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·AIM: To investigate the visual acuity after cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole (IMH) at different stages. ·METHODS: In this study, 75 IMH patients ( 75 eyes ) treated in our hospital from August 2014 to August 2016 were enrolled and underwent cataract extraction, vitrectomy and C3F8gas tamponade. Patients were divided into stage Ⅱ Group ( 18 cases ), stage Ⅲ ( 36 cases) and stageⅣ(21 cases) according to Gass stages, and macular hole closure at 2 and 4wk postoperatively were compared. The routine visual acuity examination before and after surgery were performed, and the visual acuity in each group were compared. The optical coherence tomography ( OCT) was used to measure the macular thickness before and after surgery. ·RESULTS: The closure rate of macular hole in stage Ⅱwas significantly higher than that of stage Ⅲ and IV at the 1mo after operation, that at the stage Ⅲ was significantly higher than that of stageⅣgroup, and the difference was statistically significant (P<0. 05). There was no significant difference in the rate of closure of macular hole between stage Ⅱ and stage Ⅲ at 3mo after operation (P>0. 05). The proportion of eyes with visual acuity of finger counting, 0. 02-0. 08, 0. 10-0. 20, 0. 25-0. 40 and ≥0. 50 was statistically significant different before and after surgery(P<0. 05). The improvement rate of visual acuity was 94% in stage Ⅱ, which was significantly higher than that in stage Ⅲ (83%) and stage Ⅳ (67%). The macular thickness of the stage Ⅱ and Ⅲ was significantly lower after the surgery, but there was no significant difference in the stage Ⅳ before and after surgery (P>0. 05), the decreasing range of the stage Ⅱ and Ⅲ was not statistically significantly different (P>0. 05), which were significantly higher than that of the stage Ⅳ, the difference was statistically significant (P<0. 05). ·CONCLUSION: Cataract extraction, vitrectomy and C3F8 gas tamponade surgery is conducive to the vision recovery after idiopathic macular hole, but the effects with different Gass staging are different, surgery should be performed as early as possible to improve macular hole closure and eyesight recovery.
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· AIM:To investigate the efficacy of the combined treatment of Conbercept and panretinal photocoagulation (PRP) for neovascular glaucoma (NVG) with central retinal vein occlusion (CRVO).· METHODS:The clinical data of 100 NVG patients with CRVO treated in our hospital from May 2014 to May 2017 were retrospectively analyzed.In those,50 patients treated with glaucoma filtering surgery combined with PRP were selected as control group,and based on this,50 patients treated with intravitreal injection of conbercept were included in the observation group.The best corrected visual acuity (BCVA) before treatment,and after 7d,1,3,and 6mo treatment were compared.The intraocular pressure IOP of each period with the non-contact tonometer were also compared,the effect of surgery was evaluated by slit-lamp examination of neovascularization combined with intraocular pressure,and then recurrence rate and complication was recorded during 6mo follow-up.· RESULTS:No statistically significant difference was found between preoperative and after surgery at each time point (P＞0.05).The intraocular pressure of the two groups was significantly lower than that of before the surgery,the observation group was significantly lower than that of the control group 7d and 1mo after surgery,and the difference was statistically significant (P＜0.05).There was no statistically significant difference on lOP the 3 and 6mo after surgery between two groups (P＞0.05).The operation success rate was 100％ in the observation group and was 92％ in the control group,the difference was statistically significant (P＜ 0.05).The complete success rate of the observation group was 84％,which was significantly higher than 66％ of the control group,the difference was statistically significant (P＜ 0.05).The hyphema and recurrence rate of the observation group were significantly lower than those of the control group,the difference was statistically significant (P＜0.05).There was no significant difference in the incidence of shallow anterior chamber and low intraocular pressure (P＞0.05).· CONCLUSION:Preoperative intravitreal injection of conbercept combined with panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion make the pressure recovery and neovascularization time shorter with better surgical results,and can control the anterior chamber hemorrhage and reduce the recurrence rate.
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<p><b>BACKGROUND AND OBJECTIVE</b>The level-Ib lymph node metastasis is rare in nasopharyngeal carcinoma (NPC). When and how this level should be irradiated with precise radiotherapy remains controversial. This study evaluated the prevalence and prognostic significance of level-Ib lymphadenopathy on the prognosis of NPC patients.</p><p><b>METHODS</b>From January 1990 and December 1999, 933 newly diagnosed patients with NPC treated at Sun Yat-sen University Cancer Center were randomly selected, examined with computed tomography (CT) imagining for evidence of level-Ib lymphadenopathy before treatment. All patients received radical radiotherapy with or without chemotherapy. The relationship between level-Ib lymphadenopathy and post-treatment outcomes including overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed using Kaplan-Meier methods. The Cox proportional hazards regression model was used to adjust for other prognostic factors.</p><p><b>RESULTS</b>Of the 933 patients, 55 (5.9%) were found to have level-Ib lymphadenopathy, which was associated with carotid sheath involvement, oropharynx involvement and levels, and lateral cervical lymph node involvement. In the subgroup with carotid sheath involvement, with multivariate analysis accounting for all previously known prognostic factors, level-Ib lymphadenopathy was still associated with a risk of decreased OS (RR, 2.124; P<0.001), DMFS (RR, 2.168; P<0.001), and LRFS (RR, 1.989; P=0.001).</p><p><b>CONCLUSION</b>Level-Ib lymphadenopathy in the patients with carotid sheath involvement is an independent prognostic factor.</p>