●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation...●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.展开更多
AIM:To evaluate the safety and efficacy of posterior scleral application(a modified technique)of an antimetabolite mitomycin C-soaked sponge in trabeculectomy for patients with glaucoma.METHODS:This retrospective stud...AIM:To evaluate the safety and efficacy of posterior scleral application(a modified technique)of an antimetabolite mitomycin C-soaked sponge in trabeculectomy for patients with glaucoma.METHODS:This retrospective study included 101 patients(115 eyes)with glaucoma(aged 12–83y)who underwent trabeculectomy using a modified mitomycin C-soaked sponge placement method.A piece of 3.5×10 mm2 sponge was placed vertically and posteriorly with the long side perpendicular to the limbus.The mitomycin C concentration and exposure time were 0.2–0.5 mg/m L and 1–5min,respectively.Intraocular pressure,bestcorrected visual acuity,and hypotensive medications were recorded at baseline and at the final visit.Complications,interventions required,and bleb morphology were recorded postoperatively.The primary outcome was trabeculectomy safety,including complications and bleb morphology;the secondary outcome was the trabeculectomy success rate.RESULTS:At the final follow-up[median 28mo,range 7–67mo and interquartile range(IQR)13mo],the qualified(cumulative)success rate was 93.0%and the complete success rate was 60.0%.No bleb-related complications were observed.The mean height,extent,and vascularity grades were 0.6±0.9,1.1±0.4,and 2.4±0.9,respectively.All Seidel tests were negative.The mean posteriority grade was 0.8±0.4.CONCLUSION:Trabeculectomy with the long side of a mitomycin C-soaked sponge placed perpendicular to the corneal limbus is safe and effective.展开更多
Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treat...Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .展开更多
Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically i...Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically induced scleral staphyloma in four patients was performed. The first patient was a 3-year-old young girl underwent corneal dermoid resection. The second patient was a 60-year-old man underwent nasal pterygium excision and conjunctival autograft without Mitomycin C(MMC). The other two were respectively a 74-year-old woman and a 69-year-old man underwent cataract surgery. All patients performed allogeneic sclera patch graft. In the at least half a year follow-up, the best corrected visual acuity(BCVA) of all the four patients were no worse than that of preoperative. Ocular symptoms disappeared, including eye pain, foreign body sensation, and so on. Unfortunately, the fourth patient showed sclera rejection and partial dissolution at postoperative 1 month. Conclusions: Surgically induced scleral staphyloma must be considered in the differential diagnosis of patients with staphyloma following corneal dermoid, pterygium, and cataract surgery. Allogeneic sclera patch graft is one of the methods for treating scleral staphyloma. However sclera rejection and dissolution should be considered postoperatively.展开更多
Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eye...Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts.Two patients had necrotizing scleritis,2 patients had scleral melting/perforation secondary to thermal burns,4 patients had scleral staphyloma secondary to surgery.Sclera was reconstructed with allogenic sclera patch grafts,6 in 8 patients combined autologous conjunctival pedicle flap,1 patient combined partial medial rectus translocation,1 patient combined autologous pedicle tenon graft,simultaneously.Treatment outcomes were evaluated using structural integrity,best corrected visual acuity(BCVA),scleritis remission,sclera rejection and melt,and ocular symptoms.Results:Eight patients were reviewed.In all of these cases,satisfactory anatomic and functional outcomes were achieved.In the at least half a year follow-up,the BCVA of all the eight patients were no worse than that of preoperative.No eye pain,foreign body sensation and other discomforts showed in all the patients,except one woman,who showed sclera rejection and melt 1 month postoperative.In addition,one patient showed high intraocular pressure(28 mmHg),which can be controlled by a kind of medicine.Conclusions:In this series,sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up.Attention should be paid to the sclera patch rejection and melt post operatively.展开更多
AIM: To investigate the effects of posterior scleral reinforcement(PSR) in the treatment of pathological myopia.·METHODS: The study included 52 eyes in 43 patients with pathological myopia who underwent PSR(PSR g...AIM: To investigate the effects of posterior scleral reinforcement(PSR) in the treatment of pathological myopia.·METHODS: The study included 52 eyes in 43 patients with pathological myopia who underwent PSR(PSR group), and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity(BCVA), and macular scans by optical coherence tomography(OCT) were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS: There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group(30.78±1.30 mm)(P <0.01), and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group(-19.18 ±2.12 D)(P <0.01). A statistically significant difference in BCVA was found between the PSR group(0.51 ±0.25 log MAR) and the control group(0.62±0.26 log MAR) at the postoperative 5-year follow-up(P <0.01). There were no serious complications during the 5-year follow-up period.·CONCLUSION: PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.展开更多
AIM: To investigate the effect of posterior scleral reinforcement(PSR) on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography(OCTA).·METHODS: The study incl...AIM: To investigate the effect of posterior scleral reinforcement(PSR) on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography(OCTA).·METHODS: The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR(PSR group) for 6 to 18 mo ago, and 30 age and myopia matched eyes without PSR surgery as control group.Macular, choriocapillaris and radial peripapillary capillary(RPC) flow density were measured by OCTA, and the measurements were compared between groups.·RESULTS: OCTA found no significant differences in macular flow density between PSR and control groups.For the superficial flow, whole enface flow density(WED), fovea density(FD), and parafoveal density(PD)were 46. 55 % ± 5. 19 % vs 47. 29 % ± 4. 12 %( P = 0. 542),31.45%±6.35% vs 31.17%±4.48%(P =0.841), and 48.82%±5.66% vs 49.21% ±4.15%(P =0.756) in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07% ±5.78% vs 53.95% ±4.62%(P =0.168),29.62%±6.55% vs 29.50%±6.38%(P=0.940), and 56.93%±6.17% vs 58.15% ±5.13%(P =0.407) in PSR and control groups, respectively. The choriocapillary flow density was 61.18 ±3.25% in PSR group vs 60.88% ±2.56% in control group(P=0.692). Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77%vs 48.11%±4.57%(P =0.813), 45.47%±11.44% vs 46.68%±9.02%(P=0.709), 54.32%±5.29% vs 52.47%±6.62%(P =0.349) in PSR and control groups, respectively.·CONCLUSION: OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.展开更多
AIM: To investigate the effects of posterior scleral reinforcement(PSR) combined with vitrectomy for myopic foveoschisis.· METHODS: Thirty-nine highly myopic eyes of 39 patients with myopic foveoschisis underwent...AIM: To investigate the effects of posterior scleral reinforcement(PSR) combined with vitrectomy for myopic foveoschisis.· METHODS: Thirty-nine highly myopic eyes of 39 patients with myopic foveoschisis underwent PSR combined with vitrectomy. Best corrected visual acuity(BCVA), refraction error, and the foveal thickness by optical coherence tomography(OCT) were recorded before and after the surgery, and complications were noted.·RESULTS: The follow-up period was 12 mo, and the main focus was on the results of the 12-month follow-up visit. The mean preoperative BCVA was 0.96±0.43 log MAR.At the final follow-up visit, the mean BCVA was 0.46 ±0.28 log MAR, which significantly improved compared with the preoperative one(P =0.003). The BCVA improved in33 eyes(84.62%), and unchanged in 6 eyes(15.38%). At the end of follow- up, the mean refractive error was-15.13 ±2.55 D, and the improvement was significantly compared with the preoperative one(-17.53±4.51 D)(P =0.002). Twelve months after surgery, OCT showed complete resolution of the myopic foveoschisis and a reattachment of the fovea in 37 eyes(94.87%) and partial resolution in the remained two eyes(5.13%). The foveal thickness was obviously reduced at 12-month follow-up visit(196.45 ±36.35 μm) compared with the preoperative one(389.32±75.56 μm)(P =0.002). There were no serious complications during the 12 mo follow-up period.·CONCLUSION: PSR combined with vitrectomy is a safe and effective procedure for myopic foveoschisis with both visual and anatomic improvement.展开更多
AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro . The mRNA levels of BMP-2 an...AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro . The mRNA levels of BMP-2 and BMPRs in HSFs were assayed by reverse transcription-polymerase chain reaction (RT-PCR). The protein distributions of BMP-2 and BMPRs in HSFs were further detected by immunocytofluorescence and western blot. Their protein expression was also detected in frozen human posterior scleral sections by immunohistofluorescence. RESULTS: BMP-2 and BMPRs were expressed in both HSFs and human sclera not only at mRNA level but also at protein level. The expressions of BMPRIA and BMPRII were higher than that of BMPRIB in the cytoplasm and cell membrane of HSFs in vitro. Western blot further verified the results of immunocytofluorescence. In human sclera, BMP2, BMPR IB and BMPR II were found to be expressed in the cytomatrix of HSF, and weak signal was detected about BMPRIA. CONCLUSION: BMP-2 and all three subtypes of BMPRs were found in HSFs and may play a role in scleral remodeling.展开更多
The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera ...The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities(BCVAs) of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.展开更多
This study aimed to evaluate the effect of scleral buckling combined with internal cyclopexy on the treatment of severe traumatic cyclodialysis cleft in open globe injuries(OGIS). This retrospective study recruited 10...This study aimed to evaluate the effect of scleral buckling combined with internal cyclopexy on the treatment of severe traumatic cyclodialysis cleft in open globe injuries(OGIS). This retrospective study recruited 10 patients of 10 eyes. With our surgical intervention, all the 10 eyes achieved retinal and ciliary body anatomic re-attachment. The choroidal ruptures in nine eyes were closed with complete choroidal reattachment. Postoperative best-corrected visual acuity of nine eyes had various improvements. The mean intraocular pressure was increased from 8.9±2.6 mm Hg to 13.4±4.4 mm Hg. Eventually, six eyes underwent silicone oil(SO) removal without complications, two eyes still had SO tamponade and two eyes became SO-dependent eyes. The result shows that internal direct cyclopexy combined with scleral buckling is an effective treatment for severe traumatic cyclodialysis cleft in OGIS.展开更多
AIM:To compare the effects of scleral buckling using wide-angle viewing systems(WAVS) with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment.METHODS:The study was a retrospectiv...AIM:To compare the effects of scleral buckling using wide-angle viewing systems(WAVS) with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment.METHODS:The study was a retrospective analyses of the medical records of 94 eyes(94 patients) with rhegmatogenous retinal detachment.Among them,47 eyes underwent scleral buckling using WAVS with endoiiluminator(Group W),and 47 eyes underwent scleral buckling using indirect ophthalmoscope(Group I).Surgical durations,primary success rate,best-corrected visual acuities(BCVA),delayed subretinal fluid absorptions and surgical complications were compared between the two groups.RESULTS:At baseline,there were no statistical differences between the two groups in patient's age(P=0.997),gender(P=0.853),symptom duration(P=0.216),BCVA(P=0.389),refractive error(P=0.167),intraocular pressure(P=0.595),the number of retinal breaks(P=0.832),the extent of retinal detachment(P =0.246),subretinal demarcation line(P=0.801),and macular detachment(P=0.811).The follow-up period was 12 mo.The surgical durations in Group W(with or without encircling buckling) were significant shorter than those in Group I(P<0.001 respectively).The primary success rate was94.27%in Group W,which was similar to that in Group I(92.38%,P=0.931).The BCVA in Group W was better than that in Group I(P<0.001) at 1-month follow-up visit.However,there were no significant differences between the two groups at 3-month(P=0.221),6-month(P =0.674),and 12-month(P=0.363) follow-up visits respectively.Delayed subretinal fluid absorptions were more common in Group I than in Group W at 1-month(P=0.045) follow-up visit,but there were no significant differences between the two groups at 3-month(P=0.111),6-month(P =1.000) and 12-month follow-up visits respectively.CONCLUSION:Scleral buckling using WAVS can be an alternative choose for rhegmatogenous retinal展开更多
AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted...AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18 y having>7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation.Primary outcome was improvement in best corrected visual acuity(BCVA)and secondary outcomes were assessment of intraocular lens(IOL)tilt using ultrasound biomicroscopy(UBM),mean change in astigmatism at last follow-up of 1 y and associated complications.RESULTS:The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45(log MAR)respectively(P=0.001)at last follow-up.The mean astigmatism preoperatively and postoperatively was-4.17±2.69 D and-1.86±1.25 D respectively(P=0.011).Significant IOL tilt(>5 degrees)was present in 5 cases.The mean percentage endothelial loss was 3.65%±1.92%.The most serious complication encountered was retinal detachment seen in 2 cases.CONCLUSION:SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection.We recommend caution in children having white-to-white distance>12 mm and presence of peripheral retinal degenerations.展开更多
With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remod...With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remodeling, primarily dependent on the scleral extracellular matrix(ECM) changes, is significantly linked to eye lengthening.Scleral remodeling plays a critical function in the incidence and progression of myopia.This mini-review will focus on recent research progress of scleral remodeling in the hope of providing new ideas for the prophylaxis and treatment of myopia.展开更多
AIM: To assess the sutureless scleral fixation technique for posterior chamber foldable intraocular lens(PCIOL) implantation in aphakic eyes with insufficient or no capsular support. METHODS: A technique for sutureles...AIM: To assess the sutureless scleral fixation technique for posterior chamber foldable intraocular lens(PCIOL) implantation in aphakic eyes with insufficient or no capsular support. METHODS: A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PCIOL was used which ensures sutureless fixation by permanent incarceration of the haptics in a scleral tunnel parallel to the limbus. All patients were evaluated for preoperative status [visual acuity, refractive error, K readings, intraocular pressure(IOP) measurement, slit lamp examination, fundus examination and optical biometry], postoperative status and complications. Ultrasound biomicroscopy(UBM) was done for 10 cases to evaluate optic tilt. RESULTS: The study evaluated 42 eyes of 42 patients. The follow-up period was 6 mo. Improvement of best corrected visual acuity(BCVA) one line occurred in 10 cases(23.8%) and loss of one line in 3 cases(7.1%). Intraoperative complications included: haptic kink in 4 cases(9.5%), haptic breakage in 1 case(2.4%), haptic dislocation in 1 case(2.4%), haptic slippage in 3 cases(7.1%), IOL dislocation in 1 case(2.4%) and sclerotomy related bleeding in 1 case(2.4%). Postoperative complications included: transient mild vitreous hemorrhage in 3 cases(7.1%), choroidal detachment in 1 case(2.4%), cystoid macular edema(CME) in 1 case(2.4%), optic capture in 1 case(2.4%), subconjunctival haptic in 2 cases(4.8%), ocular hypotony in 4 cases(9.5%) and ocular hypertension in 1 case(2.4%). There were no cases of retinal detachment or endophthalmitis. UBM showed optic tilt in 3 cases(30%). CONCLUSION: Fixation of three-piece foldable IOL haptics in scleral tunnel parallel to the limbus-providedaxial stability and proper centration of the IOL with minimal or no tilt in most cases and a low complication rate during the follow up period which lasted 6 mo.展开更多
AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of hi...AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combined group were 2.39±0.62 and 2.06±0.25 times, the combined group had fewer operations on average(t=-2.705, P=0.009). CONCLUSION: Intraoperative PPV treatment of MHRD with PS combined with PS marginal endolaser photocoagulation can effectively increase the rate of retinal reattachment after the first operation, reduce the number of repeated operations, and reduce the postoperative duration of silicone oil tamponade.展开更多
● AIM: To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens(SFIOL) implantation in patients with posterior capsular rupture.● METHODS: Medical records of 51 pati...● AIM: To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens(SFIOL) implantation in patients with posterior capsular rupture.● METHODS: Medical records of 51 patients with posterior capsular rupture who received high speed cutter anterior vitrectomy via limbal incision with SFIOL implantation from June 2011 to December 2013 were reviewed retrospectively for visual outcomes and complications.● RESULTS: Totally 51 eyes of 51 patients were identified(23 males and 28 females). Mean age at surgery was 67.2±15y(range 27-91y), with mean follow-up of 23±8.2mo(range 12-40mo). The 49(96.1%) eyes had improvement or unchanged of final postoperative visual acuity. The most common complication was vitreous haemorrhage(5.9%) and transient rise in intraocular pressure(5.9%) which all spontaneously resolved● CONCLUSION: High speed cutter anterior vitrectomy via limbal incision is a safe and effective method for those with posterior capsular rupture for SFIOL implantation.展开更多
AIM: To report the long-term outcome of posterior scleral reinforcement(PSR) followed by vitrectomy for pathologic myopic foveoschisis(MF).METHODS: The records of 27 patients(44 eyes) treated with posterior scleral re...AIM: To report the long-term outcome of posterior scleral reinforcement(PSR) followed by vitrectomy for pathologic myopic foveoschisis(MF).METHODS: The records of 27 patients(44 eyes) treated with posterior scleral reinforcement(PSR) followed by vitrectomy for pathologic MF were retrospectively reviewed.The best-corrected visual acuity(BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings and complications were analyzed.RESULTS: Forty-four eyes of 27 patients were included in this study. The follow-up period was 47.98±18.23mo(24-83mo). The mean preoperative BCVA(logMAR) was 1.13±0.63, and the mean postoperative BCVA was 0.30±0.33at the last visit. There showed a significant improvement in BCVA postoperatively(P<0.001). Postoperative BCVA in 41eyes(93%) was improved compared with the preoperative one. Forty-two eyes(95.45%) got total resolution of the MF after surgery. The remaining two eyes(4.55%) got partial resolution of foveoschisis. The preoperative foveal thickness was 610.45±217.11 μm and the postoperative foveal thickness at the last visit was significantly reduced to 177.64±55.40 μm(P<0.001). The preoperative axial length was 29.60±1.71 mm, and the postoperative axial length was 29.74±1.81 mm at the last visit. There was no significant increase in axial length within 47.98±18.23mo of follow-up(P=0.562). There was no recurrence of foveoschisis or occurrence of full-thickness macular hole during the whole follow-up period.CONCLUSION: For pathologic MF, PSR followed by vitrectomy is an effective procedure to improve the visual acuity and the anatomical structure of macula. It can also stabilize the axial length for a long time.展开更多
AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD wer...AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.展开更多
Aims: To compare the results of pars plana vitrectomy (PPV) and combined scleral buckling—PPV (SB/PPV) in phakic rhegmatogenous retinal detachments with inferior breaks. Methods: Randomized, prospective, clinical con...Aims: To compare the results of pars plana vitrectomy (PPV) and combined scleral buckling—PPV (SB/PPV) in phakic rhegmatogenous retinal detachments with inferior breaks. Methods: Randomized, prospective, clinical controlled trial of forty consecutive phakic eyes with primary rhegmatogenous retinal detachment, associated with inferior breaks and not complicated by proliferative vitreoretinopathy ≥grade C, to either PPV (group 1) or combined SB/PPV (group 2). Results: At 6 months follow up the primary reattachment rate was 100% (20/20 cases) in group 2 and 70% (14/20 cases) in the group 1, the difference being statistically significant (p = 0.027). The best corrected visual acuity improved significantly from a preoperative mean of 1.65 ± 1.13 (Range: 0.6 to 3) to a mean of 0.45 ± 0.11 (Range: 0.3 to 0.6) in the group 2 and in the group 1 improved from a preoperative mean of 2.34 ± 0.92 (Range: 0.48 to 3) to a mean of 0.668 ± 0.20 (Range: 0.48 to 1), the difference between the two groups being statistically significant (p = 0.001). Conclusion: Anatomical and functional success rates are significantly better with the use of a scleral explant during PPV for uncomplicated forms of phakic rhegmatogenous retinal detachments with inferior breaks.展开更多
基金Supported by Xuzhou Health Outstanding Talents Project(No.XWJC001)Critical Special Project for Social Development of Xuzhou(No.KC21153)+1 种基金Science and Technology Innovation Project of Xuzhou Municipal Health Commission(No.XWKYHT20230039)Applied Basic Research Project of Xuzhou(No.KC23016).
文摘●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.
基金Supported by the National Natural Science Foundation of China(No.82070955)the Science and Technology Program of Guangzhou(2022),China(No.202201020362)the High-level Hospital Construction Project,Zhongshan Ophthalmic Center,Sun Yat-sen University(No.303020104)。
文摘AIM:To evaluate the safety and efficacy of posterior scleral application(a modified technique)of an antimetabolite mitomycin C-soaked sponge in trabeculectomy for patients with glaucoma.METHODS:This retrospective study included 101 patients(115 eyes)with glaucoma(aged 12–83y)who underwent trabeculectomy using a modified mitomycin C-soaked sponge placement method.A piece of 3.5×10 mm2 sponge was placed vertically and posteriorly with the long side perpendicular to the limbus.The mitomycin C concentration and exposure time were 0.2–0.5 mg/m L and 1–5min,respectively.Intraocular pressure,bestcorrected visual acuity,and hypotensive medications were recorded at baseline and at the final visit.Complications,interventions required,and bleb morphology were recorded postoperatively.The primary outcome was trabeculectomy safety,including complications and bleb morphology;the secondary outcome was the trabeculectomy success rate.RESULTS:At the final follow-up[median 28mo,range 7–67mo and interquartile range(IQR)13mo],the qualified(cumulative)success rate was 93.0%and the complete success rate was 60.0%.No bleb-related complications were observed.The mean height,extent,and vascularity grades were 0.6±0.9,1.1±0.4,and 2.4±0.9,respectively.All Seidel tests were negative.The mean posteriority grade was 0.8±0.4.CONCLUSION:Trabeculectomy with the long side of a mitomycin C-soaked sponge placed perpendicular to the corneal limbus is safe and effective.
文摘Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .
文摘Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically induced scleral staphyloma in four patients was performed. The first patient was a 3-year-old young girl underwent corneal dermoid resection. The second patient was a 60-year-old man underwent nasal pterygium excision and conjunctival autograft without Mitomycin C(MMC). The other two were respectively a 74-year-old woman and a 69-year-old man underwent cataract surgery. All patients performed allogeneic sclera patch graft. In the at least half a year follow-up, the best corrected visual acuity(BCVA) of all the four patients were no worse than that of preoperative. Ocular symptoms disappeared, including eye pain, foreign body sensation, and so on. Unfortunately, the fourth patient showed sclera rejection and partial dissolution at postoperative 1 month. Conclusions: Surgically induced scleral staphyloma must be considered in the differential diagnosis of patients with staphyloma following corneal dermoid, pterygium, and cataract surgery. Allogeneic sclera patch graft is one of the methods for treating scleral staphyloma. However sclera rejection and dissolution should be considered postoperatively.
文摘Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts.Two patients had necrotizing scleritis,2 patients had scleral melting/perforation secondary to thermal burns,4 patients had scleral staphyloma secondary to surgery.Sclera was reconstructed with allogenic sclera patch grafts,6 in 8 patients combined autologous conjunctival pedicle flap,1 patient combined partial medial rectus translocation,1 patient combined autologous pedicle tenon graft,simultaneously.Treatment outcomes were evaluated using structural integrity,best corrected visual acuity(BCVA),scleritis remission,sclera rejection and melt,and ocular symptoms.Results:Eight patients were reviewed.In all of these cases,satisfactory anatomic and functional outcomes were achieved.In the at least half a year follow-up,the BCVA of all the eight patients were no worse than that of preoperative.No eye pain,foreign body sensation and other discomforts showed in all the patients,except one woman,who showed sclera rejection and melt 1 month postoperative.In addition,one patient showed high intraocular pressure(28 mmHg),which can be controlled by a kind of medicine.Conclusions:In this series,sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up.Attention should be paid to the sclera patch rejection and melt post operatively.
基金Supported by the Overseas Training Program for Medical Academic Leaders of Henan Province(No.2014005)the Project of Medical Science and Technology of f Henan Province(No.201304007)the Development Plan of Science and Technology of Henan Province(No.142102310110)
文摘AIM: To investigate the effects of posterior scleral reinforcement(PSR) in the treatment of pathological myopia.·METHODS: The study included 52 eyes in 43 patients with pathological myopia who underwent PSR(PSR group), and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity(BCVA), and macular scans by optical coherence tomography(OCT) were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS: There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group(30.78±1.30 mm)(P <0.01), and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group(-19.18 ±2.12 D)(P <0.01). A statistically significant difference in BCVA was found between the PSR group(0.51 ±0.25 log MAR) and the control group(0.62±0.26 log MAR) at the postoperative 5-year follow-up(P <0.01). There were no serious complications during the 5-year follow-up period.·CONCLUSION: PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.
基金Supported by National Natural Science Foundation of China(No.81570891No.81272981)+4 种基金the Beijing Municipal Administration of Hospitals'Ascent Plan(No.DFL20150201)Science&Technology Project of Beijing Municipal Science&Technology Commission(No.Z151100001615052)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX201307)Beijing Natural Science Foundation(No.7151003)Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau(No.2014-2-003)
文摘AIM: To investigate the effect of posterior scleral reinforcement(PSR) on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography(OCTA).·METHODS: The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR(PSR group) for 6 to 18 mo ago, and 30 age and myopia matched eyes without PSR surgery as control group.Macular, choriocapillaris and radial peripapillary capillary(RPC) flow density were measured by OCTA, and the measurements were compared between groups.·RESULTS: OCTA found no significant differences in macular flow density between PSR and control groups.For the superficial flow, whole enface flow density(WED), fovea density(FD), and parafoveal density(PD)were 46. 55 % ± 5. 19 % vs 47. 29 % ± 4. 12 %( P = 0. 542),31.45%±6.35% vs 31.17%±4.48%(P =0.841), and 48.82%±5.66% vs 49.21% ±4.15%(P =0.756) in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07% ±5.78% vs 53.95% ±4.62%(P =0.168),29.62%±6.55% vs 29.50%±6.38%(P=0.940), and 56.93%±6.17% vs 58.15% ±5.13%(P =0.407) in PSR and control groups, respectively. The choriocapillary flow density was 61.18 ±3.25% in PSR group vs 60.88% ±2.56% in control group(P=0.692). Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77%vs 48.11%±4.57%(P =0.813), 45.47%±11.44% vs 46.68%±9.02%(P=0.709), 54.32%±5.29% vs 52.47%±6.62%(P =0.349) in PSR and control groups, respectively.·CONCLUSION: OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.
基金Supported by the Projects of Henan Health and Family Planning Commission (No. 2014005)the Projects of Henan Health Department (No. 201304007)Henan Science and Technology Department (No. 142102310110)
文摘AIM: To investigate the effects of posterior scleral reinforcement(PSR) combined with vitrectomy for myopic foveoschisis.· METHODS: Thirty-nine highly myopic eyes of 39 patients with myopic foveoschisis underwent PSR combined with vitrectomy. Best corrected visual acuity(BCVA), refraction error, and the foveal thickness by optical coherence tomography(OCT) were recorded before and after the surgery, and complications were noted.·RESULTS: The follow-up period was 12 mo, and the main focus was on the results of the 12-month follow-up visit. The mean preoperative BCVA was 0.96±0.43 log MAR.At the final follow-up visit, the mean BCVA was 0.46 ±0.28 log MAR, which significantly improved compared with the preoperative one(P =0.003). The BCVA improved in33 eyes(84.62%), and unchanged in 6 eyes(15.38%). At the end of follow- up, the mean refractive error was-15.13 ±2.55 D, and the improvement was significantly compared with the preoperative one(-17.53±4.51 D)(P =0.002). Twelve months after surgery, OCT showed complete resolution of the myopic foveoschisis and a reattachment of the fovea in 37 eyes(94.87%) and partial resolution in the remained two eyes(5.13%). The foveal thickness was obviously reduced at 12-month follow-up visit(196.45 ±36.35 μm) compared with the preoperative one(389.32±75.56 μm)(P =0.002). There were no serious complications during the 12 mo follow-up period.·CONCLUSION: PSR combined with vitrectomy is a safe and effective procedure for myopic foveoschisis with both visual and anatomic improvement.
基金National Natural Science Foundation of China (No.81070753)Fundamental Research Funds of State Key Laboratory of Ophthalmology,China(No.2010C02)
文摘AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro . The mRNA levels of BMP-2 and BMPRs in HSFs were assayed by reverse transcription-polymerase chain reaction (RT-PCR). The protein distributions of BMP-2 and BMPRs in HSFs were further detected by immunocytofluorescence and western blot. Their protein expression was also detected in frozen human posterior scleral sections by immunohistofluorescence. RESULTS: BMP-2 and BMPRs were expressed in both HSFs and human sclera not only at mRNA level but also at protein level. The expressions of BMPRIA and BMPRII were higher than that of BMPRIB in the cytoplasm and cell membrane of HSFs in vitro. Western blot further verified the results of immunocytofluorescence. In human sclera, BMP2, BMPR IB and BMPR II were found to be expressed in the cytomatrix of HSF, and weak signal was detected about BMPRIA. CONCLUSION: BMP-2 and all three subtypes of BMPRs were found in HSFs and may play a role in scleral remodeling.
文摘The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities(BCVAs) of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.
文摘This study aimed to evaluate the effect of scleral buckling combined with internal cyclopexy on the treatment of severe traumatic cyclodialysis cleft in open globe injuries(OGIS). This retrospective study recruited 10 patients of 10 eyes. With our surgical intervention, all the 10 eyes achieved retinal and ciliary body anatomic re-attachment. The choroidal ruptures in nine eyes were closed with complete choroidal reattachment. Postoperative best-corrected visual acuity of nine eyes had various improvements. The mean intraocular pressure was increased from 8.9±2.6 mm Hg to 13.4±4.4 mm Hg. Eventually, six eyes underwent silicone oil(SO) removal without complications, two eyes still had SO tamponade and two eyes became SO-dependent eyes. The result shows that internal direct cyclopexy combined with scleral buckling is an effective treatment for severe traumatic cyclodialysis cleft in OGIS.
基金Supported by the Projects of Henan Health and Family Planning Commission(No.2014005)Henan Health Department(No.201304007)Henan Science and Technology Department(No.142102310110)
文摘AIM:To compare the effects of scleral buckling using wide-angle viewing systems(WAVS) with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment.METHODS:The study was a retrospective analyses of the medical records of 94 eyes(94 patients) with rhegmatogenous retinal detachment.Among them,47 eyes underwent scleral buckling using WAVS with endoiiluminator(Group W),and 47 eyes underwent scleral buckling using indirect ophthalmoscope(Group I).Surgical durations,primary success rate,best-corrected visual acuities(BCVA),delayed subretinal fluid absorptions and surgical complications were compared between the two groups.RESULTS:At baseline,there were no statistical differences between the two groups in patient's age(P=0.997),gender(P=0.853),symptom duration(P=0.216),BCVA(P=0.389),refractive error(P=0.167),intraocular pressure(P=0.595),the number of retinal breaks(P=0.832),the extent of retinal detachment(P =0.246),subretinal demarcation line(P=0.801),and macular detachment(P=0.811).The follow-up period was 12 mo.The surgical durations in Group W(with or without encircling buckling) were significant shorter than those in Group I(P<0.001 respectively).The primary success rate was94.27%in Group W,which was similar to that in Group I(92.38%,P=0.931).The BCVA in Group W was better than that in Group I(P<0.001) at 1-month follow-up visit.However,there were no significant differences between the two groups at 3-month(P=0.221),6-month(P =0.674),and 12-month(P=0.363) follow-up visits respectively.Delayed subretinal fluid absorptions were more common in Group I than in Group W at 1-month(P=0.045) follow-up visit,but there were no significant differences between the two groups at 3-month(P=0.111),6-month(P =1.000) and 12-month follow-up visits respectively.CONCLUSION:Scleral buckling using WAVS can be an alternative choose for rhegmatogenous retinal
文摘AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18 y having>7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation.Primary outcome was improvement in best corrected visual acuity(BCVA)and secondary outcomes were assessment of intraocular lens(IOL)tilt using ultrasound biomicroscopy(UBM),mean change in astigmatism at last follow-up of 1 y and associated complications.RESULTS:The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45(log MAR)respectively(P=0.001)at last follow-up.The mean astigmatism preoperatively and postoperatively was-4.17±2.69 D and-1.86±1.25 D respectively(P=0.011).Significant IOL tilt(>5 degrees)was present in 5 cases.The mean percentage endothelial loss was 3.65%±1.92%.The most serious complication encountered was retinal detachment seen in 2 cases.CONCLUSION:SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection.We recommend caution in children having white-to-white distance>12 mm and presence of peripheral retinal degenerations.
文摘With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remodeling, primarily dependent on the scleral extracellular matrix(ECM) changes, is significantly linked to eye lengthening.Scleral remodeling plays a critical function in the incidence and progression of myopia.This mini-review will focus on recent research progress of scleral remodeling in the hope of providing new ideas for the prophylaxis and treatment of myopia.
文摘AIM: To assess the sutureless scleral fixation technique for posterior chamber foldable intraocular lens(PCIOL) implantation in aphakic eyes with insufficient or no capsular support. METHODS: A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PCIOL was used which ensures sutureless fixation by permanent incarceration of the haptics in a scleral tunnel parallel to the limbus. All patients were evaluated for preoperative status [visual acuity, refractive error, K readings, intraocular pressure(IOP) measurement, slit lamp examination, fundus examination and optical biometry], postoperative status and complications. Ultrasound biomicroscopy(UBM) was done for 10 cases to evaluate optic tilt. RESULTS: The study evaluated 42 eyes of 42 patients. The follow-up period was 6 mo. Improvement of best corrected visual acuity(BCVA) one line occurred in 10 cases(23.8%) and loss of one line in 3 cases(7.1%). Intraoperative complications included: haptic kink in 4 cases(9.5%), haptic breakage in 1 case(2.4%), haptic dislocation in 1 case(2.4%), haptic slippage in 3 cases(7.1%), IOL dislocation in 1 case(2.4%) and sclerotomy related bleeding in 1 case(2.4%). Postoperative complications included: transient mild vitreous hemorrhage in 3 cases(7.1%), choroidal detachment in 1 case(2.4%), cystoid macular edema(CME) in 1 case(2.4%), optic capture in 1 case(2.4%), subconjunctival haptic in 2 cases(4.8%), ocular hypotony in 4 cases(9.5%) and ocular hypertension in 1 case(2.4%). There were no cases of retinal detachment or endophthalmitis. UBM showed optic tilt in 3 cases(30%). CONCLUSION: Fixation of three-piece foldable IOL haptics in scleral tunnel parallel to the limbus-providedaxial stability and proper centration of the IOL with minimal or no tilt in most cases and a low complication rate during the follow up period which lasted 6 mo.
基金Supported by the Project of Integrated Traditional Chinese and Western Medicine by Tianjin Municipal Health Commission(No.2021067)。
文摘AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combined group were 2.39±0.62 and 2.06±0.25 times, the combined group had fewer operations on average(t=-2.705, P=0.009). CONCLUSION: Intraoperative PPV treatment of MHRD with PS combined with PS marginal endolaser photocoagulation can effectively increase the rate of retinal reattachment after the first operation, reduce the number of repeated operations, and reduce the postoperative duration of silicone oil tamponade.
文摘● AIM: To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens(SFIOL) implantation in patients with posterior capsular rupture.● METHODS: Medical records of 51 patients with posterior capsular rupture who received high speed cutter anterior vitrectomy via limbal incision with SFIOL implantation from June 2011 to December 2013 were reviewed retrospectively for visual outcomes and complications.● RESULTS: Totally 51 eyes of 51 patients were identified(23 males and 28 females). Mean age at surgery was 67.2±15y(range 27-91y), with mean follow-up of 23±8.2mo(range 12-40mo). The 49(96.1%) eyes had improvement or unchanged of final postoperative visual acuity. The most common complication was vitreous haemorrhage(5.9%) and transient rise in intraocular pressure(5.9%) which all spontaneously resolved● CONCLUSION: High speed cutter anterior vitrectomy via limbal incision is a safe and effective method for those with posterior capsular rupture for SFIOL implantation.
基金Supported by Central Health Bureau Project(No.2020YB49)。
文摘AIM: To report the long-term outcome of posterior scleral reinforcement(PSR) followed by vitrectomy for pathologic myopic foveoschisis(MF).METHODS: The records of 27 patients(44 eyes) treated with posterior scleral reinforcement(PSR) followed by vitrectomy for pathologic MF were retrospectively reviewed.The best-corrected visual acuity(BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings and complications were analyzed.RESULTS: Forty-four eyes of 27 patients were included in this study. The follow-up period was 47.98±18.23mo(24-83mo). The mean preoperative BCVA(logMAR) was 1.13±0.63, and the mean postoperative BCVA was 0.30±0.33at the last visit. There showed a significant improvement in BCVA postoperatively(P<0.001). Postoperative BCVA in 41eyes(93%) was improved compared with the preoperative one. Forty-two eyes(95.45%) got total resolution of the MF after surgery. The remaining two eyes(4.55%) got partial resolution of foveoschisis. The preoperative foveal thickness was 610.45±217.11 μm and the postoperative foveal thickness at the last visit was significantly reduced to 177.64±55.40 μm(P<0.001). The preoperative axial length was 29.60±1.71 mm, and the postoperative axial length was 29.74±1.81 mm at the last visit. There was no significant increase in axial length within 47.98±18.23mo of follow-up(P=0.562). There was no recurrence of foveoschisis or occurrence of full-thickness macular hole during the whole follow-up period.CONCLUSION: For pathologic MF, PSR followed by vitrectomy is an effective procedure to improve the visual acuity and the anatomical structure of macula. It can also stabilize the axial length for a long time.
文摘AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.
文摘Aims: To compare the results of pars plana vitrectomy (PPV) and combined scleral buckling—PPV (SB/PPV) in phakic rhegmatogenous retinal detachments with inferior breaks. Methods: Randomized, prospective, clinical controlled trial of forty consecutive phakic eyes with primary rhegmatogenous retinal detachment, associated with inferior breaks and not complicated by proliferative vitreoretinopathy ≥grade C, to either PPV (group 1) or combined SB/PPV (group 2). Results: At 6 months follow up the primary reattachment rate was 100% (20/20 cases) in group 2 and 70% (14/20 cases) in the group 1, the difference being statistically significant (p = 0.027). The best corrected visual acuity improved significantly from a preoperative mean of 1.65 ± 1.13 (Range: 0.6 to 3) to a mean of 0.45 ± 0.11 (Range: 0.3 to 0.6) in the group 2 and in the group 1 improved from a preoperative mean of 2.34 ± 0.92 (Range: 0.48 to 3) to a mean of 0.668 ± 0.20 (Range: 0.48 to 1), the difference between the two groups being statistically significant (p = 0.001). Conclusion: Anatomical and functional success rates are significantly better with the use of a scleral explant during PPV for uncomplicated forms of phakic rhegmatogenous retinal detachments with inferior breaks.
