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Objective Face-down positioning after vitrectomy and gas tamponade is still the standard position for patients with rhegmatogenous retinal detachment.The study was to compare the nursing effects of face-down position and flexible position after vitrecto-my for the repair of rhegmatogenous retinal detachment. Methods We investigated 120 cases of patients with rhegmatogenous retinal detachment in this study.All patients received vitrectomy with long-acting gas for tamponade, 60 patients in face-down position and 60 in the flexible position.Patients were followed up for 6 months.Observation was made on the rates of anatomical retinal reattachment and postoperative complications between the groups. Results The rates of anatomical retinal reattachment after surgery were 88.33%in the face-down position group and 100% in the flexible position group respectively.As to the satisfaction of position, the flexible position group was 100%, which was much higher than 41.67%in face-down position group(P<0.01). Conclusion Flexible position nurs-ing after vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is safe and effective.Flexible position can replace face-down position for the comfort of patients with rhegmatogenous retinal detachment after vitrectomy with gas tamponade.
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BackgroundPterygium is an ocular surface disease of abnormal cell proliferative kind and angiogenesis plays an important role in its development and recurrence.Several anti-angiogenic therapies have been used to treat pterygium,but there very few studtes for the in vivo observation of the microvessles in pterygium.ObjectiveThis study was to observe angiogenesis in pterygium with a high-resolution confocal microscope in vivo and to perform immunohistochemical study in vitro.MethodsA prospective case-controlled study was designed.Twenty eyes of 20 consecutive patients with primary pterygia and 20 age- and sex-matched patients with inner eye diseases and strabismus with normal conjunctiva were enrolled in this study.An in vivo confocal microscopy imaging system (Heidelberg Retina Tomograph Ⅱ Rostock Cornea Module) was used to collect microvascular pictures from the anterior part of pterygia and normal nasal conjunctiva of controls,and then immunochemistry was performed to examine the expression of CD31 in microvessel in vitro.The vascular density values were compared between these two groups.The correlation of vascular density values between in vivo Heidelberg Retina Tomograph and in vitro immunohistochemistry was calculated.Written informed consent was obtained from pationts before any examination and surgery.ResultsUnder the in vivo confocal microscope,the microvessel density was (8929±2993) μm/mm2 and (4202 ±692)μm/mm2,respectively,in pterygium and the normal conjunctiva group with a statistically significant difference between them (t =6.881,P＜0.01 ).Immunochemistry revealed that the expression of CD31 to measure vascular density was ( 21.00 ± 4.06/400 × field ) and ( 6.07 ± 1.75/400 × field ) in pterygium and the normal conjunctiva group,showing significant difference (t =12.312,P＜0.01 ).Positive correlations were found in the vascular density values between in vivo corneal laser confocal microscopy examination and in vitro immunochemistry examination in both the pterygium group and normal conjunctiva group (pterygium group:r=0.649,P＜0.01 ;normal conjunctiva group: r=0.572,P＜0.01 ) ConclusionsIn vivo confocal microscopy imaging is superior to in vitro immunochemistry in evaluating the microvessel of pterygium.The results of this study offer a new way index for further investigation of the biological behavior of pterygium and its mechanism.
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Objective: To investigate the hemodynamic changes of ophthalmic artery(OA) and central retinal artery(CRA) in patients with primary angle-closure glaucoma(PACG) and the effects of intraocular pressure(IOP) on retrobulbar hemodynamics. Methods: Following the measurement of IOP by non-contact tonometry,hemodynamic changes of OA and CRA were examined by color Doppler imaging(CDI) in 45 patients(90 eyes) with PACG,who were divided according to IOP into a hypertension(38 eyes) and a normal tension group(52 eyes).Observations were made of the peak systolic velocity(PSV),end-diastolic velocity(EDV),pulsatility index(PI) and resistance index(RI).Results: Significant differences were found between the PACG patients and the normal controls in CRA-EDV(P
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Objective: To observe the clinical results of eyeball double perforation caused by metal foreign body treated by virectomy. Methods: By clinical examination combined with orbital CT, 12 eyes in 12 cases were diagnosed as eyeball double perforation caused by metal foreign body, all these eyes underwent vitrectomy, endocoagulation, and C_3F_8 vitreous cavity tamponade. Postoperative follow-up ranged from 6 months to 5 years. Results: Nine eyes’ retina remained attached. 3 eyes with retina detachment and PVR were reoperated with vitrectomy and silicon oil tamponade, and the retina reattached. Conclusion: Orbital CT is an accurate and sensitive method in diagnosing eyeball double perforation caused by metal foreign body, vitrectomy is an efficacious surgical method in the treatment of eyeball double perforation.
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Objective:To investigate the efficacy of Vitreoretinal surgery for retinal detachment due to macular hole in high myopia. Methods:20 cases( 20 eyes) of retinal detachment due to macular hole in high myopia from Dec. 2000 to Apr. 2004 were analysed retrospectively. 3 cases were male and 17 were female, with a following up of 2 to 30 months (15 months in average). The Pars Plana Vitrectomy with long acting gas or silicon oil tamponade were used. The patients were kept face down at least 7 days after the surgery. Results:5 eyes used silicon oil and the others used gas tamponade. The successful rate of retinal reattachment was 80% ( 16/20) with one procedure in a month after the surgery . There were 4 cases of retinal redetachment in the follow-up duration, among them 3 cases used gas and one used silicon oil tamponade. All of them refused to accept another surgery. There were 3 eyes ( 15%) of the best corrected visual acuity greater than or equal to 0.05 before surgery and 11 eyes ( 55%) equal to or greater than 0.05 after the surgery. There was a significant difference between them(P= 0.0386 ). The main complications were slight retinal bleeding in 3 eyes ( 15%); second glaucoma in 2 eyes (10 %); nuclear cataract in 4 eyes ( 20%). Conclusion:Vitreoretinal surgery for retinal detachment with macular hole is available to improve visual acuity in high myopia.
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Objective:To observe the clinic effectiveness of cryoretinopexy under light fiber illumination during vitreoretinal surgery. Methods: Twenty-two patients with complex retinal detachment underwent vitrectomy,fluid-air exchange,cryoretinopexy under light fiber illumination.Postoperative vitreous cavity tamponade was accomplished with silicone oil in 14 cases,perfluoropropane gas in 8 cases,8 cases combined with sclera encircling. Results: Postoperative follow-up ranged 3 months to 1 year,retinal tear or hole closed and retina reattached in 20 cases.The success rate of operation was 90.9%. Conclusion: Cryoretinopexy under light fiber illumination during vitreoretinal surgery positioning is easy and accurate and the effect is definite.