Objective To evaluate the 25-gauge (25G) transconjunctival sutureless vitrectomy system (TSV25G) for macular diseases. Methods The clinical data of 18 patients with macular diseases treated by the TSV25G were retrospectively analyzed. The 18 patients included 13 men and 5 women, aged from 25 to 73 years. The disease course ranged from 3.5 to 10 months, in cluding 8 epiretinal membrane, 3 idiopathic macular hole, 3 tranumatic macular hole with submacular heamorrhage, 2 vitreo-macular tractional syntrome and 2 diabetic macular edema. The surgical parameter installation was as follows: high speed cutter with rate of 1500 cuts per minute; the maximum aspiration with a TSV2 5G were 500-550 mmHg (1 mm Hg=0.133 kPa); the BSS bottle height was 40-50 cm; the intraocular pressure was 29-35 mmHg during the surgery. The postoperative follow-up period was 2.5-10 months. Results Eighteen patients had undergone the vitrectomy successfully with the operative time of 26-44 minutes (mean 35 minutes). No complication was found. Water leakage of the puncture site was found in 1 patient and was sewed up with 8-0 absorbable sutures. The mean time of inpatients were 3.5 days postoperatively. In the postoperative follow-up in 18 patients, the macular edema disappeared totally in 12 patients 3-6 months after the operation; the visual distortion disappeared in 10 and alleviated in 2; the visual acuity regained (0.8 or more) in 6 (33.3%), not changed in 4, and improved in 2. Conclusion TSV25G was safe, time-saving, and effective for macular diseases. (Chin J Ocul Fundus Dis，2004，20：137-138)
Objiective To observe the changes of angioarchitecture of the optic disc in cats eyes after radial optic neurotomy (RON). Methods Ten healthy adult cats underwent unilateral RON randomly in 10 eyes as an operative group in this trial, and the fellow eyes (10 eyes) were as the control group. The colophony samples of vascular angioarchitecture of 20 eyes were made 90 days after RON and scanning electron microscope was used for the observation. Results In the control group, the blood supply of optic disc mainly came from the short posterior ciliary artery, pial artery, and retinal ciliary artery; the choroidal capillary vessels around the optic disc didnprime;t take part in the blood supply in the anterior area; retinal central vascular system and complete arterial circle around the optic nerves were not seen. In the operative group, a V-shaped defect of the optic disc, retinal blood vessels and choroidal capillary vessels was found at the surgical incision; no injury of retinal blood vessels and choroidal large vascular layer was seen, and neovascularization at the incision were not found. Conclusions RON may cause the vascular defect of the optic disc and the peripheral local tissues. The depth of the incision doesnprime;t reach the Zinn-Hallers circle. (Chin J Ocul Fundus Dis, 2007, 23: 170-172)
Objective To investigate the effect of retinectomy 360° for severe ocular rupture and evaluate the related factors associated w ith prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone I in 5 eyes, zone I-II in 8 eyes，zone II in 3 eyes, zone II-IIIⅢ in 5 eyes, zone III in 7 eyes, zone II in 3 eyes, zone II-III in 5 eyes and zone III in 7 eyes. The presenting visual acuity was in grade 4 (0.02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360° retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes.Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrha ge in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76.9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70.0%) had corrected visual acuity of 0.02 or more, including 7 (35.0%) had 0.05 or more, 3 had 0.1 or mor e, and 1 had the best visual acuity of 0.3.Conclusion Retine ctomy may improve the prognosis of severe ocular rupture and save the visual fun ction of some patients.(Chin J Ocul Fundus Dis，2003，19：333-404)
Objective To observe the therapeutic effect of vitrectomy on Eales disease and the correlated factors affecting the visual prognosis and disease outcomes. Methods The clinical and follow-up data from 128 patients (142 eyes) with Eales disease undergone vitrectomy were retrospec tively analyzed. The statistical methods including t test,chi;2test, one-way Anova method of square-deviation(SD), and logistic regression were used to analyze the relationship between the general data of the patients (including age, sex, laterality of the eye, visual acuity before the treatment, stages of disease, duration from vitreous hemorrhage to vitrectomy, neovascularization and proliferative vitreoretinopathy, and whether or not combined with retinal detachment and other complications) and the prognosis of the visual acuity after surgery (including the surgical method, techniques, and times and complications after the surgery). The patients were 18-45 years old (mean 28.5 years) with single vitreous hemorrhage in 28 and proliferative changes in 114 in whom 59 had retinal detachment. The follow-up period after the surgery was more than 3 months (mean 35.8 months). The success criteria of the surgery were complete or part retinal reattachment, and failure of retinal reattachment, eye-ball atrophy or excis ion of the affected eye were the failure criteria. Results Successful vitrectomies had been performed on 129 eyes (90.8%) and unsuccessful ones on 13 eyes (9.2%). The difference between the stages of the disease and prognosis of visual acuity after the surgery was significant (chi;2=64.0, Plt;0.01); the duration of vitreous hemorrhage obviously affected the prognosis of visual acuity (OR=11.6，Plt;0.01); the degree, quality, curable possibility, and recurrent probability of combined retinal detachment were the key factors affecting the visual acuity after vitrectomy; the visual acuity before and after the surgery was interrelated; the method and techniques of the surgery and the different filling matters affected the visual acuity after the surgery; the difference between multiple times and once of surgery was significant (chi;2=66.84，Plt;0.01); the degree of complexity of the operative procedure, especially repetitious vitrectomies obviously affected the surgical prognosis and the improvement of visual acuity; the possibility of fa ilure of the surgery differs 7 times in patients with or without post-operative complications ( chi;2=67.23，Plt;0.01); whether the post-operative complications occurred or not significantly affected the prognosis of the visual acuity a-fter the surgery. Conclusions Vitrectomy is effective for Eales disease. The important factors affecting the prognosis of visual acuity after the operation include stages of disease, degree and extent of proliferative vitreoretinopathy, whether or not combined with retinal detachment and other complic ations, duration from vitreous hemorrhage to vitrectomy, the degree of complexity of the operation, and the complications during or after the operation. (Chin J Ocul Fundus Dis, 2006, 22:291-294)
Objective To evaluate the therapeutic effect of encircling scleral buckling surgery in rhegmatogenous retinal detachement (RRD) with vitrectomy. Methods The records of a series of 118 consecutive patients with RRD undergone encircling scleral buckling surgery and vitrectomy between 1995-1999 were reviewed. All of the patients underwent an onece vitrectomy, and they consisted of with encircling scleral buckling group and without encircling scleral buckling group. The difference of rate of retinal reattachment, and the relationship between the reattachment rate and the grade of PVR, position of retinal tear and the different intraocular tamponade substitute in both groups were analysed and compared. The average follow-up period was 6.5 mons (1.5 mons-3 ys). Results The rate of retinal reattachment in this series of 118 cases was 81.4% (96/118) in which the encircling scleral buckling group accounted for 44.7% and the group without encircling scleral buckling accounted for 55.3%. There was no statistical difference of rate of retinal reattachment between both groups with PVR C, different intraocular tamponade and various positions of retinal tears, while the rate of retinal reattachment in cases of PVR D and retinal tears posterior to equator in group without encircling scleral buckling was significanthy higher than that in encircling scleral buckling group (Plt;0.05). Conclusion The encircling scleral buckling procedure may be unprofitable in increasing the rate of retinal reattachment in vitrectomy for RRD. (Chin J Ocul Fundus Dis, 2002, 18: 212-214)
Objective To investigate the therapeutic effects of subconjunctival verapamil on outcome in an experimental model of traumatic proliferative vitreoretinopathy. Methods An experimental model of traumatic proliferative vitreoretinopathy was induced in pigme nt rabbits,which then were selected randomly to receive either subconjunctival verapamil injection treatment or a placebo injection(control)daily for 3 weeks.Animals were examined by indirect ophthalmoscopy at weekly intervals for 5 weeks. Eyes were enucleated for light microscopy 5 weeks later. Results Fifty-six percent(18 of 32)of the rabbits receiving subconjunctival verapamil injection had developed tractional retinal detachment,whereas eighty-one percent(26 of 32)of control animals had developed tractional retinal detachment(chi;2=4.655,P=0.031).The results of clinical examination and light microscopy didn't show evidence of toxicity between the verapamil treated animals and control animals. Conclusion Subconjunctival verapamil decreased the incidence of tractional retinal detachment due to traumatic proliferative vetreoretinopathy in this rabbit model.Verapamil at the dose used in this model has no evident toxicity on rabbit eyes.Further studies are needed to determine the doseresponse and efficacy of the drug. (Chin J Ocul Fundus Dis,1999,15:69-71)