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AIM: To compare the effect of different courses of budesonide nasal spray on the postoperative efficacy of endoscopic dacryocystorhinostomy.METHOD: Prospective study. A total of 90 patients(90 eyes)with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy in our hospital from January 2019 to April 2022 were selected, and they were randomly divided into three groups. In group A, 30 patients(30 eyes)continued to use budesonide nasal spray for 2mo after surgery; in group B, 30 patients(30 eyes)continued to use budesonide nasal spray for 3mo after surgery; in group C, 30 patients(30 eyes)continued to use budesonide nasal spray for 4mo after surgery. Follow-up for 6mo after surgery, Lund-Kenndey score, surgical efficacy and complications of the three groups were compared.RESULT: At 3, 4 and 6mo after surgery, the Lund-Kenndey score of group C was lower than that of group A(P<0.05), and there was no statistical difference between group C and group B(P>0.05). Following up to 6mo, the surgical efficacy of group C was better than that of group A, and the incidence of complications was lower than that of group A(P<0.05); There was no statistically significant difference in efficacy and complications between group C and group B(P>0.05).CONCLUSION: Budesonide combined with endoscopic dacryocystorhinostomy has acceptable efficacy in the treatment of chronic dacryocystitis. After 3mo of treatment, inflammation can be well controlled, which can reduce the occurrence of postoperative complications and improve the effective rate of surgery. However, increasing the treatment course cannot further improve the effective rate of surgery.
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AIM: To compare the efficacy of 25-gauge(25G)vitrectomy combined with intraocular lens transciliary sulcus scleral suture fixation and sutureless scleral tunnel interlamellar fixation in the treatment of complete lens dislocation.METHODS: Retrospective case-control study. A total of 40 patients(40 eyes)diagnosed with complete lens luxation in the vitreous cavity in our hospital from May 2015 to September 2021 were selected, among which 21 eyes(suture group)underwent 25G vitrectomy combined with intraocular lens fixation via ciliary sulci scleral suture, and 19 eyes(sutureless group)underwent 25G vitrectomy combined with interlamellar scleral tunnel fixation of intraocular lens. The patients in both groups were followed up until 3mo after surgery to observe the operative time, best corrected visual acuity(BCVA), corneal endothelial cell count(CECC), central corneal thickness(CCT)and postoperative complications.RESULTS: The operation time was significantly shorter in the sutureless group than in the suture group(31.79±6.01min vs. 45.38±8.04min, P<0.001). BCVA in both groups was significantly improved after surgery(all P<0.05), and the BCVA(LogMAR)at 1wk after operation in the sutureless group was significantly better than that in the suture group(0.32±0.14 vs. 0.57±0.25, P<0.001). At 3mo after surgery, CECC in both groups was lower than that before surgery(all P<0.01). The CCT at 1wk after operation in the suture group was greater than that before operation and at 3mo after operation(all P<0.01), and there was no significant change in CCT before and after surgery in the sutureless group. During follow-up period, the total complication rate in the sutureless group was lower than that in the suture group(26% vs. 38%, P>0.05).CONCLUSION: 25G vitrectomy combined with intraocular lens sutureless scleral tunnel interlamellar fixation in the treatment of complete lens luxation has shorter operation time, faster postoperative visual acuity improvement and fewer postoperative complications.
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@#AIM: To evaluate efficacy, safety and complications of 25G vitrectomy, phacoemulsification combined with intrascleral fixated intraocular lens(IOL)implantation for treatment of lens luxation.<p>METHODS: Totally 20 patients(20 eyes)with complete lens luxation and the hardness of lens nucleus was grade 3 or above who underwent 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation between May 2018 and December 2020 were analyzed retrospectively. The uncorrected visual acuity, best corrected visual acuity, intraocular pressure, the count of corneal endothelium cell, central corneal thickness and complications were observed. <p>RESULTS: The uncorrected visual acuity and best corrected visual acuity after operation were improved than those before treatment(<i>P</i><0.05). The number of corneal endothelial cells in the central part of cornea after operation was lower than that before operation(<i>P</i> >0.05). There was no significant difference in central corneal thickness 2wk after operation compared with that before operation(<i>P</i> >0.05). There were 3 cases of low intraocular pressure and 2 cases of high intraocular pressure, but they all returned to normal at the end of follow-up. The IOL were all centered and there were no obvious eccentricity and inclination. No other complications such as vitreous hemorrhage and retinal detachment occurred.<p>CONCLUSION: 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation is a fast, safe and simple method for the treatment of complete lens luxation.
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@#AIM: To investigate the prognostic value of DIP endoscopic scoring system for simultaneous operation of chronic dacryocystitis complicated with sinusitis.METHODS: From January 2018 to February 2021, 96 patients(96 eyes)with chronic dacryocystitis complicated with sinusitis who underwent nasal endoscopic sinus surgery and dacryocystorhinostomy were enrolled in a prospective single-blind study. Patients were examined by nasal endoscopy and recorded video to get DIP endoscopic score before operation. The patients were followed-up for 6mo, and the curative effect was based on the results of the last follow-up. The receiver operating characteristic curve(ROC curve)was drawn according to DIP endoscopic scoring system and postoperative curative effect, and the value of DIP endoscopic scoring system in predicting the prognosis of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was evaluated. According to the best cutoff value obtained by ROC curve analysis, patients were analyzed in subgroups, and the age and sex constituent ratio of two groups were compared. RESULTS: Among the 96 eyes with chronic dacryocystitis complicated with sinusitis, 86 eyes(90%)were cured, 4 eyes(4%)were improved, and 6 eyes(6%)were invalid. ROC curve analysis showed that the area under the ROC curve(AUC)of DIP endoscopic score for predicting the curative effect of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was 0.905. When Yoden index reached its peak, the DIP endoscopy score was 16.5 as the best cutoff value. At the same time, the sensitivity was 80.0% and the specificity was 86.0%. In the subgroup analysis, there was no significant difference in age and sex constituent ratio between the two groups(<i>P</i>>0.05); The surgical efficiency of patients with DIP endoscopic score <16.5 was better than the patients with DIP endoscopic score ≥16.5(<i>P</i><0.05).CONCLUSION: DIP endoscopic scoring system has a good predictive value for the prognosis of endoscopic of transnasal endoscopic sinus opening combined with dacryocystorhinostomy.
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@#AIM: To observe the changes of retinal nerve fiber layer(RNFL)thickness and visual field loss in patients with severe non proliferative diabetic retinopathy(NPDR)treated by panretinal photocoagulation(PRP).<p>METHODS: This was a prospective clinical study. From January 2017 to March 2018, 35 patients(52 eyes)with severe NPDR diagnosed in our hospital were selected as photocoagulation group(conventional therapy combined with PRP)and 35 patients(52 eyes)with severe NPDR matched with age and gender in the same period were selected as the control group(conventional therapy, use difrarel, ginkgo leaves tablets, mecobalamin and other drugs to protect blood vessels, improve microcirculation and nourish nerves). The best corrected visual acuity(BCVA), RNFL thickness and visual field of the two groups were compared after 1a after treatment.<p>RESULTS: There was no significant difference in BCVA before and after treatment in the photocoagulation group(<i>P</i>>0.05), but the BCVA of the control group decreased(<i>P</i><0.05). There was no significant difference in temporal RNFL thickness(74.5±13.7μm <i>vs</i> 70.8±11.3μm, <i>P</i>>0.05)in the photocoagulation group, and the thickness of RNFL in the other quadrants and the mean RNFL were thinner than those before treatment(<i>P</i><0.05); there was no significant change in the MS of the corresponding field of vision of the temporal nerve fiber(22.5±8.7dB <i>vs</i> 20.8±7.2dB, <i>P</i>>0.05), the other quadrants and the mean MS were lower than those before treatment(<i>P</i><0.05). Before and after treatment, the change of RNFL thickness of the patients in the photocoagulation group showed weak positive correlation or no correlation with the change of visual field MS corresponding to the RNFL at nasal, nasal superior, temporal superior, temporal, temporal superior, temporal inferior and average RNFL.<p>CONCLUSION: PRP can effectively control the further development of severe NPDR and maintain the visual acuity of patients, but the damage of PRP to RNFL and visual field cannot be ignored.
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@#AIM: To explore the value of Lund-Mackay score in the surgical treatment of chronic dacryocystitis with chronic sinusitis.<p>METHODS: Totally 92 cases(92 eyes)of chronic sinusitis with chronic dacryocystitis in our hospital from May 2016 to March 2019 were included in the prospective, single-blind study. According to Lund-Mackay score, the patients were divided into three groups: mild(22 cases), moderate(34 cases)and serious(36 cases). Each group was randomly divided into simultaneous operation group and phased operation group. We compared the operative effect and complications of simultaneous and phased operations.<p>RESULTS: In patients with mild and moderate chronic sinusitis combined with chronic dacryocystitis, there was no statistical difference in the efficiency and complications between simultaneous and phased operations(<i>P</i>>0.05). In patients with severe chronic sinusitis combined with chronic dacryocystitis, the efficiency of phased operations was higher than that of the simultaneous surgery(94% <i>vs</i> 61%, <i>P</i><0.05), and the complications were lower than that of the simultaneous surgery(<i>P</i><0.05). <p>CONCLUSION: According to Lund-Mackay score, patients with mild to moderate chronic sinusitis and chronic dacryocystitis are advised to undergo simultaneous surgery, while patients with severe rhinosinusitis are advised to undergo phased surgery.
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@#AIM: To observe the clinical effect of ranibizumab injection combined with vitrectomy,panretinal photocoagulation(PRP)and trabeculectomy in the treatment of neovascular glaucoma(NVG).<p>METHODS: Retrospective study. From March 2017 to October 2018, 44 NVG patients(44 eyes)were treated, 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + vitrectomy + PRP+trabeculectomy(group A), and 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + trabeculectomy+PRP(group B).The patients were followed up for 6mo, the visual acuity, intraocular pressure(IOP), IOP control rate, neovascularization and complications were observed. <p>RESULTS: There was no significant difference in IOP between the two groups before treatment(46.2±9.41mmHg <i>vs</i> 49.1±10.15mmHg, <i>P</i>>0.05). The IOP of group A was lower than that of group B at 1wk, 1mo and 6mo after treatment(<i>P</i><0.05). 6mo after treatment, the visual acuity, IOP control rate(95%)and neovascularization regression(91%)in group A were better than those in group B(<i>P</i><0.05), but there was no difference in the incidence of complications between the two groups during the follow-up period(<i>P</i>>0.05).<p>CONCLUSION: It is safe and effective to treat NVG with intravitreal ranibizumab injection combined with vitrectomy, PRP and trabeculectomy, which can control IOP steadily and improve visual acuity of some patients.
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@#AIM: To explore the value of Lund-Mackay score in the surgical treatment of chronic dacryocystitis with chronic sinusitis.<p>METHODS: Totally 92 cases(92 eyes)of chronic sinusitis with chronic dacryocystitis in our hospital from May 2016 to March 2019 were included in the prospective, single-blind study. According to Lund-Mackay score, the patients were divided into three groups: mild(22 cases), moderate(34 cases)and serious(36 cases). Each group was randomly divided into simultaneous operation group and phased operation group. We compared the operative effect and complications of simultaneous and phased operations.<p>RESULTS: In patients with mild and moderate chronic sinusitis combined with chronic dacryocystitis, there was no statistical difference in the efficiency and complications between simultaneous and phased operations(<i>P</i>>0.05). In patients with severe chronic sinusitis combined with chronic dacryocystitis, the efficiency of phased operations was higher than that of the simultaneous surgery(94% <i>vs</i> 61%, <i>P</i><0.05), and the complications were lower than that of the simultaneous surgery(<i>P</i><0.05). <p>CONCLUSION: According to Lund-Mackay score, patients with mild to moderate chronic sinusitis and chronic dacryocystitis are advised to undergo simultaneous surgery, while patients with severe rhinosinusitis are advised to undergo phased surgery.
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@#AIM: To observe the clinical efficacy of intravitreal injection of conbercept combined with trabeculectomy and conbercept combined with Ahmed glaucoma valve implantation in treatment of neovascular glaucoma(NVG).<p>METHODS: Totally 40 cases(40 eyes)of NVG patients selected from our hospital from February 2016 to June 2017 were retrospectively analyzed. According to the treatment methods, they were divided into group A(conbercept with trabeculectomy+ panretinal photocoagulation)and group B(conbercept combined with Ahmed glaucoma valve implantation+ panretinal photocoagulation), 20 cases(20 eyes)in each group. The visual acuity, intraocular pressure, intraocular pressure control rate, neovascularization were observed after 6mo follow-up.<p>RESULTS: Before treatment, there was no significant difference in intraocular pressure between the two groups(<i>P</i>>0.05). The intraocular pressure in group B was lower than that in group A(<i>P</i><0.05)at 6mo after treatment, but there was no significant difference in visual acuity, intraocular pressure control rate and the regression of neovascularization between the two groups(All <i>P</i>>0.05).<p>CONCLUSION: Intravitreal injection of conbercept combined with Ahmed glaucoma valve implantation and conbercept combined with trabeculectomy for NVG are safe and effective, but the former is more effective in reducing intraocular pressure.