Efficacy of scleral buckling for the treatment of rhegmatogenous retinal detachment using a novel foldable capsular buckle

●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.

Non-contact wide-field viewing system-assisted scleral buckling surgery for retinal detachment in silicone oilfilled eyes

AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.

Surgical Approaches in Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis Comparing Vitrectomy vs. Vitrectomy Combined with Scleral Buckling, Lens-Sparing vs. Phako Procedures

Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .

Comparison of scleral buckling using wide-angle viewing systems and indirect ophthalmoscope for rhegmatogenous retinal detachment

AIM：To compare the effects of scleral buckling using wide-angle viewing systems（WAVS） with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment.METHODS：The study was a retrospective analyses of the medical records of 94 eyes（94 patients） with rhegmatogenous retinal detachment.Among them,47 eyes underwent scleral buckling using WAVS with endoiiluminator（Group W）,and 47 eyes underwent scleral buckling using indirect ophthalmoscope（Group I）.Surgical durations,primary success rate,best-corrected visual acuities（BCVA）,delayed subretinal fluid absorptions and surgical complications were compared between the two groups.RESULTS：At baseline,there were no statistical differences between the two groups in patient＇s age（P=0.997）,gender（P=0.853）,symptom duration（P=0.216）,BCVA（P=0.389）,refractive error（P=0.167）,intraocular pressure（P=0.595）,the number of retinal breaks（P=0.832）,the extent of retinal detachment（P =0.246）,subretinal demarcation line（P=0.801）,and macular detachment（P=0.811）.The follow-up period was 12 mo.The surgical durations in Group W（with or without encircling buckling） were significant shorter than those in Group I（P〈0.001 respectively）.The primary success rate was94.27%in Group W,which was similar to that in Group I（92.38%,P=0.931）.The BCVA in Group W was better than that in Group I（P〈0.001） at 1-month follow-up visit.However,there were no significant differences between the two groups at 3-month（P=0.221）,6-month（P =0.674）,and 12-month（P=0.363） follow-up visits respectively.Delayed subretinal fluid absorptions were more common in Group I than in Group W at 1-month（P=0.045） follow-up visit,but there were no significant differences between the two groups at 3-month（P=0.111）,6-month（P =1.000） and 12-month follow-up visits respectively.CONCLUSION：Scleral buckling using WAVS can be an alternative choose for rhegmatogenous retinal detachment

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling

AIM： To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment （RRD） after sclera buckling （SB）. METHODS： Totally 48 patients （51 eyes） with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy （PVR）, posterior vitreous detachment （PVD）, baseline best corrected visual acuity （BCVA）, operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student＇s t-test, Wilcoxon twosample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. RESULTS： Baseline BCVA was 0.8313±0.6911 IogMAR and final BCVA was 0.4761 ±0.4956 IogMAR. Primary surgical success rate was 92.16% （47/51）. Correlation analyses revealed shorter symptoms duration （r =0.3850, P=0.0053）, less detached area （r=0.5489, P〈0.0001）, fovea （r=0.4605, P=0.0007）, no PVR （r=0.3138, P= 0.0250）, better baseline BCVA （r=0.7291, P〈0.0001）, shorter operative duration （r=0.3233, P=0.0207） and longer follow up （r=-0.3358, P=0.0160） were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square （PR2） = 0.5316, P〈0.0001], shorter symptoms duration （PR2= 0.0609, P=0.0101）, longer follow up duration （PR2=0.0278, P =0.0477） and shorter operative duration （PR2=0.0338, P=0.0350）. Patients with vision improvement took up 49.02% （25/51）. Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio （OR） =50.369, P= 0.0041] and longer follow up duration （OR=1.144, P= 0.0067）. CONCLUSION： Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Pars Plana Vitrectomy versus Combined Scleral Buckling—Pars Plana Vitrectomy for Phakic Rhegmatogenous Retinal Detachment with Inferior Breaks

Aims: To compare the results of pars plana vitrectomy (PPV) and combined scleral buckling—PPV (SB/PPV) in phakic rhegmatogenous retinal detachments with inferior breaks. Methods: Randomized, prospective, clinical controlled trial of forty consecutive phakic eyes with primary rhegmatogenous retinal detachment, associated with inferior breaks and not complicated by proliferative vitreoretinopathy ≥grade C, to either PPV (group 1) or combined SB/PPV (group 2). Results: At 6 months follow up the primary reattachment rate was 100% (20/20 cases) in group 2 and 70% (14/20 cases) in the group 1, the difference being statistically significant (p = 0.027). The best corrected visual acuity improved significantly from a preoperative mean of 1.65 ± 1.13 (Range: 0.6 to 3) to a mean of 0.45 ± 0.11 (Range: 0.3 to 0.6) in the group 2 and in the group 1 improved from a preoperative mean of 2.34 ± 0.92 (Range: 0.48 to 3) to a mean of 0.668 ± 0.20 (Range: 0.48 to 1), the difference between the two groups being statistically significant (p = 0.001). Conclusion: Anatomical and functional success rates are significantly better with the use of a scleral explant during PPV for uncomplicated forms of phakic rhegmatogenous retinal detachments with inferior breaks.

Local dry vitrectomy combined with segmental scleral buckling and viscoelastic tamponade for rhegmatogenous retinal detachment with vitreous traction

AIM:To demonstrate local dry vitrectomy combined with segmental scleral buckling and viscoelastic tamponade for the treatment of partial rhegmatogenous retinal detachment(RRD)with local vitreous traction in patients at high-risk for proliferative vitreoretinopathy(PVR).METHODS:Eleven eyes of 11 patients were retrospectively studied,including 5 retinal dialysis and 6 retinal detachment(RD;5 eyes with peripheral retinal hole and I eye with giant tear).All patients exhibited partial RD and local vitreous traction.Combined local dry vitrectomy without conventional infusion and segmental scleral buckling was performed.Viscoelastic fluid was injected into the vitreous cavity if needed Demographic information,preoperative and post­operative complications,and outcomes were recorded.RESULTS:The mean age of the patients at presentation was 26.55±13.52y.All 11 patients obtained retinal reattachment after a single surgical intervention.Postoperative visual acuities were improved or remained stable in all patients.None of them developed complications,except for temporary mildly increased intraocular pressure in 3 cases.CONCLUSION:Combined local dry vitrectomy and segmental scleral buckling are effective for patients of RRD with local vitreous traction.The technique avoids many complications associated with regular surgery and was minimally invasive to both the external and internal eye.

Chandelier-assisted scleral buckling using wide angle viewing contact lens for pseudophakic retinal detachment repair

AIM: To evaluate a modified technique for scleral buckling(SB) in pseudophakic retinal detachment(RD).METHODS: A retrospective non-comparative study included 21 consecutive eyes with uncomplicated pseudophakic RD that was repaired by chandelier assisted SB using wide angle viewing(WAV) contact lens. Segmental tire alone was used in 5 eyes(23.81%), and combined with encircling band in 7 eyes(33.33%). Radial sponge alone was used in 3 eyes(14.29%) and combined with encircling band in 6 eyes(28.57%).RESULTS: Primary success rate was(90.48%). External drainage of subretinal fluid was performed in 8 eyes(38.1%). Intraoperative complications included vitreous prolapse at chandelier sclerotomy site in 4 eyes(19.05%) and localized subretinal hemorrhage at drainage site in one eye(4.76%). No case of intraocular lens(IOL) displacement, retinal incarceration or iatrogenic retinal tear was detected. Postoperative complications included choroidal detachment in one eye(4.76%), elevated intraocular pressure in 2 eyes(9.52%), epiretinal membrane formation in one eye(4.76%) and proliferative vitreoretinopathy in 3 eyes(14.29%). Mean postoperative corrected distance visual acuity was 0.7±0.3 logMAR units. CONCLUSION: Chandelier-assisted SB using WAV contact lens is a reliable technique for repairing selected cases of simple pseudophakic RD.

Successful scleral buckling for long-standing retinal detachment with subretinal proliferation 4-year after strabismus surgery

Dear Editor,We would like to report the case of a patient with longstanding retinal detachment(RD)with subretinal proliferation after strabismus surgery who was successfully treated by scleral buckling.Globe perforation is a potentially dangerous complication of strabismus surgery that may result in vision loss or even complete blindness and pthisis bulbi[1-2].Because most cases of scleral perforation occurred with handling ocular muscles are limited in superficial in depth and short in length,and produce no complications-its true incidence is not always apparent.Older studies have reported an incidence rate of 8%-12.1%of cases[3],whereas more recent studies have reported the rate as 0.13%-2.8%[4].This decrease in the incidence has resulted from improved surgical techniques and the introduction of spatula needles.Increased awareness among surgeons may have also contributed to this decrease.Possible treatment options recommended for globe perforation include observation alone,cryopexy,diathermy,and laser retinopexy[5],however,treatment is still under debate.An iatrogenic scleral perforation typically causes damage to the immediate adjacent choroid,and there may or may not be damage to the underlying retina,depending on the depth of the needle pass[6].

Buckling Properties of Water-Drop-Shaped Pressure Hulls with Various Shape Indices Under Hydrostatic External Pressure

The water-drop-shaped pressure hull has a good streamline,which has good application prospect in the underwater observatory.Therefore,this study conducted analytical,experimental and numerical investigation of the buckling properties of water-drop-shaped pressure hulls under hydrostatic pressure.A water-drop experiment was conducted to design water-drop-shaped pressure hulls with various shape indices.The critical loads for the water-drop-shaped pressure hulls were resolved by using Mushtari’s formula.Several numerical simulations including linear buckling analysis and nonlinear buckling analysis including eigenmode imperfections were performed.The results indicated that the critical loads resolved by Mushtari's formula were in good agreement with the linear buckling loads from the numerical simulations.This formula can be extended to estimate the buckling capacity of water-drop-shaped pressure hulls.In addition,three groups of pressure hulls were fabricated by using stereolithography,a rapid prototyping technique.Subsequently,three groups of the pressure hulls were subjected to ultrasonic measurements,optical scanning,hydrostatic testing and numerical analysis.The experimental results were consistent with the numerical results.The results indicate that the sharp end of the water-drop-shaped pressure hulls exhibited instability compared with the blunt end.This paper provides a new solution to the limitations of experimental studies on the water-drop-shaped pressure hulls as well as a new configuration and evaluation method for underwater observatories.

A non-probabilistic reliability topology optimization method based on aggregation function and matrix multiplication considering buckling response constraints

A non-probabilistic reliability topology optimization method is proposed based on the aggregation function and matrix multiplication.The expression of the geometric stiffness matrix is derived,the finite element linear buckling analysis is conducted,and the sensitivity solution of the linear buckling factor is achieved.For a specific problem in linear buckling topology optimization,a Heaviside projection function based on the exponential smooth growth is developed to eliminate the gray cells.The aggregation function method is used to consider the high-order eigenvalues,so as to obtain continuous sensitivity information and refined structural design.With cyclic matrix programming,a fast topology optimization method that can be used to efficiently obtain the unit assembly and sensitivity solution is conducted.To maximize the buckling load,under the constraint of the given buckling load,two types of topological optimization columns are constructed.The variable density method is used to achieve the topology optimization solution along with the moving asymptote optimization algorithm.The vertex method and the matching point method are used to carry out an uncertainty propagation analysis,and the non-probability reliability topology optimization method considering buckling responses is developed based on the transformation of non-probability reliability indices based on the characteristic distance.Finally,the differences in the structural topology optimization under different reliability degrees are illustrated by examples.

Fault Diagnosis for Buckling Friction Components in Wet Multi-Disc Clutches Using IHHT

The wet multi-disc clutches are extensively used in various transmission systems,withone of the most prevalent failure modes being the buckling deformation of friction components.Animproved Hilbert-Huang transform method(IHHT)is proposed to address the limitations of tradi-tional time-domain vibration analyses,such as low accuracy and mode mixing.This paper first clas-sifies the buckling degree of the friction components.Next,wavelet packet transform(WPT)isapplied to the vibration signals of different buckling plates to partition them into distinct fre-quency bands.Then,the instantaneous features are extracted by empirical mode decomposition(EMD)and Hilbert transform(HT)to discarding extraneous intrinsic mode function(IMF)com-ponents.Comparative analyses of Hilbert spectral entropy and time-domain features confirm theenhanced precision of IHHT under specific classifiers,which is better than traditional methods.

Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses

AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.

Buckling Optimization of Curved Grid Stiffeners through the Level Set Based Density Method

Stiffened structures have great potential for improvingmechanical performance,and the study of their stability is of great interest.In this paper,the optimization of the critical buckling load factor for curved grid stiffeners is solved by using the level set based density method,where the shape and cross section(including thickness and width)of the stiffeners can be optimized simultaneously.The grid stiffeners are a combination ofmany single stiffenerswhich are projected by the corresponding level set functions.The thickness and width of each stiffener are designed to be independent variables in the projection applied to each level set function.Besides,the path of each single stiffener is described by the zero iso-contour of the level set function.All the single stiffeners are combined together by using the p-norm method to obtain the stiffener grid.The proposed method is validated by several numerical examples to optimize the critical buckling load factor.

Chebyshev polynomial-based Ritz method for thermal buckling and free vibration behaviors of metal foam beams

This study presents the Chebyshev polynomials-based Ritz method to examine the thermal buckling and free vibration characteristics of metal foam beams.The analyses include three models for porosity distribution and two scenarios for thermal distribution.The material properties are assessed under two conditions,i.e.,temperature dependence and temperature independence.The theoretical framework for the beams is based on the higher-order shear deformation theory,which incorporates shear deformations with higher-order polynomials.The governing equations are established from the Lagrange equations,and the beam displacement fields are approximated by the Chebyshev polynomials.Numerical simulations are performed to evaluate the effects of thermal load,slenderness,boundary condition(BC),and porosity distribution on the buckling and vibration behaviors of metal foam beams.The findings highlight the significant influence of temperature-dependent(TD)material properties on metal foam beams'buckling and vibration responses.

Free vibration and buckling analysis of polymeric composite beams reinforced by functionally graded bamboo fbers

Natural fibers have been extensively researched as reinforcement materials in polymers on account of their environmental and economic advantages in comparison with synthetic fibers in the recent years.Bamboo fibers are renowned for their good mechanical properties,abundance,and short cycle growth.As beams are one of the fundamental structural components and are susceptible to mechanical loads in engineering applications,this paper performs a study on the free vibration and buckling responses of bamboo fiber reinforced composite(BFRC)beams on the elastic foundation.Three different functionally graded(FG)layouts and a uniform one are the considered distributions for unidirectional long bamboo fibers across the thickness.The elastic properties of the composite are determined with the law of mixture.Employing Hamilton’s principle,the governing equations of motion are obtained.The generalized differential quadrature method(GDQM)is then applied to the equations to obtain the results.The achieved outcomes exhibit that the natural frequency and buckling load values vary as the fiber volume fractions and distributions,elastic foundation stiffness values,and boundary conditions(BCs)and slenderness ratio of the beam change.Furthermore,a comparative study is conducted between the derived analysis outcomes for BFRC and homogenous polymer beams to examine the effectiveness of bamboo fibers as reinforcement materials,demonstrating the significant enhancements in both vibration and buckling responses,with the exception of natural frequencies for cantilever beams on the Pasternak foundation with the FG-◇fiber distribution.Eventually,the obtained analysis results of BFRC beams are also compared with those for carbon nanotube reinforced composite(CNTRC)beams found in the literature,indicating that the buckling loads and natural frequencies of BFRC beams are lower than those of CNTRC beams.

Molecular mechanism of hypoxia and alpha-ketoglutaric acid on collagen expression in scleral fibroblasts

AIM:To investigate the molecular mechanisms underlying the influence of hypoxia and alpha-ketoglutaric acid(α-KG)on scleral collagen expression.METHODS:Meta-analysis and clinical statistics were used to prove the changes in choroidal thickness(ChT)during myopia.The establishment of a hypoxic myopia model(HYP)for rabbit scleral fibroblasts through hypoxic culture and the effects of hypoxia andα-KG on collagen expression were demonstrated by Sirius red staining.Transcriptome analysis was used to verify the genes and pathways that hypoxia andα-KG affect collagen expression.Finally,real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR)was used for reverse verification.RESULTS:Meta-analysis results aligned with clinical statistics,revealing a thinning of ChT,leading to scleral hypoxia.Sirius red staining indicated lower collagen expression in the HYP group and higher collagen expression in the HYP+α-KG group,showed that hypoxia reduced collagen expression in scleral fibroblasts,whileα-KG can elevated collagen expression under HYP conditions.Transcriptome analysis unveiled the related genes and signaling pathways of hypoxia andα-KG affect scleral collagen expression and the results were verified by RT-qPCR.CONCLUSION:The potential molecular mechanisms through which hypoxia andα-KG influencing myopia is unraveled and three novel genes TLCD4,TBC1D4,and EPHX3 are identified.These findings provide a new perspective on the prevention and treatment of myopia via regulating collagen expression.

Sutured scleral fixation of existing subluxated/dislocated acrylic one-piece intraocular lenses

AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.

Scleral buckling combined with internal cyclopexy for severe traumatic cyclodialysis cleft in open globe injuries

This study aimed to evaluate the effect of scleral buckling combined with internal cyclopexy on the treatment of severe traumatic cyclodialysis cleft in open globe injuries(OGIS). This retrospective study recruited 10 patients of 10 eyes. With our surgical intervention, all the 10 eyes achieved retinal and ciliary body anatomic re-attachment. The choroidal ruptures in nine eyes were closed with complete choroidal reattachment. Postoperative best-corrected visual acuity of nine eyes had various improvements. The mean intraocular pressure was increased from 8.9±2.6 mm Hg to 13.4±4.4 mm Hg. Eventually, six eyes underwent silicone oil(SO) removal without complications, two eyes still had SO tamponade and two eyes became SO-dependent eyes. The result shows that internal direct cyclopexy combined with scleral buckling is an effective treatment for severe traumatic cyclodialysis cleft in OGIS.

Episcleral macular buckling for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole

AIM: To evaluate anatomical and visual outcomes of episcleral macular buckling (EMB) for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole.METHODS: Five cases of EMB for initial failure of retinal reattachment after internal limiting membrane (ILM) peeling and silicone oil tamponade caused by myopic macular hole were retrospectively reviewed. A silicone sponge sutured directly across the macular region was performed on the silicone oil filled eyes. Silicone oil was removed no sooner than 1 month post- EMB. The duration of follow -up time after removal of silicone oil was more than 3 months.RESULTS: Retinas of five eyes were all reattached at the last follow-up. The postoperative vision ranged from counting fingers to 0.08.CONCLUSION: Anatomical results improved after EBM for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole, which was not evident for visual outcome.