Efficacy of scleral buckling for retinal detachment secondary to familial exudative vitreoretinopathy / 中华实验眼科杂志

Objective:To evaluate the efficacy of scleral buckling in the treatment of retinal detachment (RD) secondary to familial exudative vitreoretinopathy (FEVR).Methods:An observational case series study was conducted.A total of 37 patients (42 eyes) of RD secondary to FEVR who were treated with scleral buckling in Beijing Tongren Hospital from July 2010 to March 2021 were enrolled.There were 30 males (35 eyes) and 7 females (7 eyes), with an average age of (15.21±5.42) years old.Scleral buckling under general anesthesia was performed in all patients.There were 22 eyes with rhegmatogenous RD (RRD), of which 21 eyes were treated with local external compression combined with cerclage, and 1 eye was treated with radial spinal compression.There were 13 eyes with tractive RD (TRD), of which 12 eyes were treated with local external compression combined with cerclage and subretinal fluid drainage, and 1 eye was treated with scleral buckling combined with vitrectomy.There were 7 eyes with RRD combined with TRD, of which 4 eyes were treated with local external compression combined with cerclage and subretinal fluid drainage, and 3 eyes were treated with scleral buckling combined with vitrectomy.The average follow-up time was (30.61±10.50) months.The main outcomes were best corrected visual acuity (BCVA) of the operated eye converted to the logarithm of the minimum angle of resolution, retinal reattachment rate, and incidence of complications.The study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2018-056-GZ[2022]-07). Written informed consent was obtained from each subject or their guardians before entering the cohort.Results:The average BCVA was 0.83±0.50 at last follow-up after surgery which was better than 1.10±0.39 before surgery, and the difference was statistically significant ( t=6.639, P<0.001). There were 39 eyes with retinal reattachment and 3 eyes without retinal reattachment.The reattachment rate was 95.45%(21/22) in RRD, 84.62%(11/13) in TRD, and 100%(7/7) in RRD combined with TRD.No serious complication occurred in any patients during postoperative follow-up. Conclusions:On the premise of optimized surgical strategy based on the indications of RD secondary to FEVR, scleral buckling has a high retinal reattachment rate in the treatment of RD secondary to FEVR.

Comparison of surgical outcomes in air versus silicone oil tamponade in rhegmatogenous retinal detachment after 25G pars plana vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of air versus silicone oil tamponade for management of rhegmatogenous retinal detachment(RRD)following 25G pars plana vitrectomy(PPV).<p>METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.<p>RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both <i>P</i><0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% <i>vs</i> 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(<i>P</i><0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.<p>CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.

Comparative study of the clinical efficacy of 25G versus 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the clinical efficacy and safty of 25G and 27G pars planavitrectomy(PPV)in the treatment of rhegmatogenous retinal detachment(RRD)with air tamponade.<p>METHODS: Sixty-three cases(63 eyes)with RRD underwent 27G or 25G PPV from May 2016 to June 2018 were retrospectively reviewed. Thirty-three eyes(33 eyes)for 25G vitrectomy and 30 eyes underwent 27G vitrectomy. The main outcome measurements of the study included the best corrected visual acuity(BCVA, LogMAR), intraocular pressure, surgicaltime, retinal reattachment rate, intraoperative and postoperative complications.<p>RESULTS: There were no significant differences in baseline demographic between the two groups(<i>P</i>>0.05). The BCVA was increased significantly in both groups(all <i>P</i><0.01), but there was no significant difference in terms of visual improvement between the two groups(<i>P</i>>0.05). The mean surgical time in the 25G group was(44.13±5.9)min, which was no significant difference than that of 27G group(46.07±6.1)min(<i>t</i>=0.028, <i>P</i>=0.412). The retinal reattachment rate after a single operation was 91% and 93% for 25G and 27G group respectively(χSymbolr@@=0.015, <i>P</i>=0.902). There was no significant difference about hypotony(<6mmHg, 1mmHg=0.133kPa)between the 25G group(15%)and the 27G group(10%),(χSymbolr@@=0.376, <i>P</i>=0.540). No serious complication such as choroidal detachment and endophthalmitis was observed in both groups.<p>CONCLUSION: This study finds no significant differences in the surgical time, the rate of reattachment of retina, improvement of BCVA and complications between the 25G or 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade. 27G vitrectomy with air tamponade seems to be a safe, economical and effective surgery for RRD.

Minimally invasive vitrectomy for open ocular trauma with retinal detachment at different stages / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To study the clinical efficacy of phase Ⅱ minimally invasive vitreous surgery in different stages in treatment of open ocular trauma with retinal detachment.<p>METHODS: A retrospective analysis was performed on 41 patients(41 eyes)with open eye trauma combined with retinal detachment from December 2013 to June 2018 in the Ophthalmology Department of Xiaolan People's Hospital of Zhongshan. According to the opportunity of phase Ⅱ vitrectomy, 41 eyes were divided into two groups: 24 eyes in the early group(6d after injury)and 17 eyes in the conventional group(7-14d after injury). Postoperative follow-up with 6mo as the time point, the retinal reattachment rate, TPVR incidence, visual acuity and complications were compared between the two groups.<p>RESULTS: The retinal reduction rate was 92% in the early group and 76% in the conventional group, and the difference was not statistically significant, there was no statistical difference(<i>P</i>=0.692)in retinal reduction rate between the two groups. The incidence of TPVR in the early group was lower than that in the conventional group(<i>P</i>=0.014). The improvement of postoperative visual acuity in early group was better than the conventional group(<i>U</i>=119.5,<i> P</i>=0.0018). There was no significant difference in complications between the two groups.<p>CONCLUSION: Open ocular trauma patients with retinal detachment have better prognosis after phase Ⅱ vitrectomy within 6d after injury than 7-14d.