AIM:To evaluate the surgical outcomes of the perfluorocarbon liquid(PFCL)-assisted inverted multilayer internal limiting membrane(ILM)flaps covering technique in macular hole retinal detachment(MHRD)in high myopia wit...AIM:To evaluate the surgical outcomes of the perfluorocarbon liquid(PFCL)-assisted inverted multilayer internal limiting membrane(ILM)flaps covering technique in macular hole retinal detachment(MHRD)in high myopia with axial length(AL)≥30 mm.METHODS:In this retrospective,interventional,consecutive comparative study,44 MHRD eyes were divided into two groups:the PFCL-assisted inverted multilayer ILM flaps covering technique group(Group 1,21 eyes)and the ILM peeling group(Group 2,23 eyes).The follow-up period was>12mo.Postoperative outcomes,including retinal reattachment,macular hole(MH)closure,and bestcorrected visual acuity(BCVA),were assessed.Statistical analysis using the Mann–Whitney U test and Fisher’s exact test was conducted to compare differences between groups.RESULTS:There were no statistically significant differences in baseline preoperative clinical characteristics,including age,sex,AL,diopters,duration of symptom,lens status,posterior staphyloma presence and extent of RD.Retinal reattachment rates were higher in Group 1(90.5%)than in Group 2(82.6%),without statistical significance(P=0.667).MH closure rates were significantly higher in Group 1(85.7%)than in Group 2(17.4%;P<0.001).The Group-1 BCVA(logMAR)improved significantly from 2.13±0.91 preoperatively to 1.21±0.66 postoperatively(P=0.026).The Group 2 BCVA improved significantly from 1.91±0.53 preoperatively to 1.19±0.41 postoperatively(P=0.032).However,there were no significant differences in visual-acuity improvement between groups(P=0.460).CONCLUSION:This technique offers a more effective approach for improving MH closure rates and postoperative visual function in MHRD with AL≥30 mm in high myopia.展开更多
Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with ...Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with HMMH who were admitted to the hospital from June 2019 to June 2024 were selected.The minimum diameter of the macular hole(MH)in all patients was≤500μm.The patients were randomly divided into two groups.The experimental group received 25G pars plana vitrectomy(PPV)combined with ILM flipping and covering technique,while the reference group received PPV combined with ILM peeling.The efficacy indicators and best corrected visual acuity levels were compared between the two groups.Results:The MH closure rate and retinal reattachment rate were higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The best corrected visual acuity level was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The Chinese version of the Visual Function-Related Quality of Life Questionnaire-25(CVRQOL-25)score was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).No serious complications were observed in both groups postoperatively,and there was no difference between the two groups(P>0.05).Conclusion:The ILM flipping and covering technique can improve the MH closure rate and retinal reattachment rate in patients with HMMH(diameter≤500μm),enhance the best corrected visual acuity level,and improve the quality of life related to visual function,with fewer postoperative complications.展开更多
AIMTo assess the anatomical and visual outcome of idiopathic macular holes greater than 1000 µm using the inverted internal limiting membrane flap technique.METHODSThis retrospective case series included 5...AIMTo assess the anatomical and visual outcome of idiopathic macular holes greater than 1000 µm using the inverted internal limiting membrane flap technique.METHODSThis retrospective case series included 5 eyes of 5 patients with idiopathic macular hole with base diameter greater than 1000 µm who underwent inverted internal limiting membrane flap technique along with standard 23G pars plans vitrectomy with posterior hyaloid detachment and fluid gas exchange with 12%-14% perfluoropropane (C3F8). Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measures were visual outcome and macular hole closure.RESULTSMean age was 63.2±8.4y with all 5 subjects being females. Mean duration of symptoms was 11±14mo with a mean postoperative follow up of 13.2±13mo. The mean base diameter of the macular holes was 1420±84.8 µm (1280-1480 µm). Type 1 closure was achieved in four out of five patients, while one patient had type 2 closure using the inverted internal limiting membrane (ILM) flap technique. Median baseline BCVA was 0.79 logMAR (Snellen’s equivalent 20/120) and median final BCVA 0.6 logMAR (Snellen’s equivalent 20/80) with mean visual improvement of approximately three lines improvement. No complications related to surgical procedure were noted.CONCLUSIONThe inverted internal limiting membrane flap technique may be promising for very large macular holes with high rate of macular closure and good visual outcome.展开更多
AIM:To explore the efficacy of minimally invasive vitrectomy(MIV)with or without internal limiting membrane(ILM)peeling on the treatment of diabetic macular edema(DME)in proliferative diabetic retinopathy(PDR)combinin...AIM:To explore the efficacy of minimally invasive vitrectomy(MIV)with or without internal limiting membrane(ILM)peeling on the treatment of diabetic macular edema(DME)in proliferative diabetic retinopathy(PDR)combining with preoperative anti-vascular endothelial growth factor(anti-VEGF)injection.METHODS:Totally 132 eyes(132 patients)diagnosed PDR with DME were included between June 2015 and June 2018 in Tianjin Eye Hospital.The single MIV treatment group included 68 eyes and the MIV combined with ILM peeling group included 64 eyes.Anti-VEGF drugs were injected intravitreally 1wk before the operation and the period of follow-up was 1 to 3y.Best-corrected visual acuity(BCVA),central retinal thickness(CRT),total macular volume(TMV),macular edema(ME)severity,intraocular pressure(IOP),and complications were recorded.Prognostic factors of visual acuity following ILM peeling were analyzed.RESULTS:The BCVA was higher than preoperative values at 1,3,6,and 12mo after surgery in both groups(all P<0.05).At 6 and 12mo,the BCVA of the combined group was significantly higher than that of the MIV only group(0.52±0.23 v/s 0.64±0.29 IogMAR,P=0.011 in 6mo;0.41±0.25\/s 0.52±0.25 IogMAR,P=0.008 in 12mo).Mean CRT values postoperative were significantly lower than preoperative values in both groups from the 1^(st) month(lmo 397.65±106.18 vs 451.94±118.88 μm in MIV only group;388.88±108.68 v/s 464.36±111.53 μm in combined group;both P<0.05)and decreased gradually.The differences between the two groups were statistically significant at 3,6,and 12mo(P=0.004,0.003,0.00 respectively).The TMV was decreased from the 3^(rd) month in the single treatment group(3mo 11.14±1.66 vs 12.20±2.09 mm^(3),P<0.05).At 12mo,the proportion of eyes with edema that had CRT more than 350μm was significantly lower than before surgery(13.24%vs 77.94%in MIV only group;1.56%vs 81.25%in combined group;both P<0.05).There was no significant difference in the recurrence incidence of macular epiretinal membrane,ME,transient IOP increase,vitreous rebleeding,or traction retinal detachment between the two groups.BCVA after ILM excision was positively correlated with the CRT and ME degree before and after surgery(r=0.430,0.485,respectively;P<0.05).CONCLUSION:MIV combined with ILM peeling accelerates the absorption of ME,improves vision,reduces the postoperative CRT and TMV,and reduces the recurrence rate of postoperative ME.展开更多
AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diame...AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diameter 〉700 μm,the maximum diameter of the substrate 〉1000 μm and hole formation factor 〈0.6 underwent surgical treatment.The patients were randomly divided into two groups.Nineteen eyes with surgical flip of the internal limiting membrane in group A,18 eyes with internal limiting membrane transplantation in group B who underwent the tamponade of internal limiting membrane into the hole,autologous plasma was used to seal the hole.The patients were followed up for 3 mo,optical coherence tomography and best corrected visual acuity（BCVA） were recorded before and after operation,and the results were statistically analyzed.RESULTS：At 3 mo after operation,BCVA of the two groups was significantly improved compared with that before operation（tA=4.192,tB=4.374,P〈0.05）.But there was no significant difference in visual acuity between the two groups（χ^2=0.128,P〉0.05）.At 3 mo after operation,the closure rate of group A was 68.4%,and 100% in group B.（χ^2=5.628,P〈0.05）.The defect diameter of inner segment/outer segment at 3 mo after the operation was significantly lower than that before operation（tA=12.287,tB=15.481,P〈0.05）,and the difference was statistically significant（t=2.552,P〈0.05）.CONCLUSION：Internal limiting membrane transplantation combined with autologous whole blood can improve the postoperative closure rate of the refractory large aperture,and can effectively improve the postoperative visual acuity.展开更多
Vitrectomy combined with internal limiting membrane(ILM)peeling is popular for the treatment of macular hole(MH).However,the improvements of MH closure rate and postoperative visual acuity are not satisfactory especia...Vitrectomy combined with internal limiting membrane(ILM)peeling is popular for the treatment of macular hole(MH).However,the improvements of MH closure rate and postoperative visual acuity are not satisfactory especially in large and refractory MHs.Currently,the ILM flap technique has gradually been applied for the treatment of MH and achieved high MH closure rate.The ILM flap technique has many variations,including the difference of the size,shape,number,and manner in which the flaps put on the MHs.The ILM flap technique also has some auxiliary means including perfluoro-n-octane(PFO),dye,autologous blood and adhesive viscoelastics.There is controversy about the effects between several technique variations of ILM flap,and it needs to be explored in the future.展开更多
AIM:To introduce a modified technique of internal limiting membrane(ILM)centripetal dragging and peeling to treat idiopathic macular hole(IMH)and to observe the ILM-retina adhesive forces.METHODS:Twenty-six consecutiv...AIM:To introduce a modified technique of internal limiting membrane(ILM)centripetal dragging and peeling to treat idiopathic macular hole(IMH)and to observe the ILM-retina adhesive forces.METHODS:Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled.All patients underwent complete par plana vitrectomy,ILM dragging and peeling,fluid and gas exchange,15%C3 F8 tamponade and 2-week prone position.The best corrected visual acuity,macular hole evaluation by optical coherence tomography,and complications were evaluated.RESULTS:The mean diameter of IMH was 524±148μm(range:201-683μm),with 21 cases(80.8%)greater than 400μm.ILM dragging and peeling were successfully performed in all cases.Most of the ILM-retina adhesive forces are severe(42.3%,11/26),followed by mild(38.5%,10/26),and moderate(19.2%,5/26).The mean follow-up duration was 21.2±6.1 mo.The IMH was closed in 25(96.3%)eyes.Visual acuity(logMAR)improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively(P<0.001).CONCLUSION:Preexisting ILM-retina adhesive force is found in IMH patients.With assistance of this force,this modified technique may help to release the IMH edges and improve the closure rate of large IMH.展开更多
AIM： To evaluate the efficacy and safety of vitrectomy with internal limiting membrane（ILM） peeling for diabetic macular edema（DME）. METHODS： The PubMed, Embase, Web of Science, Cochrane, SionMed, ClinicalTrials...AIM： To evaluate the efficacy and safety of vitrectomy with internal limiting membrane（ILM） peeling for diabetic macular edema（DME）. METHODS： The PubMed, Embase, Web of Science, Cochrane, SionMed, ClinicalTrials.gov, CNKI databases and Wanfang databases, published until Oct. 2017, were searched to identify studies comparing the clinical outcomes following vitrectomy with and without ILM peeling, for treating DME. Pooled results were expressed as odds ratios（ORs） with corresponding 95% confidence intervals（CI） for vitrectomy with and without ILM peeling with regard to best corrected visual acuity（BCVA）, central macular thickness（CMT）, and complication incidents. RESULTS： A total of 14 studies involving 857 eyes were included of which three studies were Chinese and the rests were English literatures. Meta-analysis indicated that compared with vitrectomy alone, vitrectomy with ILM peeling could improve BCVA more obviously（OR=1.66, 95%CI： 1.12-2.46, P=0.01） and had higher rate of CMT reduction（OR=3.89, 95%CI： 1.37-11.11, P=0.01）. There were significant statistical differences between the two surgical methods for both BCVA and CMT（P〈0.05）. For the incidence of intraoperative and postoperative complications, the incidence of epiretinal membrane（ERM） was slightly lower in the ILM peeling group than the group without ILM peeling（OR=0.38, 95%CI： 0.07-2.00, P=0.25）, although insignificant statistically. Other incidences of overall complications, iatrogenic peripheral retinal break and increased intraocular pressure indicated no significant difference between two groups（OR=1.19, 95%CI： 0.82-1.73, P=0.36; OR=1.21, 95%CI： 0.66-2.21, P=0.53; OR=1.34, 95%CI： 0.75-2.40, P=0.32）. CONCLUSION： Vitrectomy is effective for DME and the effect can be improved by additional ILM peeling, especially for anatomical efficacy, without increasing the incidence of intraoperative and postoperative complications. However, it is imperative to gain more evaluation in the future due to the paucity of prospective randomized study.展开更多
Valsalva retinopathy was described as a particular form of retinopathy, pre-retinal and subinternal limiting membrane haemorrhages in nature that rarely may break through and become subhyloid or intravitreal, secondar...Valsalva retinopathy was described as a particular form of retinopathy, pre-retinal and subinternal limiting membrane haemorrhages in nature that rarely may break through and become subhyloid or intravitreal, secondary to a sudden increase in intrathoracic pressure. We reported a new way that Nd:YAG laser for ILM hyaloidotomy in order to drain the sub-ILM blood into vitreous cavity combined with intravitreal bevacizumab to improve the absorption of blood. Therapeutic alliance make significant outcome, protecting vision in time. We used spectralis OCT to observe sub-ILM mix cells and special ILM structure in this lesion for the first time, as the spectralis OCT can reach histology level imagination.展开更多
AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment...AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS: A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS: The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer(HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer(NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy(MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION: The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.展开更多
BACKGROUND Myopic foveoschisis(MF)is a common complication of pathological myopia.A macular hole(MH)usually results from the natural progression of MF and is a common complication of vitrectomy.Vitrectomy combined wit...BACKGROUND Myopic foveoschisis(MF)is a common complication of pathological myopia.A macular hole(MH)usually results from the natural progression of MF and is a common complication of vitrectomy.Vitrectomy combined with residual internal limiting membrane(ILM)covering and autologous blood was effective for closing a secondary MH.CASE SUMMARY A 52-year-old woman presented to our clinic with a complaint of blurred vision in the right eye for 7 years.Her best corrected visual acuity(BCVA)was 20/100,axial length was 25.79 mm and standard equivalent refractive error was-10.5 dioptres.Preoperative optical coherence tomography revealed foveoschisis in the right eye.Vitrectomy with fovea-sparing ILM peeling was performed.An MH developed and gradually expanded 5 mo after the initial vitrectomy.Vitrectomy with residual ILM covering and autologous blood was performed.The MH closed 3 wk after the second vitrectomy.CONCLUSION Fovea-sparing ILM peeling can provide residual ILM for the treatment of MH secondary to vitrectomy for MF.Vitrectomy combined with residual ILM covering and autologous blood is effective for closing secondary MH and improving BCVA.展开更多
AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were random...AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups,N-T group(11 eyes)and T-N group(11 eyes).For patients in N-T group,ILM was peeled off from nasal to temporal retina.For patients in T-N group,ILM was peeled off from temporal to nasal retina.Preoperative,postoperative 1,3,and 6 mo,autofluorescence fundus images were collected for manual measurement of distances of fixed nasal(N),temporal(T),superior(S),and inferior(I)retinal points(bifurcation or crossing of retinal vessels)around the macula to the optic disc(OD).These were respectively defined as N-OD,T-OD,S-OD,and I-OD.The retinal displacement,macular holeclosure rate,and best corrected visual acuity(BCVA)were compared between the two groups after surgery.RESULTS:At postoperative 1,3,and 6 mo,the macula slipped toward the OD,manifested by the decreased T-OD,N-OD,S-OD,and I-OD(P<0.05).No significant difference was found in the T-OD,N-OD,S-OD,and I-OD between N-T group and T-N group.IMH closure rate was 100%both in N-T group and T-N group.There was no significant difference in BCVA between two groups(P<0.05).CONCLUSION:The macula slips toward the OD after successful macular hole surgery.The two different ILM peeling pattern show similar visual outcome and retinal displacement,which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.展开更多
AIM: To evaluate the effect of internal limiting membrane(ILM) peeling with indocyanine green(ICG), brilliant blue G(BBG), triamcinolone acetonide(TA), trypan blue(TB), or without dye for the treatment of idiopathic m...AIM: To evaluate the effect of internal limiting membrane(ILM) peeling with indocyanine green(ICG), brilliant blue G(BBG), triamcinolone acetonide(TA), trypan blue(TB), or without dye for the treatment of idiopathic macular hole(IMH). METHODS: A search was conducted using Pub Med, EMBASE, and CENTRAL(Cochrane Central Register of Controlled Trials) for related studies published before October 2018. RESULTS: A total of 29 studies and 2514 eyes were included in this network Meta-analysis. For IMH closure, the rank from the best to the worse treatment was: BBG, TB, TA, ICG, and no dye. There was a significant difference in postoperative IMH closure rate between BBG and no dye. The rank of the best to the worse treatment to improve visual acuity was: BBG, TB, no dye, TA, and ICG. The improvement rate of visual acuity after using BBG was significantly higher than ICG. The improvement rate of visual acuity was more favorable with TB than ICG, TA, and no dye. CONCLUSION: BBG can contribute to better anatomical and functional outcomes compared to other dyes for ILM peeling in patients with IMH. The results show that the best treatment of ILM peeling with dyes is BBG.展开更多
AIM:To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis(MF)in highly myopic eyes.METHODS...AIM:To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis(MF)in highly myopic eyes.METHODS:This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths(ALs)ranging from 26-32 mm treated between January 2020 and January 2022.All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo.Based on the features on spectral-domain optical coherence tomography(SD-OCT),the eyes were divided into the MF-only group(Group A,n=15 eyes),MF with central foveal detachment group(Group B,n=20 eyes),and MF with lamellar macular hole group(Group C,n=13 eyes).According to AL,eyes were further divided into three groups:Group D(26.01-28.00 mm,n=12 eyes),Group E(28.01-30.00 mm,n=26 eyes),and Group F(30.01-32.00 mm,n=10 eyes).The best-corrected visual acuity(BCVA),central foveal thickness(CFT),and complications were recorded.RESULTS:The patients included 16 males and 24 females with the mean age of 56±9.82y.The BCVA and CFT improved in all groups after surgery(P<0.01),while there was no significant difference of the CFT in Group A,B,and C postoperatively(P>0.05).The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D,E,and F.Twenty eyes were injected with sterile air,and 28 eyes were injected with silicone oil for tamponade based on the AL.However,there was no statistically significant difference among Groups D,E,and F in terms of the results of sterile air or silicone oil tamponade.The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade,and the difference was not statistically significant.CONCLUSION:PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.展开更多
AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospec...AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.展开更多
AIM:To demonstrate an improved surgical technique of whole piece consecutive internal limiting membrane(ILM) peeling without preservation of the epi-fovea to treat high myopic foveoschisis(MF).METHODS:A 23-gauge 3-por...AIM:To demonstrate an improved surgical technique of whole piece consecutive internal limiting membrane(ILM) peeling without preservation of the epi-fovea to treat high myopic foveoschisis(MF).METHODS:A 23-gauge 3-port pars plana vitrectomy was performed on 16 patients with high MF.A parallel arc line along the vascular arcades was scraped out with a curved membrane scraper DSP.Next,an ILM forceps was used to catch hold of the incisal edge of the ILM flap,and the action of releasing and separating was subsequently taken toward the direction of the macular fovea.Next,the ILM forceps was used to grasp the released area,and the whole area coherent ILM peeling covering the macular fovea was implemented thereafter.Finally,the ILM was folded backwards and peeled off in the arc direction.RESULTS:At the final visit,the average central macular thickness decreased remarkably from 423.76±177.67 to 178.24±66.21 μm.The mean logarithm of the minimum angle of resolution best-corrected visual acuity of 1.37±0.59 was significantly alleviated to 0.74±0.59.CONCLUSION:The wide range of whole piece consecutive ILM peeling without preservation of the epifovea is proven to be effective and significantly reduced the occurrence of retinal tear and macular hole.展开更多
BACKGROUND Diabetic macular edema(DME),a chronic microvascular complication of diabetes,is a leading cause of visual impairment and blindness.Pars plana vitrectomy(PPV)can restore the normal macular structure and redu...BACKGROUND Diabetic macular edema(DME),a chronic microvascular complication of diabetes,is a leading cause of visual impairment and blindness.Pars plana vitrectomy(PPV)can restore the normal macular structure and reduce macular edema,whereas internal limiting membrane(ILM)peeling is used to treat tractional macular diseases.Despite the advantages,there is limited research on the combined effects of PPV with ILM peeling.AIM To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness(CMT),best-corrected visual acuity(BCVA),cystoid macular edema(CME)volume,and complications in patients with DME.METHODS Eighty-one patients(92 eyes)diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone(control group:41 patients,47 eyes)or PPV+ILM peeling(stripping group:40 patients,45 eyes);a single surgeon performed all surgeries.The two groups were compared preoperatively and 1 and 3 months postoperatively.RESULTS Preoperatively,both groups had comparable values of CMT,BCVA,and CME volume(P>0.05).After surgery(both 1 and 3 months),both groups showed significant reductions in CMT,BCVA,and CME volume compared to preoperative levels,with the stripping group showing more significant reductions compared to the control group(P<0.05).Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time,and interaction effects for CMT,BCVA,and CME volume(P<0.05).There were no significant differences in the incidence of complications between the groups(retinal detachment:control=2,stripping=1;endophthalmitis:Control=4,stripping=1;no cases of secondary glaucoma or macular holes;χ^(2)=0.296,P=0.587).CONCLUSION PPV with ILM peeling can significantly improve the visual acuity of patients with DME,reduce CMT,and improve CME with fewer complications.展开更多
With mean yield（MY）criterion,an analytical solution of the collapse load for a defect-free pipe elbow under internal pressure is first obtained.It is a function of ratio of thickness to radius t0/r0,strain hardening...With mean yield（MY）criterion,an analytical solution of the collapse load for a defect-free pipe elbow under internal pressure is first obtained.It is a function of ratio of thickness to radius t0/r0,strain hardening exponent n,curvature influence factor mand ultimate tensile strength.The collapse load increases with the increase of m,and it is the same as the burst pressure of straight pipe if m=1is assumed.The MY-based solution is compared with those based on Tresca,Mises and twin shear stress（TSS）yield criteria,and the comparison indicates that Tresca and twin shear stress yield criteria predict a lower bound and an upper bound to the collapse load respectively.However,the MY-based solution lies just between the TSS and Tresca solutions,and almost has the same precision with the Mises solution.展开更多
Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reducti...Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external展开更多
Vinda International Holdings Limited was acquired by Golden Eagle Group On March 12,2024,Vinda International Holdings Limited issued an announcement,stating that Singapore-based RGE Group had completed the acquisition...Vinda International Holdings Limited was acquired by Golden Eagle Group On March 12,2024,Vinda International Holdings Limited issued an announcement,stating that Singapore-based RGE Group had completed the acquisition of Vinda International whit a price of HK$23.5 per share and a total consideration of approximately HK$26.1 billion.On August 16,aft er the acquisition was completed,Vinda International was offi cially delisted from the Hong Kong Stock Exchange.展开更多
基金Supported by Research Incubation Fund of Xi’an People’s Hospital(Xi’an Fourth Hospital)(No.FZ-58).
文摘AIM:To evaluate the surgical outcomes of the perfluorocarbon liquid(PFCL)-assisted inverted multilayer internal limiting membrane(ILM)flaps covering technique in macular hole retinal detachment(MHRD)in high myopia with axial length(AL)≥30 mm.METHODS:In this retrospective,interventional,consecutive comparative study,44 MHRD eyes were divided into two groups:the PFCL-assisted inverted multilayer ILM flaps covering technique group(Group 1,21 eyes)and the ILM peeling group(Group 2,23 eyes).The follow-up period was>12mo.Postoperative outcomes,including retinal reattachment,macular hole(MH)closure,and bestcorrected visual acuity(BCVA),were assessed.Statistical analysis using the Mann–Whitney U test and Fisher’s exact test was conducted to compare differences between groups.RESULTS:There were no statistically significant differences in baseline preoperative clinical characteristics,including age,sex,AL,diopters,duration of symptom,lens status,posterior staphyloma presence and extent of RD.Retinal reattachment rates were higher in Group 1(90.5%)than in Group 2(82.6%),without statistical significance(P=0.667).MH closure rates were significantly higher in Group 1(85.7%)than in Group 2(17.4%;P<0.001).The Group-1 BCVA(logMAR)improved significantly from 2.13±0.91 preoperatively to 1.21±0.66 postoperatively(P=0.026).The Group 2 BCVA improved significantly from 1.91±0.53 preoperatively to 1.19±0.41 postoperatively(P=0.032).However,there were no significant differences in visual-acuity improvement between groups(P=0.460).CONCLUSION:This technique offers a more effective approach for improving MH closure rates and postoperative visual function in MHRD with AL≥30 mm in high myopia.
文摘Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with HMMH who were admitted to the hospital from June 2019 to June 2024 were selected.The minimum diameter of the macular hole(MH)in all patients was≤500μm.The patients were randomly divided into two groups.The experimental group received 25G pars plana vitrectomy(PPV)combined with ILM flipping and covering technique,while the reference group received PPV combined with ILM peeling.The efficacy indicators and best corrected visual acuity levels were compared between the two groups.Results:The MH closure rate and retinal reattachment rate were higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The best corrected visual acuity level was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The Chinese version of the Visual Function-Related Quality of Life Questionnaire-25(CVRQOL-25)score was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).No serious complications were observed in both groups postoperatively,and there was no difference between the two groups(P>0.05).Conclusion:The ILM flipping and covering technique can improve the MH closure rate and retinal reattachment rate in patients with HMMH(diameter≤500μm),enhance the best corrected visual acuity level,and improve the quality of life related to visual function,with fewer postoperative complications.
文摘AIMTo assess the anatomical and visual outcome of idiopathic macular holes greater than 1000 µm using the inverted internal limiting membrane flap technique.METHODSThis retrospective case series included 5 eyes of 5 patients with idiopathic macular hole with base diameter greater than 1000 µm who underwent inverted internal limiting membrane flap technique along with standard 23G pars plans vitrectomy with posterior hyaloid detachment and fluid gas exchange with 12%-14% perfluoropropane (C3F8). Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measures were visual outcome and macular hole closure.RESULTSMean age was 63.2±8.4y with all 5 subjects being females. Mean duration of symptoms was 11±14mo with a mean postoperative follow up of 13.2±13mo. The mean base diameter of the macular holes was 1420±84.8 µm (1280-1480 µm). Type 1 closure was achieved in four out of five patients, while one patient had type 2 closure using the inverted internal limiting membrane (ILM) flap technique. Median baseline BCVA was 0.79 logMAR (Snellen’s equivalent 20/120) and median final BCVA 0.6 logMAR (Snellen’s equivalent 20/80) with mean visual improvement of approximately three lines improvement. No complications related to surgical procedure were noted.CONCLUSIONThe inverted internal limiting membrane flap technique may be promising for very large macular holes with high rate of macular closure and good visual outcome.
基金Supported by the Hospital Project of Tianjin Eye Hospital(No.YKZD1901).
文摘AIM:To explore the efficacy of minimally invasive vitrectomy(MIV)with or without internal limiting membrane(ILM)peeling on the treatment of diabetic macular edema(DME)in proliferative diabetic retinopathy(PDR)combining with preoperative anti-vascular endothelial growth factor(anti-VEGF)injection.METHODS:Totally 132 eyes(132 patients)diagnosed PDR with DME were included between June 2015 and June 2018 in Tianjin Eye Hospital.The single MIV treatment group included 68 eyes and the MIV combined with ILM peeling group included 64 eyes.Anti-VEGF drugs were injected intravitreally 1wk before the operation and the period of follow-up was 1 to 3y.Best-corrected visual acuity(BCVA),central retinal thickness(CRT),total macular volume(TMV),macular edema(ME)severity,intraocular pressure(IOP),and complications were recorded.Prognostic factors of visual acuity following ILM peeling were analyzed.RESULTS:The BCVA was higher than preoperative values at 1,3,6,and 12mo after surgery in both groups(all P<0.05).At 6 and 12mo,the BCVA of the combined group was significantly higher than that of the MIV only group(0.52±0.23 v/s 0.64±0.29 IogMAR,P=0.011 in 6mo;0.41±0.25\/s 0.52±0.25 IogMAR,P=0.008 in 12mo).Mean CRT values postoperative were significantly lower than preoperative values in both groups from the 1^(st) month(lmo 397.65±106.18 vs 451.94±118.88 μm in MIV only group;388.88±108.68 v/s 464.36±111.53 μm in combined group;both P<0.05)and decreased gradually.The differences between the two groups were statistically significant at 3,6,and 12mo(P=0.004,0.003,0.00 respectively).The TMV was decreased from the 3^(rd) month in the single treatment group(3mo 11.14±1.66 vs 12.20±2.09 mm^(3),P<0.05).At 12mo,the proportion of eyes with edema that had CRT more than 350μm was significantly lower than before surgery(13.24%vs 77.94%in MIV only group;1.56%vs 81.25%in combined group;both P<0.05).There was no significant difference in the recurrence incidence of macular epiretinal membrane,ME,transient IOP increase,vitreous rebleeding,or traction retinal detachment between the two groups.BCVA after ILM excision was positively correlated with the CRT and ME degree before and after surgery(r=0.430,0.485,respectively;P<0.05).CONCLUSION:MIV combined with ILM peeling accelerates the absorption of ME,improves vision,reduces the postoperative CRT and TMV,and reduces the recurrence rate of postoperative ME.
文摘AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diameter 〉700 μm,the maximum diameter of the substrate 〉1000 μm and hole formation factor 〈0.6 underwent surgical treatment.The patients were randomly divided into two groups.Nineteen eyes with surgical flip of the internal limiting membrane in group A,18 eyes with internal limiting membrane transplantation in group B who underwent the tamponade of internal limiting membrane into the hole,autologous plasma was used to seal the hole.The patients were followed up for 3 mo,optical coherence tomography and best corrected visual acuity（BCVA） were recorded before and after operation,and the results were statistically analyzed.RESULTS：At 3 mo after operation,BCVA of the two groups was significantly improved compared with that before operation（tA=4.192,tB=4.374,P〈0.05）.But there was no significant difference in visual acuity between the two groups（χ^2=0.128,P〉0.05）.At 3 mo after operation,the closure rate of group A was 68.4%,and 100% in group B.（χ^2=5.628,P〈0.05）.The defect diameter of inner segment/outer segment at 3 mo after the operation was significantly lower than that before operation（tA=12.287,tB=15.481,P〈0.05）,and the difference was statistically significant（t=2.552,P〈0.05）.CONCLUSION：Internal limiting membrane transplantation combined with autologous whole blood can improve the postoperative closure rate of the refractory large aperture,and can effectively improve the postoperative visual acuity.
文摘Vitrectomy combined with internal limiting membrane(ILM)peeling is popular for the treatment of macular hole(MH).However,the improvements of MH closure rate and postoperative visual acuity are not satisfactory especially in large and refractory MHs.Currently,the ILM flap technique has gradually been applied for the treatment of MH and achieved high MH closure rate.The ILM flap technique has many variations,including the difference of the size,shape,number,and manner in which the flaps put on the MHs.The ILM flap technique also has some auxiliary means including perfluoro-n-octane(PFO),dye,autologous blood and adhesive viscoelastics.There is controversy about the effects between several technique variations of ILM flap,and it needs to be explored in the future.
基金Supported by the National Natural Science Foundation of China(No.81470642No.81770964)the Science and Technology Commission of Shanghai Municipality(No.17411952900)。
文摘AIM:To introduce a modified technique of internal limiting membrane(ILM)centripetal dragging and peeling to treat idiopathic macular hole(IMH)and to observe the ILM-retina adhesive forces.METHODS:Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled.All patients underwent complete par plana vitrectomy,ILM dragging and peeling,fluid and gas exchange,15%C3 F8 tamponade and 2-week prone position.The best corrected visual acuity,macular hole evaluation by optical coherence tomography,and complications were evaluated.RESULTS:The mean diameter of IMH was 524±148μm(range:201-683μm),with 21 cases(80.8%)greater than 400μm.ILM dragging and peeling were successfully performed in all cases.Most of the ILM-retina adhesive forces are severe(42.3%,11/26),followed by mild(38.5%,10/26),and moderate(19.2%,5/26).The mean follow-up duration was 21.2±6.1 mo.The IMH was closed in 25(96.3%)eyes.Visual acuity(logMAR)improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively(P<0.001).CONCLUSION:Preexisting ILM-retina adhesive force is found in IMH patients.With assistance of this force,this modified technique may help to release the IMH edges and improve the closure rate of large IMH.
文摘AIM： To evaluate the efficacy and safety of vitrectomy with internal limiting membrane（ILM） peeling for diabetic macular edema（DME）. METHODS： The PubMed, Embase, Web of Science, Cochrane, SionMed, ClinicalTrials.gov, CNKI databases and Wanfang databases, published until Oct. 2017, were searched to identify studies comparing the clinical outcomes following vitrectomy with and without ILM peeling, for treating DME. Pooled results were expressed as odds ratios（ORs） with corresponding 95% confidence intervals（CI） for vitrectomy with and without ILM peeling with regard to best corrected visual acuity（BCVA）, central macular thickness（CMT）, and complication incidents. RESULTS： A total of 14 studies involving 857 eyes were included of which three studies were Chinese and the rests were English literatures. Meta-analysis indicated that compared with vitrectomy alone, vitrectomy with ILM peeling could improve BCVA more obviously（OR=1.66, 95%CI： 1.12-2.46, P=0.01） and had higher rate of CMT reduction（OR=3.89, 95%CI： 1.37-11.11, P=0.01）. There were significant statistical differences between the two surgical methods for both BCVA and CMT（P〈0.05）. For the incidence of intraoperative and postoperative complications, the incidence of epiretinal membrane（ERM） was slightly lower in the ILM peeling group than the group without ILM peeling（OR=0.38, 95%CI： 0.07-2.00, P=0.25）, although insignificant statistically. Other incidences of overall complications, iatrogenic peripheral retinal break and increased intraocular pressure indicated no significant difference between two groups（OR=1.19, 95%CI： 0.82-1.73, P=0.36; OR=1.21, 95%CI： 0.66-2.21, P=0.53; OR=1.34, 95%CI： 0.75-2.40, P=0.32）. CONCLUSION： Vitrectomy is effective for DME and the effect can be improved by additional ILM peeling, especially for anatomical efficacy, without increasing the incidence of intraoperative and postoperative complications. However, it is imperative to gain more evaluation in the future due to the paucity of prospective randomized study.
文摘Valsalva retinopathy was described as a particular form of retinopathy, pre-retinal and subinternal limiting membrane haemorrhages in nature that rarely may break through and become subhyloid or intravitreal, secondary to a sudden increase in intrathoracic pressure. We reported a new way that Nd:YAG laser for ILM hyaloidotomy in order to drain the sub-ILM blood into vitreous cavity combined with intravitreal bevacizumab to improve the absorption of blood. Therapeutic alliance make significant outcome, protecting vision in time. We used spectralis OCT to observe sub-ILM mix cells and special ILM structure in this lesion for the first time, as the spectralis OCT can reach histology level imagination.
文摘AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS: A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS: The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer(HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer(NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy(MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION: The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.
文摘BACKGROUND Myopic foveoschisis(MF)is a common complication of pathological myopia.A macular hole(MH)usually results from the natural progression of MF and is a common complication of vitrectomy.Vitrectomy combined with residual internal limiting membrane(ILM)covering and autologous blood was effective for closing a secondary MH.CASE SUMMARY A 52-year-old woman presented to our clinic with a complaint of blurred vision in the right eye for 7 years.Her best corrected visual acuity(BCVA)was 20/100,axial length was 25.79 mm and standard equivalent refractive error was-10.5 dioptres.Preoperative optical coherence tomography revealed foveoschisis in the right eye.Vitrectomy with fovea-sparing ILM peeling was performed.An MH developed and gradually expanded 5 mo after the initial vitrectomy.Vitrectomy with residual ILM covering and autologous blood was performed.The MH closed 3 wk after the second vitrectomy.CONCLUSION Fovea-sparing ILM peeling can provide residual ILM for the treatment of MH secondary to vitrectomy for MF.Vitrectomy combined with residual ILM covering and autologous blood is effective for closing secondary MH and improving BCVA.
基金the National Natural Science Foundation of China(No.81870669No.81900875)+1 种基金Jiangsu Provincial Natural Science(No.BK20191059)Jiangsu Provincial Commission of Health and Family Planning(No.H201608)。
文摘AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups,N-T group(11 eyes)and T-N group(11 eyes).For patients in N-T group,ILM was peeled off from nasal to temporal retina.For patients in T-N group,ILM was peeled off from temporal to nasal retina.Preoperative,postoperative 1,3,and 6 mo,autofluorescence fundus images were collected for manual measurement of distances of fixed nasal(N),temporal(T),superior(S),and inferior(I)retinal points(bifurcation or crossing of retinal vessels)around the macula to the optic disc(OD).These were respectively defined as N-OD,T-OD,S-OD,and I-OD.The retinal displacement,macular holeclosure rate,and best corrected visual acuity(BCVA)were compared between the two groups after surgery.RESULTS:At postoperative 1,3,and 6 mo,the macula slipped toward the OD,manifested by the decreased T-OD,N-OD,S-OD,and I-OD(P<0.05).No significant difference was found in the T-OD,N-OD,S-OD,and I-OD between N-T group and T-N group.IMH closure rate was 100%both in N-T group and T-N group.There was no significant difference in BCVA between two groups(P<0.05).CONCLUSION:The macula slips toward the OD after successful macular hole surgery.The two different ILM peeling pattern show similar visual outcome and retinal displacement,which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.
基金Supported by the National Natural Science Foundation of China (No.81870686)the Natural Science Foundation of Beijing Municipal (No.7184201)the Capital’s Funds for Health Improvement and Research (No.2018-12021)
文摘AIM: To evaluate the effect of internal limiting membrane(ILM) peeling with indocyanine green(ICG), brilliant blue G(BBG), triamcinolone acetonide(TA), trypan blue(TB), or without dye for the treatment of idiopathic macular hole(IMH). METHODS: A search was conducted using Pub Med, EMBASE, and CENTRAL(Cochrane Central Register of Controlled Trials) for related studies published before October 2018. RESULTS: A total of 29 studies and 2514 eyes were included in this network Meta-analysis. For IMH closure, the rank from the best to the worse treatment was: BBG, TB, TA, ICG, and no dye. There was a significant difference in postoperative IMH closure rate between BBG and no dye. The rank of the best to the worse treatment to improve visual acuity was: BBG, TB, no dye, TA, and ICG. The improvement rate of visual acuity after using BBG was significantly higher than ICG. The improvement rate of visual acuity was more favorable with TB than ICG, TA, and no dye. CONCLUSION: BBG can contribute to better anatomical and functional outcomes compared to other dyes for ILM peeling in patients with IMH. The results show that the best treatment of ILM peeling with dyes is BBG.
基金Supported by the Natural Science Basic Research Program in Shaanxi Province(No.2020JM-683).
文摘AIM:To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis(MF)in highly myopic eyes.METHODS:This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths(ALs)ranging from 26-32 mm treated between January 2020 and January 2022.All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo.Based on the features on spectral-domain optical coherence tomography(SD-OCT),the eyes were divided into the MF-only group(Group A,n=15 eyes),MF with central foveal detachment group(Group B,n=20 eyes),and MF with lamellar macular hole group(Group C,n=13 eyes).According to AL,eyes were further divided into three groups:Group D(26.01-28.00 mm,n=12 eyes),Group E(28.01-30.00 mm,n=26 eyes),and Group F(30.01-32.00 mm,n=10 eyes).The best-corrected visual acuity(BCVA),central foveal thickness(CFT),and complications were recorded.RESULTS:The patients included 16 males and 24 females with the mean age of 56±9.82y.The BCVA and CFT improved in all groups after surgery(P<0.01),while there was no significant difference of the CFT in Group A,B,and C postoperatively(P>0.05).The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D,E,and F.Twenty eyes were injected with sterile air,and 28 eyes were injected with silicone oil for tamponade based on the AL.However,there was no statistically significant difference among Groups D,E,and F in terms of the results of sterile air or silicone oil tamponade.The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade,and the difference was not statistically significant.CONCLUSION:PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.
基金Supported by a grant from the Natural Science Foundation of Tianjin City (No.20JCZXJC00040)Tianjin Key Medical Discipline (No.Specialty) Construction Project (No.TJYXZDXK-037A)。
文摘AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.
文摘AIM:To demonstrate an improved surgical technique of whole piece consecutive internal limiting membrane(ILM) peeling without preservation of the epi-fovea to treat high myopic foveoschisis(MF).METHODS:A 23-gauge 3-port pars plana vitrectomy was performed on 16 patients with high MF.A parallel arc line along the vascular arcades was scraped out with a curved membrane scraper DSP.Next,an ILM forceps was used to catch hold of the incisal edge of the ILM flap,and the action of releasing and separating was subsequently taken toward the direction of the macular fovea.Next,the ILM forceps was used to grasp the released area,and the whole area coherent ILM peeling covering the macular fovea was implemented thereafter.Finally,the ILM was folded backwards and peeled off in the arc direction.RESULTS:At the final visit,the average central macular thickness decreased remarkably from 423.76±177.67 to 178.24±66.21 μm.The mean logarithm of the minimum angle of resolution best-corrected visual acuity of 1.37±0.59 was significantly alleviated to 0.74±0.59.CONCLUSION:The wide range of whole piece consecutive ILM peeling without preservation of the epifovea is proven to be effective and significantly reduced the occurrence of retinal tear and macular hole.
基金Youth Project of Liangxiang Hospital Fangshan District Beijing,No.2022-11.
文摘BACKGROUND Diabetic macular edema(DME),a chronic microvascular complication of diabetes,is a leading cause of visual impairment and blindness.Pars plana vitrectomy(PPV)can restore the normal macular structure and reduce macular edema,whereas internal limiting membrane(ILM)peeling is used to treat tractional macular diseases.Despite the advantages,there is limited research on the combined effects of PPV with ILM peeling.AIM To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness(CMT),best-corrected visual acuity(BCVA),cystoid macular edema(CME)volume,and complications in patients with DME.METHODS Eighty-one patients(92 eyes)diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone(control group:41 patients,47 eyes)or PPV+ILM peeling(stripping group:40 patients,45 eyes);a single surgeon performed all surgeries.The two groups were compared preoperatively and 1 and 3 months postoperatively.RESULTS Preoperatively,both groups had comparable values of CMT,BCVA,and CME volume(P>0.05).After surgery(both 1 and 3 months),both groups showed significant reductions in CMT,BCVA,and CME volume compared to preoperative levels,with the stripping group showing more significant reductions compared to the control group(P<0.05).Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time,and interaction effects for CMT,BCVA,and CME volume(P<0.05).There were no significant differences in the incidence of complications between the groups(retinal detachment:control=2,stripping=1;endophthalmitis:Control=4,stripping=1;no cases of secondary glaucoma or macular holes;χ^(2)=0.296,P=0.587).CONCLUSION PPV with ILM peeling can significantly improve the visual acuity of patients with DME,reduce CMT,and improve CME with fewer complications.
基金Sponsored by National Natural Science Foundation of China(51074052,50734002)
文摘With mean yield（MY）criterion,an analytical solution of the collapse load for a defect-free pipe elbow under internal pressure is first obtained.It is a function of ratio of thickness to radius t0/r0,strain hardening exponent n,curvature influence factor mand ultimate tensile strength.The collapse load increases with the increase of m,and it is the same as the burst pressure of straight pipe if m=1is assumed.The MY-based solution is compared with those based on Tresca,Mises and twin shear stress（TSS）yield criteria,and the comparison indicates that Tresca and twin shear stress yield criteria predict a lower bound and an upper bound to the collapse load respectively.However,the MY-based solution lies just between the TSS and Tresca solutions,and almost has the same precision with the Mises solution.
文摘Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external
文摘Vinda International Holdings Limited was acquired by Golden Eagle Group On March 12,2024,Vinda International Holdings Limited issued an announcement,stating that Singapore-based RGE Group had completed the acquisition of Vinda International whit a price of HK$23.5 per share and a total consideration of approximately HK$26.1 billion.On August 16,aft er the acquisition was completed,Vinda International was offi cially delisted from the Hong Kong Stock Exchange.
