Objective To evaluate the indications, effectiveness and complications of vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system (TSV25G) under the topical anesthesia. Methods The clinical and follow-up data of 22 eyes of 22 patients undergone vitreo-retinal surgery using TSV25G under the topical anesthesia were retrospectively analyzed. All of the patients were monocular sickened, including idiopathic macular hole in 10 eyes, idiopathic macular pucker in 6, vitreoretinal traction syndrome in 4, and vitreous hemorrhage associated with branch retinal vein occlusion in 2. Peeling of epiretinal membrane and/or internal limiting membrane, intra ocular laser coagulation, air-fluid exchange and tamponiding of C3F8 were performed according to the condition of diseases. The postoperative follow-up was 1-11 months, with the mean duration of 6.4 months. The effect of analgesia, cooperation with the patients, operative effect and complications in and after the surgery were observed. Results The operations finished successfully in all of the eyes under the topical anesthesia. The operation duration ranged from 20 to 25 minutes with average of 22 minutes. The patients cooperated with the doctor well without any discomfort. Two days after the surgery, edema of the wounded conjunctiva was found, and recovered 7 days later. A light pigment dot on the surface of the sclera could be seen at the first month. The complic ations included transient increasing of intraocular pressure in 2 eyes, feather-like opacity of lens in 5 eyes, vitreous hemorrhage in 1 eye, and air-bleb under conjunctiva in 2 eyes. No other complications related with the cut were fo und. The macular hole closed in 9 eyes with idiopathic macular hole, and the other 1 had the smaller but not closed hole. Idiopathic macular pucker, vitreoretinal traction syndrome, and vitreous hemorrhage associated with branch retinal vein occlusion were cured successfully. Conclusions Vitreoretinal surgery using the TSV25G under the topical anesthesia has many advantages such as simple procedure, short operation time, micro-invasion, less complications and rapid revovery, and mainly serves simple manipulation in some simple diseases such as idiopathic macular hole, vitreo-retinal traction syndrome, and simple hemorrhage. (Chin J Ocul Fundus Dis，2004，20：133-136)
Objective To explore the therapeutic value and effects of relaxing retinotomy for perforating traction retinal detachment(PTRD). Method A retrospective survey was done in 21 patinets (21 eyes) with PTRD who underwent vitrectomy combined with relaxing retinotomy in our hospital from 1998 to 2001.Results The retinae were completely reattached in all 21 cases. The visual acuity of 12 patients (57%) was counting finger, and the best visual acuity was 0.05. Among the 18 patients who were followed up for 6 to 25 months, 14(77.8%) remained retinal reattachment. Conclusions Relaxing retinotomy is effective for anatomic reattachment of PTRD, especially to the patients with retinal incarceration and severe proliferative vitreoretinopathy. (Chin J Ocul Fundus Dis，2003，19：5-7)
Objective By using a newly developed animal model of limited macular translocation (LMT) in rabbit eyes, to explore the complications,indications and predictability of LMT. Methods LMT models were performed in 15 rabbit eyes, and were divided into 4.5 mm group and 3.5 mm group by the length of scleral shortening.The effect of retinal translocation (distance and direction) and its complications were analyzed. In a separated group, postoperative corneal astigmatism was studied after release of scleral shortening suture 1 month after LMT. In order to study the impact of neuroretina-retinal pigment epithelium (RPE) adhesion on LMT, retinas and choroids in 4 pigmented rabbit eyes were pretreated with photocoagulation. Results Success rate of LMT was 86.7%. In these cases, retinal translocations were achieved［(distance of 610 to 2690 μm, [AKx-]±s=(1395±636)μm; translocation angle α of 10-38°, [AKx-]±s=(22.7±8.3) °］. The difference in scleral shortening between 4.5 mm and 3.5 mm groups did not significantly influence the final translocation. Major complications of LMT included intraocular bleeding, retinal break, and corneal astigmatism. Release of scleral shortening suture reduced corneal astigmatism and made it more regular, meanwhile, retinal translocation did not regress. The neuroretina-RPE adhesion induced by retinal photocoagulation made neuroretinal hydrodissection difficult, and led to retinal break readily. Conclusion Sufficient LMT models in rabbit eye were obtained with few postoperative complications. Direction of retinal translocation is an important factor influencing the effect of LMT, except for distance. Release of scleral shortening suture can effectively reduce corneal astigmatism without causing regression of retinal translocation. For the patients with a history of macular or para-macular photocoagulation, LMT should be performed carefully. (Chin J Ocul Fundus Dis, 2002, 18: 203-207)
Objective To investigate the visual function of idiopathic macular hole before and after macular surgery. Methods Vitreous-retinal surgery was performed in 19 patients(19 eyes) with idiopthic macular hole.Among them,3 eyes belonged to stage 2，10 eyes stage 3 and 6 eyes were stage 4. The visual function including international standard visual acuity,laser retinal visual acuity,photopic ERG intensity responses- and Humphrey 30deg;-2 visual field were tested and compared before and after the surgery. Results (1)International standard visual acuity was from 0.01 to 0.1 preoperatively,and from 0.04 to 0.4 post operatively,the difference was not significant(P＞0.0 5).(2)Laser retinal visual acuity was from 0.12 to 0.4 preoperatively,and from 0.2 to 0.63 postoperatively,the difference was significant (P＜0.05).(3)In photopic ERG intensity responses:the Log K value of bwave decreased after surgery (P＜0.05),but no obvious change found in Rmax and n Value after operation.(4)Humphrey visual field examination revealed the thresholds for 0-10deg; increased after surgery(P＜0.05),but not obvious for 15-30deg;． Conclusion The visual function of the macular cones are increased by macular surgery for IMH. (Chin J Ocul Fundus Dis，2000，16：213-284)
Objective To observe the efficacy of vitreoretinal surgery in the treatment of early traumatized eyes with no light perception. Methods We performed vitreoretinal surgery on 17 eyes of early traumatized eyes with no light perception.The patients were followed up for 2～14 months. Results Retinal reattachment was achieved in 11 eyes after srugery.8 eyes got visual acuity better than light perception postoperatively.Visual acuities of 5 eyes were better than 0.05 and the best one reached to 0.2. Conclusion Timely vitreoretinal surgery is valuable to the early traumatized eyes with no light perception.Retinal reattachment is the most important thing for the treatment of this kind of cases. (Chin J Ocul Fundus Dis，2000，16：213-284)