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

Preventing condensation of objective lens in noncontact wide-angle viewing systems during vitrectomy

AIM： To assess the optimal conditions for preventing condensation of objective lens during vitrectomy with noncontact wide-angle viewing systems（WAVSs）. METHODS： We explored the effectiveness of the coating with ophthalmic viscoelastic device（OVDs） on the corneal surface and the soaking the objective lens in warm-saline for preventing condensation of objective lens. First, to find the optimal soaking time to keep the objective lens warm, we measured the temperature of objective lens every minute after soaking in warm saline. Second, to find optimal distance between cornea and objective lens, which provide as wide a view as possible and less condensation at the same time, we measured the condensation time with different distances. With the obtained optimal soaking time and distance, we explored the effect of coating cornea with OVDs and soaking objective lens in warm saline on condensation time.RESULTS： One and 5 min of soaking in warm saline was most effective for keeping the lens warm enough（45.1℃±2.1℃ for 1 min and 46.4℃±1.0℃ for 5 min, P=0.109）. The mean condensation times for the control group at 1, 3, and 5 mm from corneal surface to objective lens were 1±0.4, 4±1.4, 190±26.1 s, respectively, thus 5 mm was most optimal distance for vitrectomy with WAVSs. For the OVD coating group, the mean condensation times were 1.5±0.3, 13±1.4, and 200±23.9 s at 1, 3, and 5 mm distance and borderline significant compared with control group（P=0.068, 0.051, and 0.063, respectively）. With the 1-minute warm saline soaking group, the mean condensation time were extended to 188±34.4, 416±65.7, and 600±121.3 s at 1, 3, and 5 mm distance and statistically significant compared with control（P=0.043, 0.041 and 0.043, respectively）.CONCLUSION： OVD coating on corneal surface shows no difference on condensation time with control group. However, soaking the objective lens in warm saline revealed statistically significant extension of condensation time compared to control group. Therefore, keeping the objective lens warm with soaking in warm saline is a simple but effective to prevent condensation of objective lens during vitrectomy. The thermodynamics between objective lens and cornea during vitrectomy warrants further investigation.

A SYSTEMS PHARMACOLOGY VIEW OF THE BIOACTIVITY OF THE EXTRACT FROM RHIZOME DIOSCOREA NIPPONICA MANKINO

Key for worldwide acceptance of Traditional Chinese Medicine(TCM)is the ability to provide scientific evidence combined with a quality control system based on the bioactive ingredients.Modern scientific technology tools are now available to accomplish standardization of TCM products in order to achieve a high level of efficacy and safety,enhancing the introduction into the