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 treat...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. .展开更多
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 ...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.展开更多
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.MET...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.展开更多
●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...●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.展开更多
Purpose: To assess the ratio of the frequency of primary scleral buckling procedures versus the frequency of vitrectomies performed as treatment for rhegmatogenous retinal detachments in a primary retinal surgical dep...Purpose: To assess the ratio of the frequency of primary scleral buckling procedures versus the frequency of vitrectomies performed as treatment for rhegmatogenous retinal detachments in a primary retinal surgical department.Methods: The study included all patients with rhegmatogenous retinal detachments who underwent retinal or vitreoretinal surgery in the study period from 2002 to 2006. The size of the retinal defect and the amount of proliferative vitreoretinopathy were not exclusion criteria. Patients with tractional retinal detachment due to proliferative ischemic retinopathies were excluded.Results: In the study period, 875 primary retinal and vitreoretinal surgeries were performed on 875 eyes. Among the surgeries, episcleral sponges(42.9%) formed the largest part,followed by pars plana vitrectomies(35.0%) and encircling bands(22.2%). Combining episcleral sponges and encircling bands into an episcleral surgery group revealed that two thirds(65%).of the surgeries were episcleral interventions. In the episcleral sponge group, the retinal re-detachment rate after the first surgery was 13%.Conclusion: In a university department as a primary referral unit for retinal detachments, episcleral retinal surgery can still outnumber vitreoretinal interventions, with retinal re-detachment rates which do not differ markedly from the re-detachment rates reported in randomized trials comparing vitreoretinal surgery with episcleral surgery.展开更多
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...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.展开更多
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 retrospe...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展开更多
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 con...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.展开更多
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 a...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.展开更多
Dear Sir,Iam Dr Katrina A.Mears,from the Department of Ophthalmology and Visual Sciences,University of Iowa Carver College of Medicine,200 Hawkins Drive,Iowa City,Iowa,USA.I wish to present a case of endophthalmitis s...Dear Sir,Iam Dr Katrina A.Mears,from the Department of Ophthalmology and Visual Sciences,University of Iowa Carver College of Medicine,200 Hawkins Drive,Iowa City,Iowa,USA.I wish to present a case of endophthalmitis secondary to globe penetration from a hydrogel scleral buckle which,to the best of our knowledge,is the first reported case展开更多
The in-plane elastic buckling behavior of arches is investigated using a new finite-element approach for the nonlinear analysis. The linear buckling, nonlinear primary buckling, and secondary bifurcation buckling beh...The in-plane elastic buckling behavior of arches is investigated using a new finite-element approach for the nonlinear analysis. The linear buckling, nonlinear primary buckling, and secondary bifurcation buckling behavior of arches are compared taking into account the large deformation and the effects of initial geometric imperfections or perturbations. The theoretical investigation emphasizes the nonlinear secondary bifurcation buckling behavior for a full span uniformly distributed load. The efficiency of compact method for tracing secondary buckling path is shown through several examples. Finally, a new structural design, which prevents the secondary bifurcation buckling by adding some crossed cables across the arch, is proposed to improve the limit load carrying capacity.展开更多
文摘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. .
文摘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.
基金Supported by National Natural Science Foundation of China(No.81700884)Scientific Research Foundation of National Health and Health Commission(No.WKJ-ZJ-2037)+1 种基金Zhejiang Public Welfare Technology Application Project(No.LGF21H120005)Science and Technology Project of Wenzhou(No.Y20190649).
文摘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.
基金Supported by Xuzhou Health Outstanding Talents Project(No.XWJC001)Critical Special Project for Social Development of Xuzhou(No.KC21153)+1 种基金Science and Technology Innovation Project of Xuzhou Municipal Health Commission(No.XWKYHT20230039)Applied Basic Research Project of Xuzhou(No.KC23016).
文摘●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.
文摘Purpose: To assess the ratio of the frequency of primary scleral buckling procedures versus the frequency of vitrectomies performed as treatment for rhegmatogenous retinal detachments in a primary retinal surgical department.Methods: The study included all patients with rhegmatogenous retinal detachments who underwent retinal or vitreoretinal surgery in the study period from 2002 to 2006. The size of the retinal defect and the amount of proliferative vitreoretinopathy were not exclusion criteria. Patients with tractional retinal detachment due to proliferative ischemic retinopathies were excluded.Results: In the study period, 875 primary retinal and vitreoretinal surgeries were performed on 875 eyes. Among the surgeries, episcleral sponges(42.9%) formed the largest part,followed by pars plana vitrectomies(35.0%) and encircling bands(22.2%). Combining episcleral sponges and encircling bands into an episcleral surgery group revealed that two thirds(65%).of the surgeries were episcleral interventions. In the episcleral sponge group, the retinal re-detachment rate after the first surgery was 13%.Conclusion: In a university department as a primary referral unit for retinal detachments, episcleral retinal surgery can still outnumber vitreoretinal interventions, with retinal re-detachment rates which do not differ markedly from the re-detachment rates reported in randomized trials comparing vitreoretinal surgery with episcleral surgery.
文摘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.
基金Supported by the Projects of Henan Health and Family Planning Commission(No.2014005)Henan Health Department(No.201304007)Henan Science and Technology Department(No.142102310110)
文摘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
文摘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.
基金Supported by the National Natural Science Foundation of China(No.81770963,No.81500725,No.81770964)Shanghai Shen Kang Hospital Development Center Program(No.16CR4017A).
文摘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.
文摘Dear Sir,Iam Dr Katrina A.Mears,from the Department of Ophthalmology and Visual Sciences,University of Iowa Carver College of Medicine,200 Hawkins Drive,Iowa City,Iowa,USA.I wish to present a case of endophthalmitis secondary to globe penetration from a hydrogel scleral buckle which,to the best of our knowledge,is the first reported case
文摘The in-plane elastic buckling behavior of arches is investigated using a new finite-element approach for the nonlinear analysis. The linear buckling, nonlinear primary buckling, and secondary bifurcation buckling behavior of arches are compared taking into account the large deformation and the effects of initial geometric imperfections or perturbations. The theoretical investigation emphasizes the nonlinear secondary bifurcation buckling behavior for a full span uniformly distributed load. The efficiency of compact method for tracing secondary buckling path is shown through several examples. Finally, a new structural design, which prevents the secondary bifurcation buckling by adding some crossed cables across the arch, is proposed to improve the limit load carrying capacity.