AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vit...AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vitrectomy.Patients were divided into the vitrectomy,fluid-air exchange,and observation groups according to the secondary treatment.The anatomical outcomes and postoperative visual acuity were recorded.RESULTS:The analysis included 25 eyes in 25 patients(16 females)aged 37–74y(vitrectomy group,n=10;fluid-air exchange group,n=9;observation group,n=6).Closure rate after secondary treatment was 100%in the vitrectomy group,88.9%in the fluid-air exchange group and 33.3%in the observation group.Optical coherence tomography images obtained at the last follow-up revealed that continuity of the external limiting membrane(ELM)was significantly more common(P=0.004)in the fluid-air group(8/9 eyes,88.9%)than in the vitrectomy group(2/10 eyes,20.0%)and that macular morphology was better in the fluid-air group than in the vitrectomy group.No serious complications were observed after secondary treatment.CONCLUSION:Fluid-air exchange is an alternative option to repeat vitrectomy for patients with an unclosed MH after initial vitrectomy with elevated macular edge.展开更多
·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS...·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS:This retrospective study analyzed the medical records of patients who underwent PPV for PDR and were followed up for minimum 3 mo.ILM peeling was performed based on the intraoperative surgeons’judgments.ERM was assessed by optical coherence tomography photography.The relationship between ILM peeling and postoperative ERM was analyzed.·RESULTS:In total,212 eyes from 197 patients were included in this study.The incidence of secondary ERM in the ILM non-peeling group was significantly higher than that in the ILM peeling group(37.0%vs 14.0%;P<0.001).Multivariate logistical regression revealed that ILM peeling was highly associated with the prevention of secondary ERM development[odds ratio 0.38;95%confidence interval0.17-0.86;P<0.05].·CONCLUSION:ILM peeling during PPV for PDRs can effectively reduce the incidence of secondary ERM development and is worth consideration by vitreoretinal surgeons.展开更多
AIM： To report the results of rhegmatogenous retinal detachment（RRD） repair after pars plana vitrectomy（PPV） without operative use of heavy liquid, and utilizing air tamponade in selected cases.METHODS： RRD pati...AIM： To report the results of rhegmatogenous retinal detachment（RRD） repair after pars plana vitrectomy（PPV） without operative use of heavy liquid, and utilizing air tamponade in selected cases.METHODS： RRD patients without severity of proliferative vitreoretinopathy C2 or more underwent PPV without operative use of heavy liquid, and utilizing air tamponade were consecutively enrolled. Alternative postoperative facedown position or lateral position was required for 3-5 d.RESULTS： Totally 36 eyes of 36 patients（24 males, 66.7%） aged 53.8±10.9 y underwent this modified surgery. The mean number of retinal break was 2.1±1.3. Most of the eyes（29, 80.6%） had retinal detachment involving more than one quadrant. Twenty-two（61.1%） eyes with cataract had combined phacoemulsification and intraocular lens implantation. The mean follow up time was 4.6±1.8 mo. Two eyes with retinal redetachment underwent a second retinal repair surgery with silicone oil tamponade, yielding the primary reattachment rate to 94.4%（34/36）. Six（16.7%） eyes had intraocular pressure higher than 25 mm Hg. The visual acuity（logMAR） improved from 0.98±0.74 preoperatively to 0.52±0.31 postoperatively（P〈0.001）. CONCLUSION： The success rate of this modified retinal repair surgery is comparable with traditional surgery. This technique can be considered for certain retinal detachment patients, since its apparent advantages included lower surgical complications, reduced surgery expenditure, shorter time for postoperative facedown position, and avoiding silicone oil removal surgery.展开更多
AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,fr...AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.展开更多
Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological...Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].展开更多
AIM:To investigate the safety and efficacy of sticky silicone oil(SSO)removal using a 22-gauge vein detained needle and inner limiting membrane(ILM)wrap-and-peel technique.METHODS:This retrospective consecutive case s...AIM:To investigate the safety and efficacy of sticky silicone oil(SSO)removal using a 22-gauge vein detained needle and inner limiting membrane(ILM)wrap-and-peel technique.METHODS:This retrospective consecutive case series reviewed the records of patients with a history of retinal detachment who had received silicone oil and perfluorocarbon liquid(PFCL)as intraocular tamponades.Patients were included in the analysis if they exhibited SSO remnants during silicone oil removal.The aspiration of most of the SSO remnants was performed by a 22-gauge vein detained needle.The small amounts of droplets adhered to the macula and epi-macular membrane were subsequently removed by the ILM warp-and-peel technique.The anatomical and functional outcomes,and postoperative complications were recorded.In vitro experiments were performed to simulate the formation of SSO remnants in four groups.RESULTS:Of 711 patients who underwent silicone oil removal during the study period,9 patients exhibited SSO remnants and underwent follow-up for at least 3mo.Seven eyes(78%)underwent the ILM wrap-and-peel technique to completely remove small droplets of SSO that were glued to the macula and epi-macular membrane.No obvious complications occurred.Postoperative optical coherence tomography revealed normal retinal structure in all patients.In vitro analyses showed that balanced salt solution and prolonged vibration(for 1wk)had the strongest effects on silicone oil and PFCL compound opacities.CONCLUSION:SSO remnants could be removed in an intact manner and without complications,using a vein detained needle-assisted and ILM wrap-and-peel technique.The findings suggest that PFCL and infusion fluid should be completely removed before silicone oil injection to prevent SSO formation.展开更多
AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent ...AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent 27-gauge pars plana vitrectomy(PPV)for SVF were included.Thirty-nine eyes of 39 age-and gendermatched healthy volunteers without SVF were also recruited as a healthy control.Center for Epidemiologic Studies Depression(CES-D)was used to assess volunteers and patients’depression(before and 1 wk after PPV).RESULTS:The CES-D score was 18.3±8.6 for patients,and was 12.4±6.0 for healthy control(P=0.003).Patients were significantly more likely to be in a depressive state(53.6%,defined as CES-D score≥16)than the healthy control(20.5%,P=0.005).For patients with SVF,the CES-D score was negatively correlated with their age(rs=-0.42,P=0.025).After PPV,both the CES-D score(11.9±5.4 vs 18.3±8.6,P<0.001)and proportion of depressive state(18.5%vs 53.6%,P=0.005)were significantly decreased.CONCLUSION:This study suggests that symptoms of vitreous floaters have an apparently negative impact on patients’psychological state.The PPV can effectively relieve the depressive state for patients with SVF.展开更多
文摘AIM:To evaluate whether fluid-air exchange is an effective treatment for unclosed macular hole(MH)after primary vitrectomy.METHODS:This retrospective study included patients with an unclosed MH within 1–2wk after vitrectomy.Patients were divided into the vitrectomy,fluid-air exchange,and observation groups according to the secondary treatment.The anatomical outcomes and postoperative visual acuity were recorded.RESULTS:The analysis included 25 eyes in 25 patients(16 females)aged 37–74y(vitrectomy group,n=10;fluid-air exchange group,n=9;observation group,n=6).Closure rate after secondary treatment was 100%in the vitrectomy group,88.9%in the fluid-air exchange group and 33.3%in the observation group.Optical coherence tomography images obtained at the last follow-up revealed that continuity of the external limiting membrane(ELM)was significantly more common(P=0.004)in the fluid-air group(8/9 eyes,88.9%)than in the vitrectomy group(2/10 eyes,20.0%)and that macular morphology was better in the fluid-air group than in the vitrectomy group.No serious complications were observed after secondary treatment.CONCLUSION:Fluid-air exchange is an alternative option to repeat vitrectomy for patients with an unclosed MH after initial vitrectomy with elevated macular edge.
文摘·AIM:To evaluate the role of internal limiting membrane(ILM)peeling in preventing secondary epiretinal membrane(ERM)formation in pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).·METHODS:This retrospective study analyzed the medical records of patients who underwent PPV for PDR and were followed up for minimum 3 mo.ILM peeling was performed based on the intraoperative surgeons’judgments.ERM was assessed by optical coherence tomography photography.The relationship between ILM peeling and postoperative ERM was analyzed.·RESULTS:In total,212 eyes from 197 patients were included in this study.The incidence of secondary ERM in the ILM non-peeling group was significantly higher than that in the ILM peeling group(37.0%vs 14.0%;P<0.001).Multivariate logistical regression revealed that ILM peeling was highly associated with the prevention of secondary ERM development[odds ratio 0.38;95%confidence interval0.17-0.86;P<0.05].·CONCLUSION:ILM peeling during PPV for PDRs can effectively reduce the incidence of secondary ERM development and is worth consideration by vitreoretinal surgeons.
基金Supported by the Innovation Research Project of the Eye Hospital of Wenzhou Medical University (No. YNCX201308)
文摘AIM： To report the results of rhegmatogenous retinal detachment（RRD） repair after pars plana vitrectomy（PPV） without operative use of heavy liquid, and utilizing air tamponade in selected cases.METHODS： RRD patients without severity of proliferative vitreoretinopathy C2 or more underwent PPV without operative use of heavy liquid, and utilizing air tamponade were consecutively enrolled. Alternative postoperative facedown position or lateral position was required for 3-5 d.RESULTS： Totally 36 eyes of 36 patients（24 males, 66.7%） aged 53.8±10.9 y underwent this modified surgery. The mean number of retinal break was 2.1±1.3. Most of the eyes（29, 80.6%） had retinal detachment involving more than one quadrant. Twenty-two（61.1%） eyes with cataract had combined phacoemulsification and intraocular lens implantation. The mean follow up time was 4.6±1.8 mo. Two eyes with retinal redetachment underwent a second retinal repair surgery with silicone oil tamponade, yielding the primary reattachment rate to 94.4%（34/36）. Six（16.7%） eyes had intraocular pressure higher than 25 mm Hg. The visual acuity（logMAR） improved from 0.98±0.74 preoperatively to 0.52±0.31 postoperatively（P〈0.001）. CONCLUSION： The success rate of this modified retinal repair surgery is comparable with traditional surgery. This technique can be considered for certain retinal detachment patients, since its apparent advantages included lower surgical complications, reduced surgery expenditure, shorter time for postoperative facedown position, and avoiding silicone oil removal surgery.
基金Supported by Zhejiang Provincial Highlevel Health Talents Training Project(No.CZ-RC2022010)Wenzhou Basic Medical and Health Technology Project(No.Y20220779)。
文摘AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.
文摘Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].
基金the Wenzhou Basic ScientificResearch Program (No.20211003).
文摘AIM:To investigate the safety and efficacy of sticky silicone oil(SSO)removal using a 22-gauge vein detained needle and inner limiting membrane(ILM)wrap-and-peel technique.METHODS:This retrospective consecutive case series reviewed the records of patients with a history of retinal detachment who had received silicone oil and perfluorocarbon liquid(PFCL)as intraocular tamponades.Patients were included in the analysis if they exhibited SSO remnants during silicone oil removal.The aspiration of most of the SSO remnants was performed by a 22-gauge vein detained needle.The small amounts of droplets adhered to the macula and epi-macular membrane were subsequently removed by the ILM warp-and-peel technique.The anatomical and functional outcomes,and postoperative complications were recorded.In vitro experiments were performed to simulate the formation of SSO remnants in four groups.RESULTS:Of 711 patients who underwent silicone oil removal during the study period,9 patients exhibited SSO remnants and underwent follow-up for at least 3mo.Seven eyes(78%)underwent the ILM wrap-and-peel technique to completely remove small droplets of SSO that were glued to the macula and epi-macular membrane.No obvious complications occurred.Postoperative optical coherence tomography revealed normal retinal structure in all patients.In vitro analyses showed that balanced salt solution and prolonged vibration(for 1wk)had the strongest effects on silicone oil and PFCL compound opacities.CONCLUSION:SSO remnants could be removed in an intact manner and without complications,using a vein detained needle-assisted and ILM wrap-and-peel technique.The findings suggest that PFCL and infusion fluid should be completely removed before silicone oil injection to prevent SSO formation.
基金Supported by Zhejiang Provincial Natural Science Foundation of China(No.LQ18H120004)the Innovation Research Project of the Eye Hospital of Wenzhou Medical University(No.YNCX201308).
文摘AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent 27-gauge pars plana vitrectomy(PPV)for SVF were included.Thirty-nine eyes of 39 age-and gendermatched healthy volunteers without SVF were also recruited as a healthy control.Center for Epidemiologic Studies Depression(CES-D)was used to assess volunteers and patients’depression(before and 1 wk after PPV).RESULTS:The CES-D score was 18.3±8.6 for patients,and was 12.4±6.0 for healthy control(P=0.003).Patients were significantly more likely to be in a depressive state(53.6%,defined as CES-D score≥16)than the healthy control(20.5%,P=0.005).For patients with SVF,the CES-D score was negatively correlated with their age(rs=-0.42,P=0.025).After PPV,both the CES-D score(11.9±5.4 vs 18.3±8.6,P<0.001)and proportion of depressive state(18.5%vs 53.6%,P=0.005)were significantly decreased.CONCLUSION:This study suggests that symptoms of vitreous floaters have an apparently negative impact on patients’psychological state.The PPV can effectively relieve the depressive state for patients with SVF.
