal control eyes were measured and compared. Univariate and multivariate linear regression analysis were performed to assess the association between SFCT and clinical factors. The Meta - analysis were conducted using the Stata software package to calculate the summary weighted mean differences ( WMDs) . RESULTS:The mean SFCT of the CSCR group and the normal control group was 397. 34±83. 91μm and 274. 48±62. 57μm, respectively. The CSCR eyes had a thicker choroid than the control eyes at the SFCT (P CONCLUSION:Along with the comprehensive Meta-analysis, SFCT in CSCR eyes was thicker than that of normal control eyes. Increased SFCT might be associated with CSCR.
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To investigate the curative effect of retaining the peripheral anterior lens capsule combined lensectomy with vitrectomy for ocular trauma. ●METHODS: Totally 33 patients ( 33 eyes ) with eye trauma underwent combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule and phase Ⅱposterior chamber lOL implantation. After follow - up of 6mo, visual acuity, intraocular pressure ( lOP ), lOL position, and intraoperative and postoperative complications were observed. ●RESULTS: Visions of all the patients were improved at varying degrees. After follow-up of 6mo, no obvious lens deflected and serious complications ( glaucoma, retinal detachment) appeared. ●CONCLUSlON: Combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule for ocular trauma has good curative effects of lessening complications during operation and postoperation and good visual acuity recovery.
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AIM: To investigate the time - effect relationship between the expression of rhodopsin and recoverin and photoreceptor damage induced by N - nethl - N -nitrosourea ( MNU) . METHODS: Thirty-six 7-week old Sprague-Dawley ( SD ) rats were intraperitoneally injected with MNU ( 60mg/kg ) and were put to death by dislocation of cervical vertebra 6, 12, 24h; 3, 7d after injection ( 6 per group) , respectively. As a control, six rats were injected with phosphate buffer saline (PBS) 5mL/kg and sacrificed on d3 after injection. The degree of photoreceptor apoptosis was detected by HE staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling ( TUNEL ) and transmission electron microscope ( TEM ) in the right eyes. The mRNA expressions of rhodopsin and recoverin were detected different time after injection by Western blot and immunohistochemical method in the left eyes. RESULTS:The dissolution of photoreceptor nucleus and apoptosis body were first perceived at 12h by TEM; most of cells at outer nuclear layer were presented positive reaction. The apoptotic index reached peak ( 29. 7% ±2.3%) at 24h which was coincided with the observation of TEM. The results of immunohistochemistry displayed that rhodopsin and recoverin were on a declining curve with time extension. Furthermore, the results of Western blot indicated that rhodopsin had dramatic decline at 6h after injection (P CONCLUSION:60mg/kg MNU intraperitoneally injection one - time may specifically induce photoreceptor apoptosis, The mechanism of down - regulation of rhodopsin and recoverin may be related to the selected apoptosis of photoreceptors.
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Background Salivary transplantation or duct transposition can provide continuous physiological secretion of tear substitutes.This may be an ideal method in treatment of dry eye.But the relative anatomical literatures is few,and some of the conclusions in the literatures are still controversial,which limit its clinical application.Objective This study was to discuss the possibility and the advantage and disadvantage of applying three major salivary glands to treat xerophthalmia.Methods The relationship between the branches of the facial nerve out of the parotid gland and the salivary glands,the salivary glands size,origin of blood supply,out diameter of vessels and adjacent relation were observed in 34 sides pate specimens perfused with red latex under the operating microscope.To find the vessels in recipient site to anastomose,the vessels around fossa orbitalis and forehead were anatomized and observed.The parotid gland duct transfer operation,the submandibular gland free transplantation surgery and sublingual gland free transplantation surgery in the human anatomy specimens were simulated.Results The position of parotid duct was constant.The duct length was(4.20± 1.10) cm,duct diameter was (O.60±0.30) cm.The stensen's duct was likely to be prolonged by the cheek mucous membrane or venous andthe damage of buccal branch,zygomatic branch and temporal branches of facial nerve should be avoided during the operation of transplanting stensen' s duct.When submandibular gland was transplanted,facial vessel was taken as its pedicle,whose outside diameter was (2.70 ± 0.28) mm,and the length of the transplant vascular pedicle was (1.90 ± O.30) cm.Thc anastomosed vessel was superficial temporal vessel in recipient site.When sublingual gland was transplanted,sublingual(88.2％,30 sides) or submental vessel(11.8％,4 sides) was taken as its pedicle,whose outside diameter was(1.92±0.36) mm and (1.96±0.54) mm,and the length of the transplant vascular pedicle was(2.60± 1.10) cm and(3.50±0.40) cm,and the anastomosed vessel was the frontal branch of superficial temporal vessel in recipient site.Three sides of specimens lacked sublingual glands.Conclusions It is feasible that treating severe xerophthalmia by the operation of grafting the major salivary glands or transplanting stensen' s duct on the point of anatomical view.Parotid duct inversion and the submandibular gland transplantation have been applied to clinic.However,sublingual transplantation remains to be further confirmed by the animal experiments.
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Background Sweep pattern visual evoked potential (SVEP) is an objective method of visual test.There is a clear correlation between SVEP acuity and subjective vision,but they are not identical.Recent studies showed that new regression method can improve the accuracy of SVEP acuity. Objective This trial was to investigate and compare the outcome between amplitude-spatial frequency (A-SP) regression method and amplitudelogVA (A-logVA) regression method in extrapolating the SVEP acuity.Methods SVEP was recorded in 113 eyes of 64 subjects using GT-2000 ( Guo Te,China) with the gratings of 10 different spatial frequency from 0.99 to 12.89 cpd as stimulus.The 1 13 eyes included cataract,glaucoma,corneal disease,optical neuropathy,retinal disease,ocular trauma,refractive error and normal eyes.The correlation were analyzed of SVEP acuity,decimal visual acuity and LogMAR visual acuity.The response were averaged and DFT on the monitor display.SVEP acuity was calculated by extrapolating 0 response amplitude.Results The correlation indices of decimal visual acuity curves obtained by the A-logVA function was 0.663,and that obtained by the A-SP function was 0.705.The positive correlation was seen between subjective decimal visual acuity and A-logVA decimal visual acuity (r =0.540,P＜ 0.01 ) and between subjective decimal acuity and decimal acuity calculated by the A-SP regression method (r=0.620,P＜0.01 ).SVEP decimal acuity calculated by the A-SP function regression method was significantly different from the that calculated by the A-logVA function regression method (Z =-8.688,P＜0.01 ).And the correlation indices of LogMAR visual acuity curves obtained by the A-logVA function was 0.733 and that obtained by the A-SP function was 0.715.The positive correlation was found between the subjective LogMAR acuity and that calculated by the A-SP regression method (r=0.700,P＜ 0.01 ) and between the subjective LogMAR acuity and LogMAR acuity calculated by the A-logVA regression method (r=0.710,P＜0.01 ).SVEP LogMAR acuity from A-SP function regression method was significantly different from the LogMAR acuity from A-logVA function regression method (Z=-8.748,P＜0.01 ).No significant differences of VA LogMAR were found in gender,eyes,type of disease and age(x2 =2.171,P=0.338;x2 =0.976,P=0.614;x2 =6.032,P=0.420;x2 =14.720,P=0.257 ).Conclusions SVEP can obtain the visual outcome in human.The amplitude-logVA function regression method is more accurate in extrapolating SVEP acuity.
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Background Intravitreal injection of triamcinolone acetonide (TA) can effectively eliminate central vein occlusion macular edema and improve visual acuity, and photopic negative response (PhNR) can reflect the inner retinal function of RGCs and their axons. It is possible there is a correlation between these two observations.Objective This study was to evaluate the changes of PhNR of flash electroretinogram (F-ERG) after intravitreal injection of TA for macular edema in central retinal vein occlusion ( CRVO ). Methods Thirteen eyes of 12 patients with macular edema caused by CRVO received an injection of 0. 1 ml (4 rg) of TA. PhNR,visual acuity and retinal thickness of macular area were assessed with Roland RETI scan 3. 15 system,decimal visual chart and Stratus optical coherence tomography (OCT) before and 4 weeks after the administration of TA. Written informed consent was obtained from each subject before any medical procedure. Results Visual acuity was improved in 12 eyes and stable in 1 eye 4 weeks following the intravitreal injection of TA. OCT showed that the retinal thickness of the macular area was reduced ;meanwhile,elevation of the amplitude of PhNR also was seen in the F-ERG after the administration of TA in comparison with before the administration of TA. The calculated results determined that the visual acuities were 0. 32t0. 12 and 0. 48±0. 09 (t=6. 325 ,P=0. 000) ,and the retinal thickness values of the macular area were (459.46± 131.31 ) μm and ( 297.54 ±43.31 ) μm ( t = 5.961, P = 0. 000 ), and the average amplitude of PhNR were ( 80. 23±22.96 ) μV and (61.28 ±20. 16 ) μV ( t = 4. 438, P = 0. 001 ) before and after the intravitreal injection of TA, respectively,showing significant differences. No significant correlation was found between PhNR amplitude and retinal thickness of the macular area both before and after the administration of TA ( before: r = 0. 587, P = 0. 035; after:r=-0. 011 ,P = 0. 971 ). Conclusion PhNR can be used for evaluating the status of inner retina after intravitreal injection of TA for macular edema of CRVO.
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Objective To investigate the waveform of the first-order kernel and second-order kernel of muhifocal electroretinogram stimulated with light emitting diode(LED).Design Prospective,noncomparative,interventional case series.Participant 18 subjects(18 eyes)who had been accepted the mfERG test.Method The patients were devided into two groups,they accepted the muhifocal elec- troretinogram(mfERG)stimulated with cathode ray tube(CRT)and LED using the Roland RETI Scan3.15 system.The first-order kernel or the second-order kernel was analyzed.The stimulation time of LED were changed from 1.7ms to 16.7ms.Five different stimulation time of LED in this study were 1/10(1.7ms),3/10(5ms),5/10(8.3ms),7/10(ll.7ms)and 10/10(16.7ms).Main Outcome Measure The summed responses were observed.The waveform,amplitude and implicit times of mfERG summed response were analyzed.Result The waveforms of the first-order kernel stimulated by LED were similar to those of CRT.In the second-order kernels of mfERG,the wave- forms were obviously different from those stimulated by LED and CRT.The P1 wave stimulated by CRT was sharp,but the P1 wave of LED was broad.The N2 wave of LED was deeper.The amplitude of N1 wave and P1 wave were increased,and their implicit times pro- longed with the stimulation times prolonging.Conclusion In the first-order kernel of mfERG,the waveform of the summed response stimulated by LED was similar to that of LED.In the second-order kernel of mfERG,the waveform stimulated by LED was more com- plicated,may be there were more inner retina information.(Ophthalmol CHN,2006,15:351-355)