Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To observe the clinical effect of conventional vitrectomy using transconjunctival sutureless 20 Gauge (20G) trocar. Methods The clinical data of 62 patients (63 eyes) who had undergone vitrectomy were retrospectively analyzed. The patients were divided into 2 groups according to the surgery methods. Group A: conventional vitrectomy using transconjunctival sutureless 20G trocar were performed on 33 cases (34 eyes) including 19 males (20 eyes) and 14 females (14 eyes). The patients aged from 17 to 75 years with the average age of 52.3 years. The average visual acuity was 0.04 and the average intraocular pressure was 18.25 mm Hg (1 mm Hg=0.133 kPa). Included were 13 cases of diabetic retinopathy, 9 cases of vitreous hemorrhage, 2 cases of silicone oil removal and tearing membrane off, 9 cases of complex retinal detachment, and 1 case of tearing epiretinal macular membrane. Group B: 20G conventional incision vitrectomy was performed on 29 cases (29 eyes) including 13 males (13 eyes) and 16 females (16 eyes) aged from 24 to 69 years with the average age of 49.5 years. The average visual acuity was 0.02 and the average intraocular pressure was 17.50 mm Hg. Included were 10 cases of diabetic retinopathy, 8 cases of vitreous hemorrhage, 5 cases of retinal detachment, 2 cases of longstanding retinal detachment performed with vitrectomy and scleral buckling, and 4 cases of silicone oil removal and tearing membrane off and intravitreal injection of expanding gases. Within group A, 21 eyes were treated with intraocular laser photocoagulation, 9 eyes were treated with scleral cryosurgery to block the hole, 3 eyes were treated with intravitreal injection of expanding gases, and 15 eyes were injected with silicone oil. Leakage of incision, incidence of iatrogenic holes and comfort of patients after operation were recorded and analyzed. All data were analyzed by chi;2 test statistical analysis. Results In group A, 31 eyes had a good degree of comfort without incision leakage and did not need special treatment; 3 eyes filled with inert gas needed suppression for 3 to 5 minutes, and had gas spill from the temporal incision, which needed to be sutured once. In group B, all incisions were sutured with 8.0 silk suture without any incision leakage, whileforeign body sensation and irritation was apparent. Difference on the degree of comfort in the two groups was statistically significant (chi;2 =50.56,Plt;0.01). No eyes in group A generated iatrogenic hole, while 2 eyes in group B generated ora serrata slit pores next to the puncture. Compared with each other, there was a significant statistical difference (chi;2=4.15,Plt;0.05). Conclusion Conventional vitrectomy using transconjunctival sutureless 20G trocar made the vitrectomy simpler and quicker and can reduce the incidence of iatrogenic hole significantly.
Vitrectomy and silicone oil injection were performed for treatment of 43 patients with complicated retinal detachment (RD, n=21 ) or subsequent atrophia bulbi (AB, n=22). Retinal reattachment was achieved in 14 (66.7%) of 21 patients with RD, including 11 with idiopathic proliferative vitreoretinopathy (PVR),6 with traumatic PVR, 3 with congenital uveal coloboma or Marfan syndrome. The visual acuity was better than 0.05 in 7(50%) of successful cases,and better than 0.02 in 11 (78.6%).Only 6(27.3%) patients had retina reattached with visual improvement in 22 cases of AB, including 13 of traumatic PVR,8 of idiopathic PVR.However,the intraoccular pressure was stable and shrinkage of the globe was controlled in 21 (95.5%) of 22 patients with AB.The results indicate that silicone off injection following vitrectomy may provide advanced severe PVR with a chance of successful treatment. （Chin J Ocul Fundus Dis,1994,10:4-6）
OBJECTIVE:To investigate the treatment of retinal redetachment after vitrectomy and silicone oil tamponade. METHODS:Investigating retrospectively on the treatment effect of 8 cases of redetachment of retina with proliferative vitreoretinopathy(PVR) in which the retinas had been attached formerly after vetrectomy and silicone oil tamponade operation.The reoperative procedures included pars plana vitrectomy,membranes peeling,retinotomy,inner exchange of the fluid and silicone oil tampnade and subretinal membranes were removed out in 2 eyes. RESULTS:Six eyes had anatomical reattachment postoperatively and another 2 eyes still had inferior shallow retinal detachment.Visual acuity was improved in 6 patients and remained unchange in 2 patients. CONCLUSIONS:The cause of recurrent retinal detachment might be the formation of the proliferative epiretinal and subretinal membranes,and vitrectomy to release the traction of proliferative membranes and full fluid silicone oil exchange should do good to reattachment. （Chin J Ocul Fundus Dis,1996,12: 13-15 ）
Objective To inverstingate the effect of perfluorohexyloctane(F6H8)to the retina of rabbit eyes. Methods Fifteen vitrectomized New Zealand white rabbits were injectedF6H8(experiment group,12 rabbits ) and BSS(control group,3 rabbits) into vitreous cavity.Slit-lamp biomicroscopy and indirect ophthalmoscopy were performed pre- and postoperatively in all the eyes.Histopathological examination was done after the rabbits were sacrificed at the end of the study. Results A large clear balb was formed after intravitreal injection of theF6H8 in the vitreous was injected and no retinal detachment and cataract were found.The OPL was edematous and then thinned out in 4th week in experimental group.Degenerating cells was found in inner and outer nuclear layers.Cellular vaculoar degeneration was present in TEM. ConclusionF6H8 in vitreous cavity may cause significant side effects on retina,we could not recommend it to be used as an intraocular temponade.
Objective To evaluate the clinical features, risk factors and treatment outcomes of endogenous candida albicans endophthalmitis. Methods The clinical data of 11 patients (18 eyes) with vitreous specimen culture-proven endogenous candida endophthalmitis were retrospective reviewed, including risk factors, clinical features and therapeutic methods and outcomes. Results There were 4 males and 7 females patients, aged from 19 to 72 years with a mean age of （41.61plusmn;9.76）years. Seven patients had bilateral endophthalmitis. They had histories of induced abortion (2 patients), intravenous transfusion (3 patients), colon cancer surgery (1 patient), chemotherapy after surgery of malignant lymphoma of colon (1 patient), renal transplantation (1 patient), acute necrotic pancreatitis surgery (1 patient) and diabetes (1 patient). One patient has no special medical history. All patients had no history of ocular trauma or intraocular surgery. The major complaints included blurred vision, metamorphopsia and floaters. It taken an average of (15.23plusmn;8.70) days (3-38 days) for patients to go to the hospital after getting those symptoms. The main clinical manifestations included pre- or sub-retinal white exudates and vitreous inflammations.In 18 eyes, 11 received vitreous surgery, and the other 7 were treated by intravitreal administration of anti-fungal drugs. Ten patients also underwent systemic anti-fungal therapy. The candida endophthalmitis was cured for 10/11 patients and most of them with increased visual acuity. Conclusions Endogenous candida albicans endophthalmitis is characterized by pre- or sub-retinal white exudates and vitreous inflammations. Non-standard intravenous transfusion, induced abortion and malignancy are its major risk factors. Pars plana vitrectomy or intravitreal delivery of anti-fungal drugs can cure this disease.
Seventen eyeswith complicated retinal detachment were repaired with vitrectomy,retinotomy,retinectomy or retinal suture combined with gas/fluid exchange,scleral buckle and cryotherapy.These cases include giant retinal tear with inverted retinal flap(6 eyes),severe traumatic retinal detachment(4 eyes),proliferative diabetic retinopathy(2 eyes),recurrent retinal detachmeng(3 eyes)and anterior proliferative vitreoretinopathy(2 eyes).The duration of follow up in 16 eyes was from 3 to 42 months.The retinal reattachment was in 10 eyes(62.5%),and visual acuity better than0.05 in 8 eyes(50.0%).Four eyes(25.0%)resulted in hypotony. （Chin J Ocul Fundus Dis,1996,12:7-9）