ObjectiveTo evaluate the assistant effect of intraoperative OCT (iOCT) in vitreous retinal surgery for macular disease.MethodsA retrospective case study. A total of 71 patients (71 eyes) with macular disease who underwent vitrectomy in Eye Hospital of Wenzhou Medical University at Hangzhou from June 2015 to September 2016 were collected. There were 24 males (24 eyes) and 47 females (47 eyes), aged from 25 to 78 years, with the mean age of 63.35±10.01 years. Among 71 eyes, there were 26 eyes with idiopathic macular hole, 42 eyes with idiopathic epiretinal membrane, 3 eyes with vitreomacular traction syndrome. The examination of iOCT was performed on the patients during 23G minimally invasive vitreoretinal surgery combined with internal limiting membrane peeling. Use observational method to compare the difference between result of iOCT and observation under the microscope, record the change of treatment strategy.ResultsEight eyes (11.27%) iOCT results were different from the surgeon’s observation, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome. The treatment strategy was changed in 8 eyes (11.27%) based on iOCT result, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome.ConclusionsiOCT can help the surgeon find some subtle morphological changes which can hardly be seen by eyes. The surgeon can change and optimize the treatment strategy based on the result of iOCT.
ObjectiveTo observe and preliminarily analyze the risk factors related to silicone oil dependence after pars plana vitrectomy (PPV) in open globe injuries (OGI) . MethodsA retrospective clinical study. This study included 211 patients with OGI who received PPV treatment from January 1, 2005 to December 31, 2016 in Eye Injury Vitrectomy Study database. Silicone oil dependence was defined as the intraocular pressure ＜10 mm Hg (1 mm Hg= 0.133 kPa) in silicone oil tamponade eye 6 months after PPV. The patient's age, intraocular pressure, type of injury, length of eyeball wound, as well as the presence of ciliary body injury, choroidal injury, and retinal resection and/or defect area were recorded in detail. Logistic multifactorial regression analyzed the correlation between age, eye wound length and ciliary body iinjury, choroidal injury and retinal resection and/or defect severity and silicone oil dependence. Results211 OGI eyes underwent vitrectomy were included, the mean age of the study population was 32.93 years (range 1-73 years), and the median follow-up period was 20.06 months (range 5.85-90.58 months). Among the 211 eyes, 121 (57.3%, 121/211), 52 (24.6%, 52/211), 23 (10.9%, 23/211) and 15 (7.1%, 15/211) were rupture, perforation, intraocular foreign bodies and penetrating injury, respectively. 98 eyes (46.4%, 98/211) of silicone oil dependence in total, among them, 64 (65.3%, 64/98), 19 (19.4%, 19/98), 9 (9.2%, 9/98) and 6 (6.1%, 6/98) eyes were rupture, perforation, intraocular foreign body and penetrating injury, respectively. Correlation analysis revealed that silicone oil dependence was significantly associated with ciliary body injury [odds ratio (OR) = 2.150, 95% confidence interval (CI) 1.052-4.393], choroidal injury (OR=3.233, 95%CI 1.454-7.191), and retinal injury (OR=2.731, 95%CI 1.393-5.353). No correlation was found with age (OR= 0.981, 95%CI 0.960-1.002) or ocular wound length (OR=1.716, 95%CI 0.987-2.984) (P＞0.05). ConclusionSilicone oil dependency following PPV in OGIs are associated with ciliary body, choroidal, and retinal injuries, but no association with age or length of the ocular wound.