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.
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)
PURPOSE:To evaluate the ability Of retinoic acid(RA) in silicon oil(SiO)to inhibit the proliferation of injected intraocular fibroblast cells. METHODS:Thirty New Zealand white rabbits (58 eyes)were divided into three groups. In control group ,only SiO(10 eyes)or BSS(10 eyes)were injected intravitreally and 5mu;g/ml (18 eyes)or 10mu;g/ml (20 eyes)RA in SiO were injected into other lwo groups respectively. Three days after gas-compression vitrectomy, 2 times;105 fibroblasts and Sio(0.5ml)or BSS(0.5ml)were injected in all eyes sequentially.The morbidity of tractional retinal detachment (TRD) were observed by ophthalmoscope until 4 weeks. RESULTS:After 4 weeks,in control ,5mu;g/ml RA in SiO and 10mu;g/ml RA in SiO group,80. 00%,44.44%,and 30.00% eyes developed TRD respectively. Significant statistical differences were found between the control group and the two treated groups (P＜0.05). CONCLUSIONS:5mu;g/ml or 10mu;g/ml RA in SiO can inhibit the occurrence of TRD effectively. （Chin J Ocul Fundus Dis,1997,13:174-176）
ObjectiveTo compare the effects of intravitreal tamponade of C3F8 with silicon oil on postoperative vitreous hemorrhage and visual prognosis after vitrectomy for proliferative diabetic retinopathy (PDR). MethodsThe clinical data of 121 patients (127 eyes) who underwent primary vitrectomy due to PDR were analyzed retrospectively. All the patients were divided into two groups according to different intravitreal tamponade, including C3F8 tamponade group (53 patients with 56 eyes) and silicone oil tamponade group (68 patients with 71 eyes). There was no difference of gender (χ2=0.956), age (t=1.122), duratiion of diabetes (t=0.627), fasting blood glucose (t=1.049), systolic pressure (t=1.056), diastolic pressure (t=0.517), history of hypertension (χ2=0.356), nephropathy (χ2=1.242), preoperative laser photocoagulation (χ2=1.225) and All the patients underwent three port pars plana vitrectomy. The mean follow-up was 2 years ranging from 6 months to 4 years. And then the incidence and onset time of postoperative vitreous hemorrhage and postoperative BCVA of the two groups were compared. ResultsPostoperative vitreous hemorrhage occurred in 14 of 56 eyes (25.00%) in C3F8 tamponade group. The average onset time of postoperative vitreous hemorrhage were (64.64±59.09) days ranging from 7-225 days and mostly were within 30-60 days (35.71%, 5/14). Postoperative vitreous hemorrhage also occurred in 7 of 71 eyes (9.89%) of silicone oil tamponade group after silicone oil removal with an average onset time of (25.29±20.46) days ranging from 3-65 days and were mostly within 15-30 days (42.86%, 3/7). There was a significant difference in the incidence of postoperative vitreous hemorrhage between the two groups (χ2=5.200, P<0.05). BCVA of the two groups was improved significantly after operation (Z=2.472, 3.114; P<0.05). Postoperative BCVA of silicone oil tamponade group was poorer than C3F8 tamponade group (Z=1.968, P<0.05). ConclusionBoth C3F8 and silicone oil tamponade can improve the visual acuity after vitrectomy for PDR. Compared with C3F8, silicone oil tamponade had lower incidence and late onset of postoperative vitreous hemorrhage after vitrectomy for PDR.
Objective To investigate the effect of prophylactic 360°laser retinopexy on retinal redetachment after silicone oil removal. Methods The clinical data of 181 vitreoretinal patients after silicone oil removal were retrospectively analyzed. In 88 patients (photocoagulation group) was taken prophylactic 360-degree laser retinopexy before silicone oil removal; in 93 patients (control group) without prophylactic laser retinopexy. The incidence, time, the cause of retinal redetachment and the complications of laser retinopexy after silicone oil removal in two groups were observed. Results The duration of silicone oil tamponade is 4~72 weeks, averaging 13.7±2.4 weeks. 20 cases of retinal redetachment were recorded after silicone oil removal, including 5 cases (5.7%) in photocoagulation group and 15 cases (16.1%) in control group. The difference between two groups is statistically significant (Plt;0.05). Among these 20 patients with retinal redetachment, 10 occured during the first 3 days after the operation, 6 during 4~7 days, 3 during 8~14 days. 1 case occured 2 months after the operation. 11 cases of redetachment result from the omission of small retinal breaks located in ora serrata or behind the photocoagulation zone, or the reopening of primary retinal breaks because of insufficient photocoagulation and freezing during the operation. 1 case result from the hole that come from laser photocoagulation scar tracted by nearby proliferative tissue. 7 cases result from the formation of new breaks from the proliferative vitreoretinopathy(PVR) or proliferation of residual vitreous. There are 52 cases of burning of pupillary border, with the incidence of 59%. Conclusions Prophylactic 360-degree laser retinopexy is associated with a decrease of the incidence of retinal redetachment after removal of silicone oil. （Chin J Ocul Fundus Dis，2008，24：283-285）
Objective To verify the changes of optics and refraction of the eyes after retinal detachment surgery with the tamponade of silicone oil in vitreous cavity. Methods The optical calculation was taken as the following by using the parameter of Gullstrand model eye:（1）The refraction of silicone filled eye in non-accommodative status;（2）The refraction of silicone filled eye in non-accommodative status;（3）The aniseikonia analysis when one eye filled with the silicone oil;（4）The IOL power re-calculation． Results （1） Compa red with the normal eye,the eye filled with silicone oil is moved toward high hyperopia of +9．19 D;（2）When corrected,the accommodation amplitude reduced 1.42 D induced by filling silicone oil. Conclusion When eye filled with silicone oil,the change of refractive power tends to be highly hyperopic,the amplitude of accommodation decreased,and the regular IOL power calculation formula is no longer available. (Chin J Ocul Fundus Dis，2000，16：139-212)
Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD). Methods The clinical interventional caseseries study included 104 patients (112 eyes) with DTRD, who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas. Among the eyes, there were 6 eyes with iris neovascularization (INV), 1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment. There were no preexisting retinal holes or breaks prior to surgery nor any iatrogenic retinal breaks developed during vitrectomy. Cataract removal combined with intraocular lens implant surgeries were performed on 15 eyes. Followup duration varied from 12 to 65 months (mean: 29 months). Results Subretinal fluid was completely absorbed within 2 months after surgery. In 107 eyes (95.54%), the retina reattached after surgery and remained attached till the end of followup period. Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%), remained unchanged in 14 eyes (12.50%) and got worse in 19 eyes (16.79%). The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes, 66.00% Vs 46 eyes/62 eyes, 74.19%,chi;2=0.89, P=0.344). No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries. Seven (6.25%) eyes showed INV (5 new onset eyes), and none of them developed into NVG. In multivariate logistic regression, factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis ［adjusted odds ratio (OR)=10.2］, low preoperative BCVA (OR=11.1) and low postoperative BCVA (OR=16.7). Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oilor gas tamponade if there are no preoperative or intraoperative retinal breaks, and only using irrigation fluid could access a good longterm prognosis result.
Objective To observe the effect of emergent vitrectomy combined with lensectomy, silicone oil temponade for endogenous endophthalmitis. Methods The clinical data of 28 patients (30 eyes) with endogenous endophthalmitis were analyzed retrospectively. All patients had no history of ocular trauma and intraocular surgery history. There were 21 patients without systemic symptoms, three patients with fever, two patients with eye pain and headache, and two patients with abdominal pain when presentation. All patients diagnosed by best corrected visual acuity, intraocular pressure, slit-lamp microscopy, direct and indirect ophthalmoscope examination and intraocular B-ultrasound examination. Emergent surgery (vitrectomy, lensectomy, silicone oil temponade) was performed in all 30 patients, those with fever or abdominal pain was also treated by relevant clinical departments. Vitreous purulence was taken in all patients before vitrectomy for bacterial, fungal culture and drug sensitivity test. The follow-up was 18 to 30 months. The preoperative and postoperative visual acuity, intraocular pressure and eye retention situation were observed.Results Endophthalmitis was controlled in 28/30 eyes (93.3%) after surgery, recurrent vitreous empyema occurred in 2/30 eyes (6.7%). Evisceration was performed on those two eyes as uncontrolled intraocular pressure. The visual acuity improved significantly at one month and 18 months after surgery (chi;2=19.87, 32.44; P＜0.01). Postoperative intraocular pressure was normal in 24 eyes (80.0%), transient elevated and controlled in six eyes (chi;2=7.43；P＜0.05). 12/28 (42.9%) vitreous samples were positive for pathogen culture, including 7/12 (58.3%) positive for bacteria, 5/12 (41.7%) positive for fungi. There are 18/28 patients (64.3%) also had hepatobiliary system infections. Conclusion Emergent vitrectomy combined with lensectomy, silicone oil temponade is effective for endogenous endophthalmitis.