Ocular trauma treated with pars plana vitrectomy: early outcome report

AIM： To evaluate demographic variables and visual outcomes, among patients with ocular injuries involving the posterior segment, managed with pars plana vitrectomy.· METHODS： The records of patients were studied retrospectively from March to September 2010, to determine the age, gender, place of occurrence of trauma, visual acuity, anatomical site, nature of injury,wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo.·RESULTS： Ninety patients（77 males, 13 females）, with a mean age of 32.7 ±15.8y were included over the 6-month period. The majority of cases occurred in the workplace（47 patients）, followed by home（14 patients）.The mean visual acuity（log MAR） of patients significantly improved from 2.36 ±0.72 preoperatively to 1.50 ±1.14 postoperatively. Twenty-three patients had preoperative vision better than 2.0 log MAR, the postoperative visual acuity was significantly better among these patients than patients with worse than 2.0 log MAR（P 〈0.001）. Visual improvement between groups with early vitrectomy（〉7d）and delayed vitrectomy（〉7d） was not significantly different（P =0.66）. Postoperative visual acuity was not significantly different between patients with injury in Zone I and II（P =0.64）, but patients with injury in Zone III had significantly poorer visual acuity（P =0.02）. Patients with relative afferent pupillary defect had significantly poorer postoperative visual acuity（P =0.02）. Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visualacuity were significantly different between groups with different ocular trauma scores（P〈 0.001）.·CONCLUSION： Trauma is more likely to occur in men under 40 y of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy.

Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification

BACKGROUND During anesthesia administration for cataract surgery,low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing,with the use of additional drops intraoperatively increasing the risk of complications.Accordingly,there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine.AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy.METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study.Patients were divided into the proparacaine surface anesthesia(SA)group(65 cases)and the compound acupuncture-medicine anesthesia group(CAMA group,65 cases).Patients in the CAMA group were provided acupuncture analgesia in addition to SA.Preoperative anxiety[Self-Rating Anxiety Scale(SAS)score and state anxiety inventory(SAI)score],intraoperative stress,vital signs,analgesia,and cooperation,as well as postoperative adverse events,were compared between groups.RESULTS More marked reductions in anxiety were observed among patients in the CAMA group,with corresponding reductions in SAS and SAI scores.During the operation,no change in the secretion of E,NE,or Cor group compared to the preoperative period was observed in the CAMA,which was markedly lower than that in the SA group.Heart rate,blood pressure,and respiratory rate were more stable intraoperatively in the CAMA group.In addition,the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group.Accordingly,patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery.Furthermore,marked reductions in intraoperative adverse effects were observed in the CAMA group,indicating greater overall safety.CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.

Analysis of the effect of repair materials for orbital blowout fracture on complications

AIM: To investigate the effect of repair materials for orbital blowout fractures on the occurrence of postoperative complications. METHODS: The clinical data and follow-up data of 54 subjects with orbital blowout fractures were retrospectively analyzed. The study was divided into three groups according to the used repair materials: titanium mesh(16 cases), Medpor(12 cases), and Medpor titanium mesh(26 cases). All test data were analyzed using the SPSS version 23.0 statistical software. The mean age and duration of disease between the groups were compared through oneway analysis of variance. The Chi-square(χ~2) test was used to compare the number of males and females, different fracture types, and different surgical approaches among groups. The χ~2 test was used to compare the frequencies for complications in each group.RESULTS: The baseline characteristics of age and gender in each group were matched(F=1.763, P=0.172;χ~2=0.026, P=0.987). In addition, there was no difference in the type of fracture and surgical approach(χ~2=0.460, P=0.977;χ~2=0.691, P=0.952), or the incidence of complications(χ~2=0.081, P=0.960) between the three groups. CONCLUSION: Although there is no difference in effect of various repair materials on the incidence of complications, the effect of repair materials on postoperative complications of orbital blowout fractures should not be ignored.