AIM:To introduce and evaluate the clinical efficacy of a new technique,the use of viscoelastic substances(VS)to close leaking sclerotomy in 23G microincision vitrectomy,and to observe its effect on the visual acuity a...AIM:To introduce and evaluate the clinical efficacy of a new technique,the use of viscoelastic substances(VS)to close leaking sclerotomy in 23G microincision vitrectomy,and to observe its effect on the visual acuity and intraocular pressure(IOP)of patients.METHODS:Patients who underwent 23G vitrectomy in Ningbo Eye Hospital before the use of VS technique(June 2019 to September 2020)and after the use of VS technique(October 2020 to December 2021)were selected as the subjects of this study.The above cases underwent operation by the same surgeon and were retrospectively analyzed.VS technique was used as the alternative to suturing,in which a small amount of VS was injected at the leaking sclerotomy and then gently massaged to confirm leaking sclerotomy closure.RESULTS:A total of 174 eyes were covered in the study,including 84 eyes in the control group(before the use of VS technique)and 90 eyes in the VS technique group.The number of eyes that needed to be sutured decreased considerably from 42.9%in the control group to 3.3%in the VS technique group,and the proportion of subconjunctival hemorrhage at 1-2d after surgery decreased remarkably from 35.7%in the control group to 2.2%in the VS technique group.No substantial differences in the incidence of mean IOP and low IOP were found between 1-2 and 3-20d after surgery in the VS technique group.No major complications associated with VS technique were identified during the study.CONCLUSION:In 23G microincision vitrectomy,VS technique is a safe,simple,and effective method to close leaking sclerotomy.展开更多
·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: T...·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: Twelve medically uncontrolled NVG with earlier 23 -gauge vitrectomy for PDR underwent AGV implantation. The control of intraocular pressure (IOP), preoperative and postoperative best -corrected visual acuity, the development of intraoperative and postoperative complications were evaluated during the follow-up. ·RESULTS: The mean follow-up was 15.4±4.3 months (9-23 months). Mean preoperative IOP was 49.4±5.1mmHg and mean postoperative IOP at the last visit was 17.5 ± 1.6mmHg. The control of IOP was achieved at the final follow -up visits in all patients, however, 8 of 12 patients still needed anti-glaucoma medication (mean number of medications, 0.8±0.7). The visual acuity improved in nine eyes, and the visual acuity unchanged in three eyes at the final follow -up visits. The complications that occurred were minor hyphema in three eyes, choroid detachment in two eyes, and the minor hyphema and choroid detachments were reabsorbed without any surgical intervention. ·CONCLUSION: AGV implantation is a safe and effective procedure that enables successful IOP control and vision preservation in the NVG patients with the history of earlier 23-gauge vitrectomy for PDR.·展开更多
AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment(RRD) repair.METHODS: This was a ret...AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment(RRD) repair.METHODS: This was a retrospective, consecutive,noncomparative, interventional case series of 30 eyes of30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications.RESULTS: Primary reattachment was achieved in 27eyes(90.0%). The reasons for redetachment(3 eyes, 10%)were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy,respectively. The logarithm of the minimum angle of resolution visual acuity(mean±SD) improved from 0.76±0.74 preoperatively to 0. 21 ± 0. 37 6 months’ postoperatively(P 【0.0001). Postoperative hypotony was not detected,but 1 eye( 3. 3 %) had increased intraocular pressure(30 mm Hg) with spontaneous resolution. No endophthalmitis developed during follow-up. Macular pucker was detected in 3 eyes(10.0%).· CONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.展开更多
Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Metho...Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.展开更多
基金Supported by General Class A of the Zhejiang Medical and Health Science and Technique Plan Project in 2020(No.2020ky288)Zhejiang Provincial Science and Technique Program of Traditional Chinese Medicine(No.2021ZB268)+2 种基金Health Science and Technique Program of Zhejiang Province(No.2021PY073)Yinzhou District Agriculture and Social Development Field Science and Technique Project(No.2021AS0058No.2020AS0080)。
文摘AIM:To introduce and evaluate the clinical efficacy of a new technique,the use of viscoelastic substances(VS)to close leaking sclerotomy in 23G microincision vitrectomy,and to observe its effect on the visual acuity and intraocular pressure(IOP)of patients.METHODS:Patients who underwent 23G vitrectomy in Ningbo Eye Hospital before the use of VS technique(June 2019 to September 2020)and after the use of VS technique(October 2020 to December 2021)were selected as the subjects of this study.The above cases underwent operation by the same surgeon and were retrospectively analyzed.VS technique was used as the alternative to suturing,in which a small amount of VS was injected at the leaking sclerotomy and then gently massaged to confirm leaking sclerotomy closure.RESULTS:A total of 174 eyes were covered in the study,including 84 eyes in the control group(before the use of VS technique)and 90 eyes in the VS technique group.The number of eyes that needed to be sutured decreased considerably from 42.9%in the control group to 3.3%in the VS technique group,and the proportion of subconjunctival hemorrhage at 1-2d after surgery decreased remarkably from 35.7%in the control group to 2.2%in the VS technique group.No substantial differences in the incidence of mean IOP and low IOP were found between 1-2 and 3-20d after surgery in the VS technique group.No major complications associated with VS technique were identified during the study.CONCLUSION:In 23G microincision vitrectomy,VS technique is a safe,simple,and effective method to close leaking sclerotomy.
基金Shanghai Leading Academic Discipline Project, China (No.S30205)
文摘·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: Twelve medically uncontrolled NVG with earlier 23 -gauge vitrectomy for PDR underwent AGV implantation. The control of intraocular pressure (IOP), preoperative and postoperative best -corrected visual acuity, the development of intraoperative and postoperative complications were evaluated during the follow-up. ·RESULTS: The mean follow-up was 15.4±4.3 months (9-23 months). Mean preoperative IOP was 49.4±5.1mmHg and mean postoperative IOP at the last visit was 17.5 ± 1.6mmHg. The control of IOP was achieved at the final follow -up visits in all patients, however, 8 of 12 patients still needed anti-glaucoma medication (mean number of medications, 0.8±0.7). The visual acuity improved in nine eyes, and the visual acuity unchanged in three eyes at the final follow -up visits. The complications that occurred were minor hyphema in three eyes, choroid detachment in two eyes, and the minor hyphema and choroid detachments were reabsorbed without any surgical intervention. ·CONCLUSION: AGV implantation is a safe and effective procedure that enables successful IOP control and vision preservation in the NVG patients with the history of earlier 23-gauge vitrectomy for PDR.·
文摘AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment(RRD) repair.METHODS: This was a retrospective, consecutive,noncomparative, interventional case series of 30 eyes of30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications.RESULTS: Primary reattachment was achieved in 27eyes(90.0%). The reasons for redetachment(3 eyes, 10%)were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy,respectively. The logarithm of the minimum angle of resolution visual acuity(mean±SD) improved from 0.76±0.74 preoperatively to 0. 21 ± 0. 37 6 months’ postoperatively(P 【0.0001). Postoperative hypotony was not detected,but 1 eye( 3. 3 %) had increased intraocular pressure(30 mm Hg) with spontaneous resolution. No endophthalmitis developed during follow-up. Macular pucker was detected in 3 eyes(10.0%).· CONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.
文摘Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.
文摘目的观察术前应用康柏西普眼内注射对23G玻切治疗增殖性糖尿病视网膜病变疗效的影响。方法回顾性病例对照研究。观察增殖性糖尿病视网膜病变手术患者共46人50只眼,药物注射辅助组22例,术前3~7天给予玻璃体腔注射10 mg/ml的康柏西普0.5 mg（0.05 ml）;单纯手术对照组28例,常规行23G玻璃体切割术。对比两组术后最佳矫正视力log MAR BCVA、手术时间、医源性裂孔发生率、电凝使用次数、术中及术后出血发生率情况。结果随访两组术后12 m平均log MAR BCVA分别为（0.75±0.22）和（1.14±0.50）（P〈0.05）;注药组平均手术时间为（74.27±16.82）min,而对照组为（98.56±13.74）min（P〈0.05）;医源性裂孔在注药组中有2例,占9.09%,而对照组中有6例,占21.43%（P〈0.05）;在注药组术中有4例使用电凝,占18.18%,对照组为16例,占57.14%（P〈0.05）;注药组有1例出现术中出血,占4.55%,对照组为11例,占39.29%（P〈0.05）;注药组有1例出现术后复发玻璃体积血,占4.55%,对照组为5例,占17.86%（P〈0.05）。结论在应用23G微创玻切治疗增殖性糖尿病视网膜病变术前玻璃体腔注射康柏西普可以显著提高术后视力,缩短手术时间,减少医源性裂孔和术中术后出血的发生率,降低手术难度及减少并发症的发生。
