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Background@#To determine the visual and anatomical outcomes after rhegmatogenous retinal detachment surgery.@*Methods@#Case files of patients who had surgery for rhegmatogenous retinal detachment at the 3rd state central hospital May 2019 and May 2021 were reviewed. Information obtained included age, sex, presenting and post-operative visual acuity, anatomical reattachment, post- operative complications and causes of treatment failure.@*Results@#Risk factors for retinal detachment included myopia in 8 eyes (32%), trauma in 7 eyes (28%), prior cataract surgery in 2 eyes (8%). 22 eyes (88%) presented with macula off while 3 eyes (12%) presented with macula partly or completely attached. Visual acuity at presentation was <0.01 in 15 eyes (60%). Following surgery, retina was attached in 23 eyes (92%) and remained detached 2 eyes (8%). Visual acuity after surgery was 0.1< 17 eyes, 0.4< 7 eyes. Visual acuity improved in 23 eyes (84%), remained the same in 2 eyes (8%). @*Conclusion@#Myopia and trauma are important risk factors for Rhegmatogenous Retinal Detachment. Majority of patients in this setting presented late with Rhegmatogenous Retinal Detachment and this was responsible for relatively poor visual outcomes despite good anatomical results after surgery. Proper screening of eyes at risk and education of patients is important for preventing visual loss due to retinal detachment.
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Purpose: To analyze and report outcomes of microincision vitrectomy surgery (MIVS) for Stage 4 and 5 retinopathy of prematurity (ROP). Methods: Medical records of 202 eyes of 129 premature children undergoing MIVS for Stage 4/Stage 5 ROP between January 2012 and April 2015 were evaluated. The primary outcome measure was the proportion of eyes with anatomical success (defined as attached retina at the posterior pole at last follow-up). Complications associated with MIVS were noted and analysis of risk factors associated with poor anatomical outcome was also done using logistic regression. Results: Mean age of presentation of babies with Stage 4 ROP (2.9 ± 1.75 months) was lower than those with stage 5 disease (5.62 ± 2.55 months) (P < 0.005). One hundred seventeen eyes (56% or 58%) had Stage 5, 38 (19%) had Stage 4a, and 47 (23%) Stage 4b. Ninety-four eyes (47%) had received prior treatment (laser and/or anti-vascular endothelial growth factors [VEGF]). Lens-sparing vitrectomy (LSV) was performed in 58 (29%) eyes while lensectomy with vitrectomy (LV) was performed in 144 (71%) eyes. At a mean follow-up of 32.5 weeks, 102 (50.5%) eyes achieved anatomical success, including 74% eyes in Stage 4a and 4b and 33% in Stage 5. Complications included intraoperative break formation (19%), postoperative vitreous hemorrhage (28%), raised intraocular pressure (12.7%), and cataract progression (2.4%). Factors significantly associated with favorable anatomical outcome were Stage 4 disease (vs. Stage 5) (odds ratio [OR] 5.8; confidence interval [CI] =2.6–13.8, P < 0.005), prior treatment (laser ± anti-VEGF) (OR 2.5; CI 1.4–4.7, P < 0.005) surgery with 25G MIVS (vs. 23G) (OR: 1.7; CI = 0.98–3.00, P = 0.05) and LSV (vs. LV) (OR 7; CI = 3.4–14.6, P < 0.005). Retinal break was significantly associated with poor anatomical outcome (OR 0.21; CI = 0.09–0.5, P < 0.005). Conclusion: MIVS along with wide angle viewing systems allow surgeons to effectively manage ROP surgeries while at the same time reducing complication rate in these eyes which have complex pathoanatomy and otherwise grim prognosis.
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@#AIM: To investigate the clinical efficacy and safety of vitrectomy combined with stage I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.<p>METHODS: Select 67 case(76 eyes)of diabetic retinopathy complicated with cataract patients in the First Affiliated Hospital of Jiamusi University during March 2015 to April 2017 as retrospective analysis. According to different surgical methods, they were divided into group A(stage I vitrectomy + phacoemulsification + silicone oil filling + intraocular lens implantation, phase II silicone oil extraction)and group B(stage I vitrectomy + lens phacoemulsification + silicone oil filling), stage II silicone oil extraction + intraocular lens implantation). The visual acuity improvement, intraocular pressure and postoperative complications were compared between the two groups.<p>RESULTS: At 3mo after operation, there was no difference in visual acuity between the two groups(<i>P</i>>0.05). There was no significant change in intraocular pressure between the two groups 3mo before and after surgery(<i>P</i>>0.05). Vitreous hemorrhage(3% <i>vs</i> 5%), choroidal hemorrhage(0% <i>vs</i> 2%), retinal detachment(6% <i>vs</i> 2%), retinal tears(6% <i>vs</i> 10%)There was no significant difference in incidence(<i>P</i>>0.05).<p>CONCLUSION: There was no significant difference in the efficacy of vitrectomy combined with I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.
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Objective To observe and analysis the clinical effects and postoperative complications of intravitreal injection of conbercept during vitrectomy surgery (VRS) in severe proliferative diabetic retinopathy (PDR) treatment.Methods This is a prospective non-randomized controlled clinical study.A total of fifty-seven patients (sixty eyes) with severe PDR were enrolled in Tianjin Eye Hospital from June 2015 to March 2016,and the patients were divided into conbercept injection group and control group according to the patients' surgical method intention selection.The patients in conbercept injection group received an intravitreal injection of 0.05 ml conbercept solution during the surgery.The patients in control group only received VRS.The operations of the two groups were completed by the same doctor,and the follow-up time was 6 to 10 months after the surgery.The incidence of postoperative complications including a transient high intraocular pressure,early and late incidence of vitreous hemorrhage(VH),epiretinal membrane and traction retinal detachment (TRD),neovascular glaucoma (NVG),the central retinal thickness (CRT) and the best corrected visual acuity (BCVA) (LogMAR visual acuity) were comparatively analyzed.Results The incidence of early VH was 6.7％ (2/30) in conbercept injection group,which was significantly lower than 26.7％ (8/30) in control group (x2 =4.32,P =0.04).The incidences of late VH were 3.3％ (1/30) and 10.0％ (3/30) in conbercept injection group and control group,and the differences had no statistically significant difference (x2 =1.07,P＞0.05).The incidences of a transient high intraocular pressure,TRD and NVG between the two groups had no statistically significant difference (x2=0.69,0.22,2.07;all at P＞0.05).The change of CRT from one week to one month after the operation in conbercept injection group was more remarkable than that in the control group,and the difference was statistically significant (t=-3.23,P＜0.05).The mean LogMAR BCVA in two groups at 1 month and 6 months after operation were both improved in different degrees compared with the preoperative vision.The difference of mean LogMAR BCVA at 6 months was statistically significant (P＜0.05).Conclusions The intravitreal injection of conbercept during VRS in severe PDR patients can effectively prevent postoperative early VH,decrease CRT and improve visual acuity.
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·AIM:To compare the short-term surgical results of 27-gauge ( 27G ) with 25 - gauge ( 25G ) microincision vitrectomy surgery ( MIVS ) for the treatment of vitreoretinal diseases and evaluate the feasibility, safety and effectiveness of 27G MIVS. · METHODS: Two hundred and seventeen eyes with various vitreoretinal diseases underwent 27G or 25G MIVS from April 2016 to October 2017 and were retrospectively reviewed. One hundred and thirty-five eyes underwent 27G vitrectomy and 82 eyes for 25G vitrectomy. The main outcome measurements of the study included surgical time, intraoperative complications, postoperative ocular inflammation reaction, short-term best corrected visual acuity ( BCVA, LogMAR ) recovery and intraocular pressure fluctuation. ·RESULTS: All surgeries were completed successfully, and no eye in 27G group needed conversion to 25G vitrectomy. The mean surgical times in the 25G group was 56. 4±38. 9 min, which was significant longer than that of 27G group (45. 5 ± 26. 1 min, t= 2. 422, P= 0. 016). However, when comparing the surgical time for each category of disease, there were no significant differences observed (P>0. 05). Within the first week postoperatively, the mean cumulative score of conjunctival congestion, anterior chamber flare and aqueous cell in 25G group were 2.4±1.4, 0.7±1 and 0.5±1, which were higher than those in 27G group (2. 1 ± 1. 6, 0. 3 ± 0. 6, and 0. 2 ± 0. 4), with significant differences (P=0. 038, P=0. 011, P=0. 046 respectively). The improvement of BCVA was-0. 4±0. 9 in 25G group, and -0. 2 ± 0. 9 in the 27G groups respectively (t= -1. 636, P = 0. 103 ). The rate of transient ocular hypotony of the 25G vitrectomy was 19. 5% (16 eyes), which was higher than that of the 27G group without significant difference ( 15. 6% , 21 eyes; χ2= 0. 565, P=0. 452). When the eyes injected with silicone oil were excluded, there was no significant difference in intraocular pressure fluctuation between the 25G group (3. 59±0. 69mmHg) and the 27G group (3. 58±0. 47mmHg;t=0. 007, P=0. 995). ·CONCLUSION: The 27G microincision vitrectomy can be used to treat various vitreoretinal diseases. It is a safe and effective surgical procedure with small incision and mild anterior segment inflammatory reaction.
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Objective To observe and analysis the clinical effects and postoperative complications of intravitreal injection of conbercept during vitrectomy surgery ( VRS ) in severe proliferative diabetic retinopathy ( PDR) treatment. Methods This is a prospective non.randomized controlled clinical study. A total of fifty.seven patients (sixty eyes) with severe PDR were enrolled in Tianjin Eye Hospital from June 2015 to March 2016,and the patients were divided into conbercept injection group and control group according to the patients ' surgical method intention selection. The patients in conbercept injection group received an intravitreal injection of 0. 05 ml conbercept solution during the surgery. The patients in control group only received VRS. The operations of the two groups were completed by the same doctor, and the follow.up time was 6 to 10 months after the surgery. The incidence of postoperative complications including a transient high intraocular pressure, early and late incidence of vitreous hemorrhage(VH),epiretinal membrane and traction retinal detachment(TRD),neovascular glaucoma(NVG),the central retinal thickness ( CRT ) and the best corrected visual acuity ( BCVA ) ( LogMAR visual acuity ) were comparatively analyzed. Results The incidence of early VH was 6. 7％( 2/30 ) in conbercept injection group, which was significantly lower than 26. 7％(8/30) in control group (χ2=4. 32,P=0. 04). The incidences of late VH were 3. 3％(1/30) and 10. 0％(3/30) in conbercept injection group and control group,and the differences had no statistically significant difference (χ2=1. 07,P>0. 05). The incidences of a transient high intraocular pressure,TRD and NVG between the two groups had no statistically significant difference (χ2=0. 69,0. 22,2. 07;all at P>0. 05). The change of CRT from one week to one month after the operation in conbercept injection group was more remarkablethan that in the control group,and the difference was statistically significant (t=-3. 23,P<0. 05). The mean LogMAR BCVA in two groups at 1 month and 6 months after operation were both improved in different degrees compared with the preoperative vision. The difference of mean LogMAR BCVA at 6 months was statistically significant (P<0. 05). Conclusions The intravitreal injection of conbercept during VRS in severe PDR patients can effectively prevent postoperative early VH,decrease CRT and improve visual acuity.
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Objective To analyse the retrobulbar haemodynamic changes after vitrectomy in patients with rhegmatogenous retinal detachment (RRD). Methods Color Doppler flow imaging (CDFI) was used for measurement of blood flow velocities including peak systolic velocity (PSV), end diastolic velocity (EVD) and resistive indexes (RI) of the ophthalmic artery (OA), posterior ciliary arteries (sPCA) and central retinal artery (CRA) in 50 eyes of 50 patients with RRD. In them 22 eyes were filled with silicone oil, 28 eyes were filled with 12%C3F8 and 22 eyes were operated to remove silicone oil after filled with silicone oil for 2-4 months, and then CDFI parameters were obtained. The contralateral eyes were used as control eyes before and after the operation. Results There were no significant differences in CRA and sPCA, and PSV, EDV and RI before treatment between RD and OA eyes and control eyes (P>0.05). PSV and EVD of CRA were significantly increased 3 months after surgery, RI were decreased significantly (P<0.05). There were no significant differences in blood flow parameters of OA and sPCA before and after surgeries (P>0.05). No changes were found in control eyes 3 months after surgery. Conclusion VRS might increase the velocity of CRA, decrease RI and improve ocular blood supply postoperatively.
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Objective To analyse the retrobulbar haemodynamic changes after vitrectomy in patients with rhegmatogenous retinal detachment (RRD). Methods Color Doppler flow imaging (CDFI) was used for measurement of blood flow velocities including peak systolic velocity (PSV), end diastolic velocity (EVD) and resistive indexes (RI) of the ophthalmic artery (OA), posterior ciliary arteries (sPCA) and central retinal artery (CRA) in 50 eyes of 50 patients with RRD. In them 22 eyes were filled with silicone oil, 28 eyes were filled with 12%C3F8 and 22 eyes were operated to remove silicone oil after filled with silicone oil for 2-4 months, and then CDFI parameters were obtained. The contralateral eyes were used as control eyes before and after the operation. Results There were no significant differences in CRA and sPCA, and PSV, EDV and RI before treatment between RD and OA eyes and control eyes (P>0.05). PSV and EVD of CRA were significantly increased 3 months after surgery, RI were decreased significantly (P<0.05). There were no significant differences in blood flow parameters of OA and sPCA before and after surgeries (P>0.05). No changes were found in control eyes 3 months after surgery. Conclusion VRS might increase the velocity of CRA, decrease RI and improve ocular blood supply postoperatively.
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AIM: To analyze the effect of preoperative intravitreal injection of Ranibizumab ( lVR ) in patients undergoing pars plana vitrectomy ( PPV ) for proliferative diabetic retinopathy ( PDR) . ●METHODS:ln this retrospective research, 62 patients (67 eyes ) with PDR in the First Affiliated Hospital of Xinjiang Medical University from Jun. 2014 to Jun. 2015 were recruited. They were assigned to an experimental group ( n=37 eyes ) and a control group ( n=30 eyes ) . The patients in experimental group were given 1 injection of lVR ( Lucentis 1. 0mg/0. 1mL ) 1wk before surgery, whereas those in control group went down to surgery directly. The average operation time, iatrogenic breaks, the use of tamponade, electric coagulation, and vision increase rate were comparatively analyzed between two groups. ●RESULTS:The average operation time was (91. 7±20. 8) min in the experimental group vs (117. 6±18. 6)min in the PPV group(t = -5. 314,P ●CONCLUSION:lVR before microincision vitrectomy can effectively shorten the operation time, reduce the use of electric coagulation and intraocular tamponade, and improve the rate of visual improvement for PDR patients.