Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Purpose To evaluate the safety and efficacy of draining subretinal fluid with transchoroidal probing by using the traditional needling and diode endolaser probing. Methods The investigation included 70 consecutive patients(74 eyes) with rhegmatogenous retinal detachment undergoing scleral buckling surgery.Seventy cases were randomly divided into 2 groups,group A 34 cases(36 eyes)with the needle drainage procedure and group B 36 cases(38 eyes) with the diode probe respectively.The safety and efficacy were compared in between the 2 groups. Results No operative failure was found in these 2 groups.In group A,subretinal hemorrhage occurred in 3 eyes,and retinal incarceration,retinal preforation in one eye. No significant complication occurred in group B. Conclusion Diode laser drainage has the advantage in that it may reduce the incidence of operative complication with drainage.This technique might be used in any case requiring drainage of subretinal fluid especially of rhegmat ogenous retinal detachment in cases of shallow retinal detachment. (Chin J Ocul Fundus Dis,1998,14:202-203)
Objective To investigate the effects of cryoanalgesia for post-thoracotomy pain on the intercostal nerves. Methods Two hundred and eight patients suffering from thoracotomy were divided into three groups, according to different analgesia received respectively. Cryoanalgesia group （n = 80）： cryoanalgesia on the intercostal nerves, intercostals nerves was freezed at -55 ℃ for 90 seconds ; patient controlled analgesia by vein （PCA group, n= 80）： patient controlled analgesia was practiced intravenously, and control group （n = 48）： Dolantin given irregularly intra-muscularly and/or tramadol orally. Severity of pain was graded by visual analogue scale. Forced expiratory volume in one second（FEV1.0） was measured and pulmonary complication after operation was compared. Results There was a statistically significant improvement in postoperative pain scores and an improvement in respiratory function tests for patients in cryoanalgesia group（X2 = 74.93,15.04,P〈0. 05）. FEV1.0 in cryoanalgesia group was significantly higher than that in control group（1. 97±0.27L vs. 1. 39±0. 14 L,P〈0. 05）. Pulmonary complication in cryoanalgesia group after operation was lower than that in control group （6. 25% vs. 31. 25%, P〈0. 05 ）, Conclusion Cryoanalgesia on post-thoracotomy pain is very effective and may improve the respiratory function after operation.
Objective To explore the histopathological changes of the radial optic neurotomy (RON) in human eyes, and to establish the theoretical foundation for the effective RON. Methods Ten patients with unaffected eyeball or optic disc who had undergone ophthalmectomy (7 patients) or orbital exenteration (3 patients) because of intraocular or orbital tumor were gathered. A double-incision in pars plana was performed. One was inserted into illuminating fiber, and an other was inserted into a standard microvitreoretinal (MVR) blade (unbent MVR blade in 4 patients and bent ones in 6; radial incision on nasal side of the optic disc in 4 patients and on both nasal and temporal side in 6). The histopathological examination was performed to observe the location and depth of the incision. Results Eleven incisions were found in 8 out of 10 patients, of which surgical spaces can be observed clearly. Three incisions were obliquely inserted into the optic nerves, 5 sieve plate lateral incisions had the surgical intervals conne cted with the subarachnoid spaces, and 3 incisions caused obvious damage of retinal ganglion cell axons due to the position close to the center. Nine incisions approached to the retrolaminal level, and the other 2 reached the laminal and pr elaminal level respectively. Injured retina beside the optic disc in 1 incision was found. Central retinal vessels were not damaged. Conclusions An optimal incision may be in the edge of the lamina cribrosa, whose depth should be in the level of lamina cribrosa and retrolamina, with surgical intervals connected with the subarachnoid spaces. (Chin J Ocul Fundus Dis，2004，20：67-70)
Objective To evaluate the curative effects of vitreoctomy or simple scleral buckling on retinal multiple-tear detachment associated with tracted anterior flap. Methods The clinical data of 89 eyes in 89 patients with retinal multiple-tear detachment associated with tracted anterior flap diagnosed in Jan, 1999-Jan, 2002 were retrospectively analyzed. In the 89 patients, 41 had undergone vitreoctomy and 48 had undergone scleral buckling without vitrectomy. In the duration of 2- to 36-month follow-up with the mean of (11.02±7.90) months, visual acuity, retinal reattached rate and postoperative complication were examined and the results in the 2 groups were compared. Results In 41 eyes underwent vitreocotmy, successful reattachment was found in 38 (92.7% ); visual acuity increased in 33 (80.5%), didn′t change in 6 (14.6%), and decreased in 2 (4.9%); leakage of flocculent membrane in anterior chamber occured was found in 2 (4.9%), complicated cataract in 3 (7.3%),and severe proliferative vitreoretinopathy (PVR) in 3 (7.3%). In 48 eyes underwent scleral buckling, 41 (85.4%) had success reattachment; visual acuity increased in 36 (75.0%), didn′t change in 4 (8.3%), and decreased in 8 (16.7%); leakage of flocculent membrane in anterior chamber was found in 6 (12.5%), complicated cataract in 9 (18.8 %), and severe PVR in 8 (16.7%). Conclusion There isn′t any difference of the success rate of the surgery between vitrectomy and scleral buckling for retinal multiple-tear detachment associated with tracted anterior flap.The better visual acuity and less complications are found in the vitrectomy gro up than those in the scleral buckling group. (Chin J Ocul Fundus Dis，2004，20：209-211)
目的 正确评价胰岛素瘤的各种定位诊断方法和各种手术治疗方法。 方法 回顾性分析吉林大学第一医院普外科与吉林省肿瘤医院普外科1985年6月至2005年6月期间诊治的38例胰岛素瘤的临床资料，系统评价术前超声、术中超声、术前CT及术前增强CT定位诊断方法。结果 术前超声、术前CT、术前增强CT及术中超声检查其确诊率分别为47.4%、51.5%、85.7%及100%。行肿瘤局部摘除术21例，单纯远端胰腺切除术14例，远端胰腺切除术联合脾摘除3例。结论 胰岛素瘤的术前定位诊断较困难，术前超声与术前CT在术前定位诊断方面差异无统计学意义，术前增强CT能够明显提高胰岛素瘤的术前诊断率，术中超声是胰岛素瘤最有效的定位诊断方法。行肿瘤摘除术是治疗良性胰岛素瘤的最佳方式，能够降低术后并发症发生率。多发性胰岛素瘤或恶性胰岛素瘤应行胰腺次全切除术以避免复发，必要时可联合脾脏摘除。
Primary acinic cell carcinoma (ACC) of the lung is extremely rare. The World Health Organization tumor classification defines ACC as "a malignant epithelial neoplasm that demonstrates some cytological differentiation towards (serous) acinar cells". It is considered to be a low-grade malignant tumor. Since the first case described by Fechner in 1972, less than 30 cases have been reported in the literature. The rarity of this tumor may leads it to be confused with other primary lung tumors and incorrectly diagnosed. We reported a female patient with primary ACC of the lung with mediastinum deviation at age of 27 years received a right pneumonectomy. She was followed up for 12 months postoperatively and remains well.