ABSTRACT
Abstract Bone metastases may evolve with events (pain, fractures and compression) that the orthopedic surgeon will encounter regardless of his subspecialty. Accumulated surgical knowledge is predictive for the prevention of impending fractures, as well as of pathological fractures. We will present a guide to properly evaluate and conduct a patient with bone implant for surgeons who are not specialists in this area.
Resumo As metástases ósseas podem evoluir com eventos (dor, fraturas e compressão) com os quais o cirurgião ortopédico irá se depararar independentemente da sua subespecialidade. Os conhecimentos cirúrgicos acumulados são predicativos para a prevenção de fraturas iminentes, assim como de fraturas patológicas. Apresentaremos um guia para avaliar e conduzir de forma adequada um paciente com implante ósseo para cirurgiões que não sejam especialistas na área.
Subject(s)
Humans , Bone Neoplasms/therapy , Carcinoma/therapy , Fractures, Bone/prevention & control , Fractures, Bone/therapy , Neoplasm Metastasis/therapyABSTRACT
Objective@#To evaluate the clinical effects of vitrectomy with or without fovea-sparing internal limiting membrane peeling on macular foveoschisis (MF) secondary to pathologic myopia.@*Methods@#A non-randomized controlled study was adopted.Twenty-three patients (25 eyes) with refractive error ≥-8.00 DS and MF either combined with foveal retinal detachment or epi-macualr membrane or lamellar macular hole.The subjects were divided into non-internal limiting membrane peeling group (11 patients /11 eyes) who underwent triamcinolone (TA) assisted vitrectomy and fovea-sparing internal limiting membrane peeling group (12 patients/14 eyes) who underwent TA assisted vitrectomy with fovea-sparing internal limiting membrane peeling.The baseline data such as age, best corrected visual acuity (BCVA), refractive error, axial length were not significant difference between the two group.Main outcomes were BCVA, remission of MF defined by optical coherence tomographyc OCT as well as complications.This study followed the Declaration of Helsinki and this protocol was approved by Ethic Committee of Xiamen Eye Center of Xiamen University (NO.XMYKZX-2016-YWS-007).@*Results@#All patients completed follow-up for more 6 months.BCVA (LogMAR) was 0.47±0.30 in non-internal limiting membrane peeling group and 0.40±0.33 in fovea-sparing internal limiting membrane peeling group, showing no significant difference between the two groups (t=0.66, P=0.52). Complete remission of MF was achieved in 22 eyes.The remission time in non-internal limiting membrane peeling group was 2.5 (1.8, 9.3) months, and 1.0 (1.0, 3.8) months in fovea-sparing internal limiting membrane peeling group, no statistical significance was obtained between the two groups (U=35.00, P=0.09). One eye had post-operative macular hole in non-internal limiting membrane peeling group, accounting for 9%, while in fovea-sparing internal limiting membrane peeling group, one eye had macular hole, accounting for 7%, and one eye had rhegmatogenous retinal detachment post-operatively, accounting for 7%.@*Conclusions@#MF can be resolved by vitrectomy while complete remission can achieved more quickly when combined with fovea-sparing internal limiting membrane peeling.
ABSTRACT
Objective To evaluate the clinical effects of vitrectomy with or without fovea-sparing internal limiting membrane peeling on macular foveoschisis (MF) secondary to pathologic myopia.Methods A non-randomized controlled study was adopted.Twenty-three patients (25 eyes) with refractive error ≥-8.00 DS and MF either combined with foveal retinal detachment or epi-macualr membrane or lamellar macular hole.The subjects were divided into non-internal limiting membrane peeling group (11 patients / 11 eyes) who underwent triamcinolone (TA) assisted vitrectomy and fovea-sparing internal limiting membrane peeling group (12 patients/14 eyes) who underwent TA assisted vitrectomy with fovea-sparing internal limiting membrane peeling.The baseline data such as age,best corrected visual acuity (BCVA),refractive error,axial length were not significant difference between the two group.Main outcomes were BCVA,remission of MF defined by optical coherence tomographyc OCT as well as complications.This study followed the Declaration of Helsinki and this protocol was approved by Ethic Committee of Xiamen Eye Center of Xiamen University (NO.XMYKZX-2016-YWS-007).Results All patients completed follow-up for more 6 months.BCVA (LogMAR) was 0.47±0.30 in non-internal limiting membrane peeling group and 0.40-±0.33 in fovea-sparing internal limiting membrane peeling group,showing no significant difference between the two groups (t =0.66,P=0.52).Complete remission of MF was achieved in 22 eyes.The remission time in non-internal limiting membrane peeling group was 2.5 (1.8,9.3) months,and 1.0 (1.0,3.8) months in fovea-sparing internal limiting membrane peeling group,no statistical significance was obtained between the two groups (U =35.00,P =0.09).One eye had post-operative macular hole in non-internal limiting membrane peeling group,accounting for 9％,while in fovea-sparing internal limiting membrane peeling group,one eye had macular hole,accounting for 7％,and one eye had rhegmatogenous retinal detachment post-operatively,accounting for 7％.Conclusions MF can be resolved by vitrectomy while complete remission can achieved more quickly when combined with fovea-sparing internal limiting membrane peeling.