RESUMO
There has been ongoing progress in the new technique and equipment in vitreoretinal surgery in recent years, contributing to the improvement of treatment of various vitreoretinal diseases. The application of 3D heads-up display viewing system (3D viewing system) has been one of the most fascinating breakthroughs in vitreoretinal surgery. Unlike the traditional method in which the surgeons have to look through the microscope eyepieces, this system allows them to turn their heads up and operate with their eyes on a high-definition 3D monitor. It provides the surgeons with superior visualization and stereoscopic sensation. And increasing studies have revealed it to be as safe and effective as the traditional microscopic system. Furthermore, the surgeons can keep a heads-up position in a more comfortable posture and lesson the pressure on cervical spine. Meanwhile, 3D viewing system makes it easier for the teaching and learning process among surgeons and assistants. However, there are still potential disadvantages including the latency between surgeon maneuver and visualization on the display, learning curves and cost. We hope that the 3D viewing system will be widely used and become a useful new tool for various vitreoretinal diseases in the near future with rapid development in the technology and constant upgrade of the system.
RESUMO
There has been ongoing progress in the new technique and equipment in vitreoretinal surgery in recent years,contributing to the improvement of treatment of various vitreoretinal diseases.The application of 3D heads-up display viewing system (3D viewing system) has been one of the most fascinating breakthroughs in vitreoretinal surgery.Unlike the traditional method in which the surgeons have to look through the microscope eyepieces,this system allows them to turn their heads up and operate with their eyes on a high-definition 3D monitor.It provides the surgeons with superior visualization and stereoscopic sensation.And increasing studies have revealed it to be as safe and effective as the traditional microscopic system.Furthermore,the surgeons can keep a heads-up position in a more comfortable posture and lesson the pressure on cervical spine.Meanwhile,3D viewing system makes it easier for the teaching and learning process among surgeons and assistants.However,there are still potential disadvantages including the latency between surgeon maneuver and visualization on the display,learning curves and cost.We hope that the 3D viewing system will be widely used and become a useful new tool for various vitreoretinal diseases in the near future with rapid development in the technology and constant upgrade of the system.
RESUMO
The internal limiting membrane (ILM),composed of collagen fibers,glycosaminoglycans,laminin and fibronectin,is the basement membrane of the retinal Müller glia cells and serves as an interface between the vitreous and retina.The ILM is the structural interface between the vitreous and retina.ILM removal ensures separation of the posterior hyaloid from the macular surface,which can relieve macular traction and prevent postoperative epiretinal membrane formation.Thus,vitrectomy with ILM peeling has become an increasingly utilized and vital component in surgical intervention for various vitreoretinal disorders.However,many recent studies showed that ILM peeling is a procedure that can cause immediate traumatic effects and progressive modification on the underlying inner retinal layers.There were some surgical strategy (fovea-sparing ILM peeling or inverted internal limiting membrane flap technique,or Abrasion Technique).But some controversies exist,such as when ILM peeling is necessary,which adjuvant to use to perform the procedure,and what is the best technique to peel the ILM.A full assessment ILM structure and function and related factors of surgery is helpful to predict the anatomical and functional prognosis.
RESUMO
Objective To observe the surgical effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy (FEVR).Methods 34 eyes of 27 patients with FEVR who underwent either scleral buckling or vitrectomy were enrolled in this study.There are stage 2B in 2 eyes (5.88％),stage 3B in 7 eyes (20.59％),stage4Ain 1 eye (2.94％),stage4Bin 16 eyes (47.06％),stage 5 in8 eyes (23.53％).5 eyes associated with rhegmatogenous retinal detachment.The surgical approaches had been chosen according to the disease stage,severity,extent and morphology of the proliferative membrane.13 eyes (stage 2B in 2 eyes,3B in 4 eyes,and 4 in 7 eyes) underwent scleral buckling and 21 eyes (stage 3B in 3 eyes,4 in 10eyes,and 5 in 8 eyes) underwent vitreoretinal surgery.The main outcome measurement was the anatomic status of the macula,which was recorded as attached,partially attached or remain detached.The mean follow up was (18.00 ± 14.61) months (range 4 to 60 months).Results Among 13 eyes received scleral buckling,the macula was attached in 2 eyes with stage 2B (15.38％),partially attached in 11 eyes (84.62％) including 4 eyes with stage 3B,1 eye with stage 4A and 6 eyes with stage 4B.Among 21 eyes received vitrectomy,the macula was attached in 8 eyes (38.10％) including 2 eyes with stage 3B,4 eyes with stage 4 and 2 eyes with stage 5;the macula was partially attached in 9 eyes (42.86 ％) inducing 4 eyes with stage 4 and 5 eyes with stage 5;the macula remained detached in 4 eyes (19.05％) including 1 eye with stage 3B,2 eyes with stage 4 and 1 eye with stage 5.Conclusion If the surgical approaches were chosen based on the stage of FEVR and the severity,extent and morphology of the proliferative membrane,the surgery is effective and beneficial to FEVR patients.
RESUMO
Recent years have witnessed tremendous progress in vitreoretinal surgery.The treatment of vitreoretinal diseases has increased enormously and its related indications expanded widely with the contribution of the emerging novel technologies,methods,equipment and new ideas.Attaching importance to minimally invasive surgery,application of auxiliary drugs,development of improved equipment and surgical technique were the main features. Further basic and clinical research is necessary to promote innovation and development of vitreoretinal surgery in China to keep pace with and surpass advanced technology.
RESUMO
Five eyes of acute retinal necrosis(ARN) with multiple retinal breaks and retinal detachment were treated by closed vetrectomy combined with encircling buckle, gas/fluid exchange, endolaser and cryotherapy. After operation, the detached retinas reattached in 4 eyes, and among them the visual acuity was 0.2 in 1 eye, and better than 0.05 in 3 eyes. The follow-up duration in 5 eyes was from 6 to 18 months and recurrent retinal detachment was found in one eye.
RESUMO
39 cases (49 eyes) with retinal periphlebitis (Eales' disease) were treated by laser photocoagulation and followed up for 3～64 months, averaging 17 months. The visual acuity improved in 29 eyes (59.1％), remained unaltered 15 eyes (30.7％),and diminished in 5 eyes (10.2％). The results showed that laser photocoagulation was effective and safe for the treatment of Eales' disease. The importance of early diagnosis, early treatment, periodical follow-up and the use of corticosteroids were discussed.