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AIM: To determine whether the 23 - gauge ( 23G ) vitrecomy cutter could replace scissors in conventional 20-gauge ( 20G ) pars plana vitrectomy for treating severe proliferative diabetic retinopathy ( PDR) . METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C3 F8 tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity ( BCVA) , retinal reattachment were analyzed. RESULTS: The operative time was 35- 120 ( average 79-19±29. 82) min; intraoperative iatrogenic retinal breaks were detected in 2 eyes (7%). At the end of 3mo follow up, BCVA>0. 1 were in 9 eyes, from 0. 05-0. 1 in 10 eyes, CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.
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OBJECTIVE@#To discuss the cause of disease, treatment and therapeutic effect in patients with rhegmatogenous retina detachment (RRD) combined with non-secondary glaucoma.@*METHODS@#Clinical data of 28 patients with RRD combined with primary or congenital glaucoma were retrospectively analyzed.@*RESULTS@#Twenty-five out of the 28 patients succeeded with one operation (89.3%). The intraocular pressure of post-operation:on the 1st day was 10 approximately 46 (28.1+/-6.5) mmHg, on the 7th day was (18.9+/-7.2) mmHg, and on the last re-examination day was (17.6+/-6.2) mmHg. Anti-glaucoma operation was performed in 10 patients after the retinal operation. Chroidal hemorrhage was found in 2 patients and 2 chroidal exudations were found after the retinal operation.@*CONCLUSION@#The proportion of primary open angle glaucoma is higher than that of primary angle closure glaucoma, and trauma or surgery before the retinal operation is an important cause in glaucoma patients with RRD. There is no obvious difference in the ratio of surgical success between non-secondary glaucoma with RRD and those RRD patients without glaucoma. Vitreotomy+ silicon oil injection or drainage of subretinal fluid+air injection+cryocoagulation+explants is recommended. Chroid is easily involved. It is important to control the intraocular pressure during and after the surgery. The final visual acuity is rather poor, which may be related to the glaucoma and intraocular pressure.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glaucoma , Cirurgia Geral , Descolamento Retiniano , Cirurgia Geral , Estudos Retrospectivos , Acuidade Visual , VitrectomiaRESUMO
● AIM: To investigate the sequential changes of HIF-1 α Protein and mRNA in hypoxic bovine retinal microvessel endothelial cells.● METHODS: The bovine retinal microvessel endothelial cells were cultured in normoxic and CoCl2-induced hypoxic conditions respectively. Expressions of HIF-1 α Protein were measured with immunohistochemical staining, and RT-PCR was used to determine the HIF-1 α mRNA.● RESULTS: HIF-1 α began to increase 1h after hypoxia,and reached the peak at 4h. After 16h, it declined significantly. Compared with the normoxic group, the expression of HIF-1 α protein in the hypoxic groups had significant difference (P<0.01), and HIF-1 α mRNA expression was unchanged under hypoxia.● CONCLUSION: HIF-1 α participates in the hypoxic procedures in retinal microvessel endothelial cells, and hypoxia induce time-dependent changes of HIF-1 α protein expression, which is not modulated on the transcription level. Analysis of HIF-1 α expression revealed a temporal and spatial changes with regard to the hyperoxic repression, indicating that HIF-1 may play a major role in the development of retinopathy of prematurity and other ischemic retinal disorders such as diabetic retinopathy.