PURPOSE: To evaluate the benefit of pars plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) in eyes with diffuse diabetic macular edem a refractory to laser photocoagulation.DESIGN: Prospective...PURPOSE: To evaluate the benefit of pars plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) in eyes with diffuse diabetic macular edem a refractory to laser photocoagulation.DESIGN: Prospective, consecutive, interve ntional case series. METHODS: Diabetic patients with biomicroscopic, angiographi c, and tomographic evidence of diabetic macular edema persisting for at least 3 months after numerous sessions of macular photocoagulation were evaluated for in clusion. Patients with biomicroscopic evidence of epiretinal membrane or taut po sterior hyaloid, previous vitreoretinal surgery, or active proliferative diabeti c retinopathy were excluded. The main outcome measures were macular thickness, a s measured by optical coherence tomography (OCT) and visual acuity (VA). RESULTS : PPV with ILM removal was performed in 11 eyes of 10 patients (four men, six wo men; mean age=58.2 years). Six-month follow-up data were available for 10 eyes (91%). At 6 months postoperatively, central macular thickness had improved by at least 20%in eight of 11 eyes (mean preoperative thickness of 421 μm compare d with mean postoperative thickness of 188 μm; P=.007). Mean VA improved from 2 0/352 to 20/94 at 6 months (P=.002). By the most recent visit (range=6-20 month s postoperatively), VA had improved by at least 2 Snellen lines in 6 of 10 eyes treated with surgery alone. CONCLUSIONS: The early results of this ongoing study suggest that PPV with ILM removal may provide anatomic and visual benefit in so me eyes with chronic diabetic macular edema unresponsive or unamenable to additi onal laser photocoagulation.展开更多
目的观察显微直视下睫状体光凝治疗玻璃体切除术后难治性青光眼的疗效。方法选择近1年来我院诊治的10例玻璃体切除术后难治性青光眼患者,获得知情同意后使用23 G玻切套管行眼内光凝,在显微镜下直视配合巩膜顶压光凝1/3～1/2周睫状突,术...目的观察显微直视下睫状体光凝治疗玻璃体切除术后难治性青光眼的疗效。方法选择近1年来我院诊治的10例玻璃体切除术后难治性青光眼患者,获得知情同意后使用23 G玻切套管行眼内光凝,在显微镜下直视配合巩膜顶压光凝1/3～1/2周睫状突,术后3 d、1周、1个月及3个月复查视力、眼压,观察眼内反应等情况。结果术后所有患者眼压较术前明显下降,术前平均﹙37.75±6.70﹚mm Hg（30.0～50.0 mm Hg）,术后3个月时平均﹙16.21±6.86﹚mm Hg（9.5～28.0 mm Hg）,差异具有统计学意义（P〈0.01,配对t检验）,术前术后视力比较无统计学差异,术中术后所有患者均未出现明显并发症。结论眼内激光直视配合巩膜顶压下行睫状体光凝是治疗玻璃体切除术后难治性青光眼的一种安全有效的手段。展开更多
Background: and objective: Current literature review fails to disclose any series describing the use of two-port vitrectomy in adult patients. This study was performed to determine the feasibility and efficacy of pars...Background: and objective: Current literature review fails to disclose any series describing the use of two-port vitrectomy in adult patients. This study was performed to determine the feasibility and efficacy of pars plana vitrectomy surgery using two (rather than three or four)-port access for treatment of diabetic patients with nonclearing vitreous haemorrhage due to retinal neovascularization. Design: Interventional prospective case series: to measure ability to allow for long-term resolution of chronic uncomplicated vitreous haemorrhage in diabetic patients, and to study the frequency and nature of complications associated with this technique. Methods: Two-port pars plana vitrectomy (with endolaser treatment and membrane delamination if necessary) was performed in a prospective series of 12 consecutive diabetic patients with nonclearing vitreous haemorrhage due to retinal neovascularization. Results: Successful removal of vitreous haemorrhage resulted in all patients. No visually significant intraoperative complications occurred. Best postoperative visual acuity correlated with lenticular and macular perfusion status. Conclusion: Two-port pars plana vitrectomy is an efficient (and potentially safer and faster) alternative to the standard three-port vitrectomy in selected patients.展开更多
文摘PURPOSE: To evaluate the benefit of pars plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) in eyes with diffuse diabetic macular edem a refractory to laser photocoagulation.DESIGN: Prospective, consecutive, interve ntional case series. METHODS: Diabetic patients with biomicroscopic, angiographi c, and tomographic evidence of diabetic macular edema persisting for at least 3 months after numerous sessions of macular photocoagulation were evaluated for in clusion. Patients with biomicroscopic evidence of epiretinal membrane or taut po sterior hyaloid, previous vitreoretinal surgery, or active proliferative diabeti c retinopathy were excluded. The main outcome measures were macular thickness, a s measured by optical coherence tomography (OCT) and visual acuity (VA). RESULTS : PPV with ILM removal was performed in 11 eyes of 10 patients (four men, six wo men; mean age=58.2 years). Six-month follow-up data were available for 10 eyes (91%). At 6 months postoperatively, central macular thickness had improved by at least 20%in eight of 11 eyes (mean preoperative thickness of 421 μm compare d with mean postoperative thickness of 188 μm; P=.007). Mean VA improved from 2 0/352 to 20/94 at 6 months (P=.002). By the most recent visit (range=6-20 month s postoperatively), VA had improved by at least 2 Snellen lines in 6 of 10 eyes treated with surgery alone. CONCLUSIONS: The early results of this ongoing study suggest that PPV with ILM removal may provide anatomic and visual benefit in so me eyes with chronic diabetic macular edema unresponsive or unamenable to additi onal laser photocoagulation.
文摘目的观察显微直视下睫状体光凝治疗玻璃体切除术后难治性青光眼的疗效。方法选择近1年来我院诊治的10例玻璃体切除术后难治性青光眼患者,获得知情同意后使用23 G玻切套管行眼内光凝,在显微镜下直视配合巩膜顶压光凝1/3～1/2周睫状突,术后3 d、1周、1个月及3个月复查视力、眼压,观察眼内反应等情况。结果术后所有患者眼压较术前明显下降,术前平均﹙37.75±6.70﹚mm Hg（30.0～50.0 mm Hg）,术后3个月时平均﹙16.21±6.86﹚mm Hg（9.5～28.0 mm Hg）,差异具有统计学意义（P〈0.01,配对t检验）,术前术后视力比较无统计学差异,术中术后所有患者均未出现明显并发症。结论眼内激光直视配合巩膜顶压下行睫状体光凝是治疗玻璃体切除术后难治性青光眼的一种安全有效的手段。
文摘Background: and objective: Current literature review fails to disclose any series describing the use of two-port vitrectomy in adult patients. This study was performed to determine the feasibility and efficacy of pars plana vitrectomy surgery using two (rather than three or four)-port access for treatment of diabetic patients with nonclearing vitreous haemorrhage due to retinal neovascularization. Design: Interventional prospective case series: to measure ability to allow for long-term resolution of chronic uncomplicated vitreous haemorrhage in diabetic patients, and to study the frequency and nature of complications associated with this technique. Methods: Two-port pars plana vitrectomy (with endolaser treatment and membrane delamination if necessary) was performed in a prospective series of 12 consecutive diabetic patients with nonclearing vitreous haemorrhage due to retinal neovascularization. Results: Successful removal of vitreous haemorrhage resulted in all patients. No visually significant intraoperative complications occurred. Best postoperative visual acuity correlated with lenticular and macular perfusion status. Conclusion: Two-port pars plana vitrectomy is an efficient (and potentially safer and faster) alternative to the standard three-port vitrectomy in selected patients.
