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Objective To compare the safety and efficacy of 23-Gauge pars plana vitrectomy (PPV) and PPV combined with scleral buckling-PPV (SB-PPV) in proliferative rhegmatogenous retinal detachments with inferior breaks.Methods Retrospectively nonrandomized clinical case study was conducted in 70 patients with proliferative rhegmatogenous retinal detachment associated with inferior breaks between January 2013 and December 2016,including 39 eyes receiving SB-PPV procedures as the SB-PPV group and 31 eyes undergoing PPV procedures as the PPV group.And anatomical success rate for one procedure,lens trauma rate,retinotomy rate,postoperative best corrected visual acuity (BCVA) outcome and intraocular pressure (IOP) were recorded and analyzed.Results The anatomical success rate for one procedure was 92.3％ (36/ 39) in the SB-PPV group and 74.2％ (23/31) in the PPV group,and the difference was statistically significant (P ＜ 0.035).The lens trauma rate was 2.6％ (1/39) in the SB-PPV group and 19.4％ (6/31) in PPV group,with the difference being statistically significant (P ＜0.05).The retinotomy rate was 5.1％ (2/39) in the SB-PPV group and 32.3％ (10/31) in the PPV group,and the difference approached statistically significance (P ＜0.05).There was no significant difference in the postoperative BCVA and IOP between the two groups (both P ＞ 0.05).Conclusion SB-PPV can increase the anatomical success rate for one procedure in patients with rhegmatogenous retinal detachment associated with inferior breaks,and reduce retinotomy rate and lens trauma rate.
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Objective To investigate the inhibitory effects of chitosan nano-particles loaded tetrandrine (Tet) on proliferation of cultured pterygium fibroblasts.Methods The deoxycholic acid-modified chitosan (DAMC) derivative was synthesized through amidation reaction,and their properties were investigated.The viability of human pterygium fibroblasts (HPF) was evaluated by cell counting kit-8 (CCK-8) assay after cells were interacted with Tet/DAMC nano-particles on day 1,3 and 5.Results The synthesized chitosan derivative and Tet formed drug-loaded nano-particles,and the agent-loading capacity was approximately 76％,and the sizes of agent-loaded nano-particles were 50-500 nm,with Zeta potential values being positive.The result of in vitro drug release experiment indicated that the nano-particles constantly released Tet in a controlled manner within 48 h.The viability of HPF in Tet group was (60.70 ± 2.30) ％,(50.22 ± 2.35) ％,(21.99 ± 2.07) ％ on day 1,3,5,respectively,but the corresponding data in Tet/DAMC group was (79.77 ±2.09)％,(63.24 ±2.83)％,(40.28 ± 1.19)％,respectively.The CCK-8 assay demonstrated that the Tet/DAMC nano-particles could inhibit HPF proliferation,and presented lower toxicity than Tet alone.Conclusion Chitosan nano-particles loaded tetrandrine exhibits a sustained agent-release behavior,which has obvious inhibitory effects on the proliferation of human pterygium fibroblasts,but its cytotoxicity is significantly lower than the original drug's,thereby possessing a great promise for improving the outcome of Tet for the prevention of pterygium recurrence.
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AIM: To analyze the clinical effects of preoperative intravitreal Conbercept combined vitrectomy for proliferative diabetic retinopathy ( PDR) patients.?METHODS:From June 2014 to May 2017, 57 patients (65 eyes) diagnosed with PDR. The patients were divided into two groups according to whether received preoperative intravitreal conbercept: intravitreal group ( 27 cases, 31 eyes), control group (30 cases, 34 eyes). Intravitreal group was treated with 0. 05mg ( 0. 05mL ) conbercept intravitreal injection 3d before vitrectomy, while control group was treated with vitrectomy alone. The overall surgical time, intraoperative bleeding, use of endodiathermy, iatrogenic retinal hole, and silicone oil, postoperative vitreous hemorrhage and the best corrected visual acuity were recorded and analyzed.?RESULTS: The average surgical time of intravitreal group was lower ( P < 0. 05 ), while intraoperative hemorrhage rate, rate of endodiathermy application, iatrogenic hiatal incidence, rate of silicone oil application, incidences of recurrent vitreous hemorrhage of intravitreal group were lower than those of control group ( all P<0. 05 ) . Intravitreal group got better postoperative best corrected visual acuity than control group (P<0. 05).?CONCLUSION: Intravitreal conbercept for proliferative diabetic retinopathy before 25G vitrectomy decreased surgical complications, reduced the surgical time and postoperative vitreous hemorrhage, and improved the potoperative best corrected visual acuity.