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@#AIM: To analyze the risk factors of corneal epithelial dysfunction(CED)after pars plana vitrectomy(PPV).<p>METHODS: Clinical data of 235 patients with 235 eyes of PPV from July 2016 to June 2018 in our hospital were retrospectively analyzed. The age, sex and related medical history of the patients(such as ocular lesions and systemic diseases)were collected, and the intraocular fillers, operation time, postoperative intraocular pressure were recorded. Logistic regression was used to analyze the risk factors of CED after PPV.<p>RESULTS: The incidence of CED after PPV was 16.6%(39/235), and the incidence of persistent corneal epithelial lesion was 1.3%(3/235). Logistic regression showed that age, preoperative xerophthalmia, diabetes mellitus, Silicone oil filling, postoperative high intraocular pressure and operation time were risk factors for CED after PPV. The <i>OR</i> values were 1.270, 5.218, 18.598, 4.659, 10.799 and 1.104, respectively.<p>CONCLUSION: Age, preoperative xerophthalmia, diabetes mellitus, silicone oil filling, postoperative high intraocular pressure and operation time are risk factors for CED after PPV.
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@#AIM:To observe, analyze and compare the effect of minimally external surgery under microscopy and traditional external surgery on the treatment of non-complicated rhegmatogenous retinal detachment. <p>METHODS:The clinical data of 53 patients with 53 eyes of non-complicated rhegmatogenous retinal detachment in our hospital was analyzed retrospectively, of which the minimally external retinal detachment surgery under microscopy was performed in 25 patients with 25 eyes of non-complicated rhegmatogenous retinal detachment(the research group), and the traditional external retinal detachment surgery was performed in 28 patients with 28 eyes of non-complicated rhegmatogenous retinal detachment(the control group). All surgeries were performed by the same surgeon, and the clinical efficacy and complications of the two groups were compared and analyzed. <p>RESULTS: In postoperative hole closure, there was no significant difference in the primary rate of reattachment of the retina between the two groups(<i>P</i>>0.05). There was a statistically significant difference in postoperative complications between the two groups(<i>P</i><0.05). The best corrected visual acuity after surgery was better than that before surgery in both groups. There was no significant difference in the increase of postoperative visual acuity between the two groups(<i>P</i>>0.05). There was a statistically significant difference in operative time between the two groups(<i>P</i><0.05). <p>CONCLUSION: The effect of minimally external retinal surgery under microscopy and traditional external retinal surgery is similar in the treatment of non-complicated rhegmatogenous retinal detachment, but the minimally external retinal surgery has the advantages of shorter time, less damage and fewer complications.
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? AIM: To observe the efficacy and safety of the phacoemulsification combined with goniosynechialysis and the phacoemulsification combined with trabeculectomy for angle-closure glaucoma ( ACG ) with different closure conditions accompanied with cataract.?METHODS:A total of 65 patients (70 eyes) with primary ACG accompanied with cataract were selected from those admitted in our hospital and were given phacoemulsification with goniosynechialysis ( group A, 30 patients with 33 eyes ) and the phacoemulsification with trabeculectomy ( group B, 35 patients with 37 eyes ) according to the conditions of the closed anterior angle, respectively. The two groups of patients were observed for preoperative and postoperative intraocular pressure ( IOP ) , vision, anterior chamber depth, and complications, and were followed up for 6. 5mo (6-8mo) on average.?RESULTS: Mean postoperative IOP in either group A or group B at 1mo after operation was of statistically significant difference, compared with mean preoperative IOP (P0. 05) and postoperative complications (P>0. 05).?CONCLUSION: Clinical doctors can choose appropriate treatment according to different conditions of the closed anterior angle in patients with primary angle- closure glaucoma.
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BACKGROUND: Cerebral stroke is a disease with a high disability rate and a high fatality rate. This study was undertaken to assess the risk of stroke associated pneumonia (SAP) in patients with ischemic stroke using A2DS2 score. METHODS: Altogether 1279 patients with ischemic stroke who were treated in our department from 2009 to 2011 were retrospectively analyzed with A2DS2 score. A2DS2 score was calculated as follows: age ≥75 years=1, atrial fi brillation=1, dysphagia=2, male sex=1; stroke severity: NIHSS score 0–4=0, 5–15=3, ≥16=5. The patients were divided into three groups according to A2DS2 score: 620 in score 0 group, 383 in score 1–9 group, and 276 in score ≥10 group. The three groups were comparatively analyzed. The diagnostic criteria for SAP were as follows: newly emerging lesions or progressively infiltrating lesions on post-stroke chest images combined with more than two of the following clinical symptoms of infection: (1) fever ≥38 °C; (2) newly occurred cough, productive cough or exacerbation of preexisting respiratory tract symptoms with or without chest pain; (3) signs of pulmonary consolidation and/or wet rales; (4) peripheral white blood cell count ≥10×109/L or ≤4×109/L with or without nuclear shift to left, while excluding some diseases with clinical manifestations similar to pneumonia, such as tuberculosis, pulmonary tumors, non-infectious interstitial lung disease, pulmonary edema, pulmonary embolism and atelectasis. The incidence and mortality of SAP as well as the correlation with ischemic stroke site were analyzed in the three groups respectively. Mean± standard deviation was used to represent measurement data with normal distribution and Student'st test was used. The chi-square test was used to calculate the percentage for enumeration data. RESULTS: The incidence of SAP was significantly higher in the A2DS2 score≥10 group than that in the score 1–9 and score 0 groups (71.7％ vs. 22.7％, 71.7％ vs. 3.7％, respectively), whereas the mortality in the score≥10 group was signifi cantly higher than that in the score 1–9 and score 0 groups (16.7％ vs. 4.96％, 16.7％ vs. 0.3％, respectively). The incidences of cerebral infarction in posterior circulation and cross-MCA, ACA distribution areas were significantly higher than those in the SAP group and in the non-SAP group (35.1％ vs.10.1％, 11.4％ vs. 7.5％, respectively). The incidence of non-fermentative bacteria infection was significantly increased in the score≥10 group. CONCLUSIONS: A2DS2 score provides a basis for risk stratification of SAP. The prevention of SAP needs to be strengthened in acute ischemic stroke patients with a A2DS2 score≥10.
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AIM: To assess the impact of diabetes on corneal endothelial cells through the quantitative analysis of corneal endothelial cell morphology for patients with diabetics. METHODS: The corneal thickness and endothelial cell morphology of 360 eyes of 299 cases were detected using full automatic corneal endothelial cell analyzer. The normal control group included 175 eyes of 148 cases, and there were 185 eyes of 151 cases for the patients with diabetes, 110 eyes of 92 cases for the non-proliferating phase group and 75 eyes of 59 cases for the proliferating phase group. The average density of central corneal endothelial cells, proportion of hexagonal cells, coefficient of variation and corneal thickness were compared among groups, and then the statistical analysis was conducted. RESULTS: Compared with the cornea of the normal group, in the diabetes group, the coefficient of variation of corneal endothelial cells and central corneal thickness increased, while the average density of central corneal endothelial cells and proportion of hexagonal cells decreased, showing a significant difference (P0. 05). CONCLUSION: Compared with the cornea of normal control group, in the diabetes group, the corneal endothelial cells show abnormal morphology, which aggravates with the severity of lesions, especially for the significant changes in the coefficient of variation and the proportion of hexagonal cells. As a result, the corneal resistance to damage in patients with diabetes will decrease.