OBJECTIVE To search an ideal carrier of transferred keratinocytes for transplantation. METHODS The transferred keratinocytes were seeded on the surfaces of the artificial dermis and the silicone membrane and cultured in vitro for 2 weeks. The growth of the keratinocytes was observed by microscope and scanning electron microscope. RESULTS The keratinocytes implanted on the artificial dermis began to rupture and died after 2 to 3 days. While the keratinocytes adhered well on the surface of silicone membrane with pseudopodia formation after 1 week under scanning electron microscope, and the cells kept normal morphological and proliferative properties 2 weeks later. CONCLUSION The silicone membrane can be applied as an useful carrier for the keratinocytes transplantation.
Objective To evaluate the efficacy and its affecting factors of silicone oil as an introocular tamponade for copmlicated retinal detachments in children(le;14 years). Methods We analysed retrospectively 34 cases(36 eyes) of complicated retinal detachments in children, who were performed with pars plana vitrectomy combined with silicone oil tamponade from June 1993 to November 1997. Results After 3-21 months of follow-up, the detached retinas in 19 eyes(52.7%) were reattached, in 10 eyes(27.8%) partially reattached and in 6 eyes (16.7%) redetached, 1 eye(2.8) had a media opacity that precluded evaluation of the retina. Postoperative visual acuity was less than 0.05 in 12 eyes(33.3%), and 0.05-0.2 in 20 eyes(55.6%), 2 cases(4 eyes) could not tell their visions(11.1%). Conclusion Silicone oil tamponade is an effctive therapy for complicated retinal detachments in children. The major cause of surgical fai;ure was development of recurrent proliferative vetrioretinopathy. (Chin J Ocul Fundus Dis,1999,15:7-8)
Objective To evaluate glaucoma and anterior chamber angle changes after intravitreal silicone oil injection(SOI). Methods The intraocular pressure(IOP) and anterior chamber angles of 34 e yes(33 patients)undergone pars plana vitrectomy and SOI were observed. Results Glaucoma occurred in 9 eyes(26%),in which silicone oil glaucoma(SOG) accounted for 77%(7/9).The changes of the superior part of anterior chamber angle were peripheral anterior synechiae in 11 eye(32%) and SO emulsification droplets in 22 eyes(64%) in 1～4.5 months after surgeries.Glaucoma occurred in 6 eyes of 7 eyes undergone peripheral iridectomy at the inferio r part of the iris after the closure of iridectomy holes (plt;0.05). Conclusion High incidence of glaucoma was found in this series of patients after intravitreal silicone oil injection,and the main causes of SOG were closure of the inferior iridecomy hole and silicone emulsification. (Chin J Ocul Fundus Dis, 2001,17:105-107)
Objective To investigate the characteristics of ultrasonogram of eyes with silicon oil tamponade. Methods Forty-seven patients (47 eyes) who had undergone the operation of silicon-oil removing were examined by A-(to determine the length of ocular axis) and B-scan before and after the operation respectively. The length of ocular axis and cubage of vitreous chamber were detected and the characteristics of the ultrasonograms were observed according to the default parameters of ultrasonograph. Results The results of A-scan showed that the preoperative axial length was 1.465 times of the postoperative one in the eyes without lens, and 1.284 times in eyes with lens; after modified the parameter according to the acoustic velocity, the preoperative axial length was (0.78±0.34) mm longer than the postoperative one in the eyes without lens, and (0.56±0.32) mm in eyes with lens. The results of A-scan showed that the cubage of vitreous chamber enlarged obviously in eyes with silicon oil tamponade, and the acoustic features included complete filling and partial filling according to the amount of silicon oil. Several arc echoes at the posterior segment of eye were detected in the silicon-oil-filling eyes with retinal detachment. Conclusion In the silicon-oil-filling eyes with lengthened ocular axis, the characteristics of B-scan images are affected by acoustic velocity through silicon oil, the amount of silicon oil capacity and the emulsification of silicon oil. (Chin J Ocul Fundus Dis，2004，20：349-351)
Objective To investigate the main causes and risk factors of recurrent retinal detachment (RRD) after silicone oil removal (SOR) in eyes with complex retinal detachment. Methods It was a retrospective case series study. A total of 458 eyes of 455 consecutive patients who underwent pars plana vitrectomy with silicone oil tamponade were recruited in this study. All patients underwent vitrectomy operation. Additionally, they were given heavy water, membrane peeling, retinotomy or partial cutting, intraocular laser photocoagulation or frozen, gas-liquid exchange or direct oil exchange operation accordingly. Ninety-eight eyes with multiple holes, old retinal detachment, hyperplasia and serious traction lesions underwent scleral buckling surgery simultaneously. Intravitreal silicone oil was padded at the end of operation. Cutting, stripping or resection and 360° preventive laser photocoagulation were applied while the epiretinal membrane was found and need treatment during SOR. Holes or suspicious hiatus underwent intraocular laser photocoagulation or cryotherapy during the operation. One week after SOR and during follow-up, the visual acuity, intraocular pressure (IOP), slit lamp microscope, and ophthalmoscope examination were examined with the same technique and methods as preoperation. The eyes were divide into two groups based on the attachment status of retina after SOR, which were reattached group (419 eyes) and redetached group (39 eyes) respectively. The following data were recorded: the age of patients, ocular axial length, logarithm of minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) and IOP before vitrectomy operation and before and after SOR, the number of retinal breaks, the duration of silicone oil filling, the duration of followup, and the related factors during vitrectomy operation and SOR. The relation of age, sex, high myopia, the size and location of holes, aphakic eye, proliferative vitreoretinopathy (PVR) C3 level and above, previous history of failed retinal detachment operation, 360° preventive laser photocoagulation, assistant scleral buckling surgery, SOR via corneal puncture to RRD after SOR were analyzed. Odds ratio (OR) and its 95% confidence interval (CI) were calculated for the age ＜40 years old and gender. High myopia, assistant scleral buckling surgery and SOR via corneal puncture were further analyzed by multiple regression equation. Results After SOR operation, the total average logMAR BCVA was 0.86±0.63. The average logMAR BCVA was 0.82±0.59 and 0.99±0.70 respectively for the reattached and redetached groups, which was not statistically different (F=1.559,P＞0.05). The number of high myopia eyes in the reattached and redetached groups were 116 and 22 eyes, respectively, accounted for 27.7% and 56.4%, and the difference was statistically significant (χ2=13.984,P＜0.01). Three eyes underwent vitrectomy with scleral buckling occured RRD, accounting for 3.1%; while 36 eyes underwent vitrectomy without scleral buckling occured RRD, accounting for 10.0%. The incidence of RRD between them was statistically significant (χ2=4.761,P＜0.05). The incidence of RRD was not retated to the PVR levels before the operation, previous history of failed retinal detachment operation, aphakic eye and preventive laser photocoagulation (OR=1.626, 1.699, 1.986, 0.709; 95%CI:0.836-3.162, 0.832-3.658, 0.921-4.279, 0.268-1.875; P＞0.05) . RRD had a close relation with high myopia and assistant scleral buckling surgery (OR=3.380, 0.284; 95%CI:1.733 -6.595, 0.086-0.944; P＜0.05). The raise of risk derived from SOR via corneal puncture had no statistical significance (OR=2.119; 95%CI: 1.043-4.306; P＞0.05). The incidence of RRD after SOR was 8.5%; of which, 35.9% originated from new breaks and 69.2% were related to new breaks, in contrast, only 5.1% originated from PVR but 51.3% were related to PVR. ConclusionsHigh myopia is an independent prognostic risk factor of RRD after SOR. Combined scleral buckling surgery is a protective factor of RRD after SOR. To the well reattached eyes before SOR, the new breaks seems to be the main cause of RRD, wheras PVR was probably a secondary phenomenon.
Objective To observe the therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia.Methods The clinical data of 48 high myopia patients (48 eyes) with macular hole retinal detachment were retrospectively analyzed. Retinal detachment was mainly at the posterior pole; macular hole was confirmed by noncontact Hruby lens and optical coherence tomography (OCT). Phacoemulsification combined with pars plana vitrectomy and silicon oil tamponade were performed to all patients, of which 41 had undergone internal limiting membrane peeling, and 23 had intraocular lens implanting. The oil had been removed 3.5-48.0 months after the first surgery and OCT had been performed before the removal. The followup period after the removal of the silicon oil was more than 1 year.Results The edge of the macular hole could not be seen under the noncontact Hruby lens 1 week after the surgery in all but 5 patients, and the visual acuity improved. The silicon oil had been removed in all of the 48 patients; the OCT scan before the removal showed that the closed macular holes can be in U shape (8 eyes), V shape (6 eyes) or W shape (23 eyes). About 1338 months after the oil removal, retinal detachment recurred in 2 patients with the Wshaped holes. At the end of the followup period, 16 patients (33.3%) had U or Vshaped macular holes, and 32 patients (66.7%) had Wshaped macular holes. The rate of retinal reattachment was 100%.Conclusion Combined surgery of anterior and posterior segment and silicon oil tamponade is effective on macular hole retinal detachment in eyes with high myopia.
Along with the wide application of silicone gel implants in augmentation mammaplasty, more complications appeared. The author reported 24 cases of complicationssince 1989, including one case of heamtoma, one case of infection, two cases of injury of the sensory nerves to the nipple, four cases of asymmetric breast (as ymmetry in position and size), three cases of deformed appearance, six cases of constracture of the fibrous coating membrane, one case of rupture of prosthesis,one case of sinus formation and three cases of abnormal milk secretion. The causes of the complications and their prevention were discussed.
ObjectiveTo explore the safety and efficacy of the treatment of peripheral bronchopleural fistula with customized silicone plug through bronchoscope. MethodsA total of 19 patients with BPF admitted to Hunan Provincial People’s Hospital from July 2017 to May 2023 were included. Detailed medical records of the patients were collected, including etiology, fistula location, treatment methods, complications, and effective rates, to assess the safety and efficacy of customized silicone plug occlusion. ResultsThe average age of the 19 patients was 61.58 years (range from 42～84 years). The fistulas were located at the right upper lobe in 8 cases, the right middle lobe in 2 cases, the right lower lobe in 2 cases, the left upper lobe in 2 cases, and the left lower lobe in 5 cases. Causes included 9 cases after pneumonectomy, 6 cases of spontaneous pneumothorax, 1 case post Microwave Ablation Therapy for lung nodule, 1 case of advanced lung cancer under radiotherapy and chemotherapy, 1 case of candidal pneumonia, and 1 case of pulmonary tuberculosis. 15 patients were successfully occluded for the first time, 1 case failed to place the plug, and 3 cases had silicone plug dislodgement within 1 week after the procedure, with a short-term effective rate of 73.68% (14 cases). A total of 40 customized silicone plugs were placed, with an average of (2.10±0.74), and the mean diameter of the plugs used was 6.4 mm, with a range of 3 to 9 mm. Fifteen patients were recruited for long-term follow-up, with a median follow-up time of 15 months (range from 1.5 to 53 months). One patient developed a new fistula on the 45th day, who was treated with a combined small Y-type single bullet-covered stent for occlusion. One patient died of severe pneumonia 3 months postoperatively, and one died of type II respiratory failure at the 30th month, both deaths were unrelated to the interventional procedure. The long-term effective rate was 68.42% (13 cases). ConclusionPlacing customized silicone plugs through bronchoscopy can rapidly and effectively occlude peripheral BPF, with satisfactory long-term outcome.
We uesd domestic perfluorotributylamine to treat 21 eyes with giant retinal tears,including 5 rhegmatogenous retinal detachment with folded and fixed flap and 16 giant retinal tears resulting from retinotomy and retinectomy due to complicated retinal detachment.The success rate of retinal reattachment was over 95%,with no serious side effects.The activities and complications of perfluorotributylamine in the mangement of giant retinal tears were discussed. （Chin J Ocul Fundus Dis,1996,12: 22-24）
ObjectiveTo compare the safety and efficacy of a modified 23G with suturing incision and traditional 23G vitrectomy for silicone oil removal. MethodsA total of 177 patients (180 eyes) who underwent silicon oil removal (the average tamponade period was 4.5 months) were enrolled in this prospective study. The patients included 112 males (113) and 65 female (67). The mean age was (43.8±10.3) years. The corrected vision, indirect ophthalmoscopy, intraocular pressure, B-ultrasound and optical coherence tomography were measured for all patients. All patients had no complete retinal detachment. The patients were randomly divided into modified 23G with suturing incision group (group A, 88 eyes) and traditional 23G vitrectomy (group B, 92 eyes). The differences of sex (χ2=1.596), age, corrected vision (t=0.785), intraocular pressure (t=0.352), primary disease (χ2=1.982) and lens condition (χ2=2.605) were not significant (P>0.05). The operation time, intraocular pressure, silicon oil retention, choroidal detachment, retinal redetachment and endoophthalmitis were recorded at the end of the operation. ResultsThe difference of mean operation time was not significant between group A and B (t=1.950,P>0.05). The differences of mean visual acuity 1 day, 1 week and 3 months after operation were not significant between group A and B (t=0.873, 1.115, 0.141; P>0.05). There was difference of mean intraocular pressure at 1 day after operation (t=2.550,P<0.05), but not at 1 week and 3 months after operation (t=1.451,1.062; P>0.05) between group A and B. There were 25 eyes (28.4%) with intraocular hypotension, 8 eyes (9.1%) with choroidal detachment, 5 eyes (5.7%) with vitreous hemorrhage, 9 eyes (10.2%) with retinal redetachment, and 7 eyes (8.0%) with silicon oil retention in group A. There were 5 eyes (5.4%) with intraocular hypotension, 2 eyes (2.2%) with choroidal detachment, 2 eyes (2.2%) with vitreous hemorrhage, 8 eyes (8.7%) with retinal redetachment, and 1 eye (1.1%) with silicon oil retention in group B. The differences of incidence of intraocular hypotension, choroidal detachment and silicon oil retention were significant (P<0.05). No endoophthalmitis occurred. ConclusionThe safety of modified 23G with suturing incision is better than traditional 23G vitrectomy for silicone oil removal, with decreased incidence of intraocular hypotension, choroidal detachment and silicon oil retention.