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AIM:To observe the clinical efficacy of vitrectomy at different times for open ocular trauma and explore the timing of stage Ⅱ vitrectomy.METHODS: Retrospective case series study. A total of 60 cases(60 eyes)with open ocular trauma who visited our ophthalmology department from June 2022 to February 2023 were included. They were divided into treatment group A(interval ≤14 d)and treatment group B(interval >14 d)based on the interval between the stage Ⅰ emergency treatment surgery and the stage Ⅱ vitreoretinal surgery. Among the 32 cases(32 eyes)in the treatment group A, 16 eyes(50%)had eyeball rupture, 13 eyes(41%)had penetrating injury, and 3 eyes(9%)had perforating injury. Among the 28 cases(28 eyes)in the treatment group B, 15 eyes(54%)had eyeball rupture, 12 eyes(43%)had penetrating injury, and one eye(4%)had perforating injury. The two groups of patients were followed-up for 6 mo after surgery, and the treatment effects were compared.RESULTS:There was no statistically significant difference in visual acuity between the two groups of patients before vitrectomy(P>0.05). In the treatment group A, 10 eyes(31%)had significantly improved visual acuity, 21 eyes(66%)had effectively enhanced visual acuity, and 1 eye(3%)had no improvement in visual acuity at 6 mo after surgery. Among the 28 eyes in the treatment group B, 5 eyes(18%)had significantly improved vision, 16 eyes(57%)had effectively enhanced vision, and 7 eyes(25%)had no change in vision, with statistically significant difference between the two groups(U=322.5, P=0.032). There was no significant difference between the treatment group A and the treatment group B in complications such as secondary glaucoma, silicone oil dependence, vitreous hemorrhage, and eyeball atrophy(P>0.05). There was no evidence of traumatic proliferative vitreoretinopathy(TPVR)in the treatment group A during postoperative follow-up, which was significantly lower than that of the treatment group B(P<0.05).CONCLUSION:The prognosis of the stage Ⅱ vitrectomy for open ocular injury is relatively good after completing the stage Ⅰ surgery within 2 wk.
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Background The generation of advanced glycosylation end products (AGEs) is one of the most important characteristics in diabetes mellitus (DM).Its role in diabetic eye disease is still unclear.Objective This study was to investigate the changes of AGE levels in human cataractous lens in diabetic patients and further explore the relationship of lens AGEs with early diabetic retinopathy (DR).Methods This study protocol was approved by Ethic Committee of He Eye Hospital.A cases controlled clinical study was carried out.Forty human nuclei were obtained from 40 cataract patients during the phacoemulcification in He Eye Hospital from August to December 2014,with the nuclear hardness of Ⅲ-Ⅳ grades (Emery grading).The eyes were divided into non-DM (NDM) group and DM group,and the DM group was further divided into non-DR (NDR) group,non-proliferative DR (NPDR) group and proliferative DR (PDR) group.Lens AGE level was quantitatively detected by ELISA.Results The content of pentosidine was (31.90±5.00),(35.83±4.22) and (38.59±5.11)pg/ml,and that of carboxymethyl lysine (CML) was (18.82±3.84),(19.65±2.12) and (23.77±4.73) μg/L,and that of imidazolone was (13.12±2.71),(14.48±2.01) and (15.37 ±2.74) pg/ml in the NDR group,NPDR group and PDR group,respectively,which was significantly higher than (27.69 ± 1.53) pg/ml,(11.36 ±1.47) μg/L and (10.21 ± 0.54) pg/ml in the NDM group (all at P＜0.01).The contents of pentosidine and CML in the lens were significantly higher in the PDR group than those in the NDR group (all at P＜0.05);while there was no significant differences in the pentosidine content in the lens among the NDR group,NPDR group and PDR group (all at P＞0.05).The positive correlations were found between CML content and pentosidine content (r =0.623,P =0.000),between CML content and imidazolone content (r =0.717,P =0.000) as well as between pentosidine content and imidazolone content (r=0.669,P =0.000).Conclusions The levels of pentosidine,CML and imidazolone in cataractous lens are obviously elevated in the DM patients.The levels of pentosidine and CML in the lens are gradually raised as the aggravation of DR.AGEs might be a potential maker for the assessment of diabetes.