AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（...AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（PSR group）, and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity（BCVA）, and macular scans by optical coherence tomography（OCT） were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS： There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group（30.78±1.30 mm）（P 〈0.01）, and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group（-19.18 ±2.12 D）（P 〈0.01）. A statistically significant difference in BCVA was found between the PSR group（0.51 ±0.25 log MAR） and the control group（0.62±0.26 log MAR） at the postoperative 5-year follow-up（P 〈0.01）. There were no serious complications during the 5-year follow-up period.·CONCLUSION： PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.展开更多
AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study in...AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR （PSR group） for 6 to 18mo ago, and 30 age and myopia matched eyes without PSR surgery as control group. Macular, choriocapillaris and radial peripapillary capillary （RPC） flow density were measured by OCTA, and the measurements were compared between groups. RESULTS： OCTA found no significant differences in macular flow density between PSR and control groups. For the superficial flow, whole enface flow density （WED）, fovea density （FD）, and parafoveal density （PD） were 46.55%±5.19% vs 47.29%±4.12% （P=0.542）, 31.45%±6.35% vs 31.17%±4.48% （P=0.841）, and 48.82%±5.66% vs 49.21%±4.15% （P=0.756） in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07%±5.78% vs 53.95%±4.62% （P=0.168）, 29.62%±6.55% vs 29.50%±6.38% （P=0.940）, and 56.93%±6.17% vs 58.15%±5.13% （P=0.407） in PSR and control groups, respectively. The choriocapillary flow density was 61.18±3.25% in PSR group vs 60.88%±2.56% in control group （P=0.692）. Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77% vs 48.11%±4.57% （P=0.813）, 45.47%±11.44% vs 46.68%±9.02% （P=0.709）, 54.32%±5.29% vs 52.47%±6.62% （P=0.349） in PSR and control groups, respectively.CONCLUSION： OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.展开更多
Optical coherence tomography angiography(Angio-OCT) has introduced a new non-invasive,quantitative method to assess superficial and deep capillary networks of the retina.In this study,we investigated macular retinal t...Optical coherence tomography angiography(Angio-OCT) has introduced a new non-invasive,quantitative method to assess superficial and deep capillary networks of the retina.In this study,we investigated macular retinal thickness and flow density change following posterior scleral reinforcement(PSR) surgery,using an RTVue XR Avanti Angio-OCT,in patients with pathological myopia.A total of 13 patients with pathological myopia were recruited and all patients completed the 6 months follow-up visit.Data from 22 eyes were used in this study.The mean age was 36.23±15.29 years,and 43%(n=6) were men.Spherical equivalent refractive error(SE) ranged from –8.0 to –24.0 D.Postoperative axial length,best-corrected visual acuity and SE did not change significantly at each follow-up,compared with pre-operative measures(P>0.05).Postoperative flow density of superficial and deep retinal layers at each sector did not change significantly at each follow-up,compared with preoperative measures(P>0.05).However,we found significant decrease in retinal thickness of parafovea-inferior sector after PSR surgery(P<0.01),indicating potential relaxation of vitreofoveal traction after PSR surgery.展开更多
With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remod...With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remodeling, primarily dependent on the scleral extracellular matrix(ECM) changes, is significantly linked to eye lengthening.Scleral remodeling plays a critical function in the incidence and progression of myopia.This mini-review will focus on recent research progress of scleral remodeling in the hope of providing new ideas for the prophylaxis and treatment of myopia.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 analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 fema...AIM:To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 females with a mean age of 54.8±14.1y)who demonstrated at least one inferior recurrence of RRD were included in this retrospective study.All patients were categorized as having received either circular scleral buckling(SB),pars plana vitrectomy(PPV),a combination of SB and PPV(SB+PPV),PPV with retinotomy(PPV+RT),or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade(PPV+RT+pPFCL).All cases were followed up until successful retinal reattachment or third recurrence.The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and bestcorrected visual acuity(BCVA).RESULTS:After the treatment of the first recurrence,the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV(P=0.0012),PPV+RT(P=0.028),or PPV+RT+pPFCL(P=0.047)group.There was no statistically significant difference between PPV+SB,PPV+RT,and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence(42 eyes).However,there was a statistically significant(P=0.016)trend towards a decrease of recurrence rate after PPV+RT+pPFCL.There was no statistically significant improvement of BCVA in either study group(P>0.05)after both first and second recurrence surgery.The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence.CONCLUSION:Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV.RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes,however,without functional improvement.展开更多
AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro. The mRNA levels of BMP-2 and...AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro. The mRNA levels of BMP-2 and BMPRs in HSFs were assayed by reverse transcription-polymerase chain reaction (RT-PCR). The protein distributions of BMP-2 and BMPRs in HSFs were further detected by immunocytofluorescence and western blot. Their protein expression was also detected in frozen human posterior scleral sections by immunohistofluorescence. RESULTS: BMP-2 and BMPRs were expressed in both HSFs and human sclera not only at mRNA level but also at protein level. The expressions of BMPRIA and BMPRII were higher than that of BMPRIB in the cytoplasm and cell membrane of HSFs in vitra Western blot further verified the results of immunocytofluorescence. In human sclera, BMP2, BMPR IB and BMPR II were found to be expressed in the cytomatrix of HSF, and weak signal was detected about BMPRIA. CONCLUSION: BMP-2 and all three subtypes of BMPRs were found in HSFs and may play a role in scleral remodeling.展开更多
The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera ...The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities（BCVAs） of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.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
AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted...AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18 y having>7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation.Primary outcome was improvement in best corrected visual acuity(BCVA)and secondary outcomes were assessment of intraocular lens(IOL)tilt using ultrasound biomicroscopy(UBM),mean change in astigmatism at last follow-up of 1 y and associated complications.RESULTS:The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45(log MAR)respectively(P=0.001)at last follow-up.The mean astigmatism preoperatively and postoperatively was-4.17±2.69 D and-1.86±1.25 D respectively(P=0.011).Significant IOL tilt(>5 degrees)was present in 5 cases.The mean percentage endothelial loss was 3.65%±1.92%.The most serious complication encountered was retinal detachment seen in 2 cases.CONCLUSION:SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection.We recommend caution in children having white-to-white distance>12 mm and presence of peripheral retinal degenerations.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 present a novel scleral flap suturing technique for filtering glaucoma surgery in order to control high postoperative intraocular pressure（IOP）.METHODS：Description of ‘the accordion suture＇ technique for ...AIM：To present a novel scleral flap suturing technique for filtering glaucoma surgery in order to control high postoperative intraocular pressure（IOP）.METHODS：Description of ‘the accordion suture＇ technique for mitomycin C augmented trabeculectomy.In cases of postoperative high IOP,pulling the loop of the suture helps to lift up the scleral flap by an even pressure on both edges.By means of this technique,the scleral flap opens up in an ‘‘accordion＇＇ manner,thus preventing flap obstruction and providing adequate aqueous flow.RESULTS：Our study group consisted of 8 eyes of 8 patients with neovascular glaucoma.Mean age of the subjects was 67.42±8.21 y and female/male ratio was 4/4.Mean preoperative IOP was 37±7.48 mm Hg.Mitomycin C augmented trabeculectomy was carried out on the subjects without any complications.The scleral flap closure is performed with three separate sutures;initially,our accordion suture through the center of the flap,and two releasable sutures on both corners.All the patients received removal of two side releasable sutures concomitant with pulling the accordion suture,without any complications.The average traction time was 3.5±0 wk postoperatively.The mean postoperative IOP was 11.37±2.72 mm Hg.No suture related complications were observed.CONCLUSION：This technique can be the suture of choice for filtering glaucoma surgery in experienced hands by its easy learning curve for precisely indicated patients.展开更多
基金Supported by the Overseas Training Program for Medical Academic Leaders of Henan Province(No.2014005)the Project of Medical Science and Technology of f Henan Province(No.201304007)the Development Plan of Science and Technology of Henan Province(No.142102310110)
文摘AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（PSR group）, and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity（BCVA）, and macular scans by optical coherence tomography（OCT） were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS： There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group（30.78±1.30 mm）（P 〈0.01）, and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group（-19.18 ±2.12 D）（P 〈0.01）. A statistically significant difference in BCVA was found between the PSR group（0.51 ±0.25 log MAR） and the control group（0.62±0.26 log MAR） at the postoperative 5-year follow-up（P 〈0.01）. There were no serious complications during the 5-year follow-up period.·CONCLUSION： PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.
基金Supported by National Natural Science Foundation of China(No.81570891No.81272981)+4 种基金the Beijing Municipal Administration of Hospitals'Ascent Plan(No.DFL20150201)Science&Technology Project of Beijing Municipal Science&Technology Commission(No.Z151100001615052)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX201307)Beijing Natural Science Foundation(No.7151003)Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau(No.2014-2-003)
文摘AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR （PSR group） for 6 to 18mo ago, and 30 age and myopia matched eyes without PSR surgery as control group. Macular, choriocapillaris and radial peripapillary capillary （RPC） flow density were measured by OCTA, and the measurements were compared between groups. RESULTS： OCTA found no significant differences in macular flow density between PSR and control groups. For the superficial flow, whole enface flow density （WED）, fovea density （FD）, and parafoveal density （PD） were 46.55%±5.19% vs 47.29%±4.12% （P=0.542）, 31.45%±6.35% vs 31.17%±4.48% （P=0.841）, and 48.82%±5.66% vs 49.21%±4.15% （P=0.756） in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07%±5.78% vs 53.95%±4.62% （P=0.168）, 29.62%±6.55% vs 29.50%±6.38% （P=0.940）, and 56.93%±6.17% vs 58.15%±5.13% （P=0.407） in PSR and control groups, respectively. The choriocapillary flow density was 61.18±3.25% in PSR group vs 60.88%±2.56% in control group （P=0.692）. Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77% vs 48.11%±4.57% （P=0.813）, 45.47%±11.44% vs 46.68%±9.02% （P=0.709）, 54.32%±5.29% vs 52.47%±6.62% （P=0.349） in PSR and control groups, respectively.CONCLUSION： OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.
基金supported by the Priming Scientific Research Foundation for the junior researcher in Beijing Tongren Hospital,Capital Medical University(2018-YJJ-ZZL-034)
文摘Optical coherence tomography angiography(Angio-OCT) has introduced a new non-invasive,quantitative method to assess superficial and deep capillary networks of the retina.In this study,we investigated macular retinal thickness and flow density change following posterior scleral reinforcement(PSR) surgery,using an RTVue XR Avanti Angio-OCT,in patients with pathological myopia.A total of 13 patients with pathological myopia were recruited and all patients completed the 6 months follow-up visit.Data from 22 eyes were used in this study.The mean age was 36.23±15.29 years,and 43%(n=6) were men.Spherical equivalent refractive error(SE) ranged from –8.0 to –24.0 D.Postoperative axial length,best-corrected visual acuity and SE did not change significantly at each follow-up,compared with pre-operative measures(P>0.05).Postoperative flow density of superficial and deep retinal layers at each sector did not change significantly at each follow-up,compared with preoperative measures(P>0.05).However,we found significant decrease in retinal thickness of parafovea-inferior sector after PSR surgery(P<0.01),indicating potential relaxation of vitreofoveal traction after PSR surgery.
文摘With the increasing prevalence in recent years, myopia has become an essential global health concern.In most instances, an increased axial length of the eye is the structural cause of nearsightedness.The scleral remodeling, primarily dependent on the scleral extracellular matrix(ECM) changes, is significantly linked to eye lengthening.Scleral remodeling plays a critical function in the incidence and progression of myopia.This mini-review will focus on recent research progress of scleral remodeling in the hope of providing new ideas for the prophylaxis and treatment of myopia.
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.
文摘AIM:To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 females with a mean age of 54.8±14.1y)who demonstrated at least one inferior recurrence of RRD were included in this retrospective study.All patients were categorized as having received either circular scleral buckling(SB),pars plana vitrectomy(PPV),a combination of SB and PPV(SB+PPV),PPV with retinotomy(PPV+RT),or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade(PPV+RT+pPFCL).All cases were followed up until successful retinal reattachment or third recurrence.The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and bestcorrected visual acuity(BCVA).RESULTS:After the treatment of the first recurrence,the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV(P=0.0012),PPV+RT(P=0.028),or PPV+RT+pPFCL(P=0.047)group.There was no statistically significant difference between PPV+SB,PPV+RT,and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence(42 eyes).However,there was a statistically significant(P=0.016)trend towards a decrease of recurrence rate after PPV+RT+pPFCL.There was no statistically significant improvement of BCVA in either study group(P>0.05)after both first and second recurrence surgery.The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence.CONCLUSION:Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV.RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes,however,without functional improvement.
基金National Natural Science Foundation of China (No.81070753)Fundamental Research Funds of State Key Laboratory of Ophthalmology,China(No.2010C02)
文摘AIM: To investigate the distribution of bone morphogenetic protein receptors (BMPRs) in human scleral fibroblsasts (HSFs) and in human sclera. METHODS: Primary HSFs were cultured in vitro. The mRNA levels of BMP-2 and BMPRs in HSFs were assayed by reverse transcription-polymerase chain reaction (RT-PCR). The protein distributions of BMP-2 and BMPRs in HSFs were further detected by immunocytofluorescence and western blot. Their protein expression was also detected in frozen human posterior scleral sections by immunohistofluorescence. RESULTS: BMP-2 and BMPRs were expressed in both HSFs and human sclera not only at mRNA level but also at protein level. The expressions of BMPRIA and BMPRII were higher than that of BMPRIB in the cytoplasm and cell membrane of HSFs in vitra Western blot further verified the results of immunocytofluorescence. In human sclera, BMP2, BMPR IB and BMPR II were found to be expressed in the cytomatrix of HSF, and weak signal was detected about BMPRIA. CONCLUSION: BMP-2 and all three subtypes of BMPRs were found in HSFs and may play a role in scleral remodeling.
文摘The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities（BCVAs） of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.
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AIM:To evaluate functional outcome of sutureless scleral tunnel intraocular lens(SSTIOL)in children with crystalline lens subluxation of more than 7 clock hours.METHODS:A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18 y having>7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation.Primary outcome was improvement in best corrected visual acuity(BCVA)and secondary outcomes were assessment of intraocular lens(IOL)tilt using ultrasound biomicroscopy(UBM),mean change in astigmatism at last follow-up of 1 y and associated complications.RESULTS:The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45(log MAR)respectively(P=0.001)at last follow-up.The mean astigmatism preoperatively and postoperatively was-4.17±2.69 D and-1.86±1.25 D respectively(P=0.011).Significant IOL tilt(>5 degrees)was present in 5 cases.The mean percentage endothelial loss was 3.65%±1.92%.The most serious complication encountered was retinal detachment seen in 2 cases.CONCLUSION:SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection.We recommend caution in children having white-to-white distance>12 mm and presence of peripheral retinal degenerations.
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.
文摘AIM：To present a novel scleral flap suturing technique for filtering glaucoma surgery in order to control high postoperative intraocular pressure（IOP）.METHODS：Description of ‘the accordion suture＇ technique for mitomycin C augmented trabeculectomy.In cases of postoperative high IOP,pulling the loop of the suture helps to lift up the scleral flap by an even pressure on both edges.By means of this technique,the scleral flap opens up in an ‘‘accordion＇＇ manner,thus preventing flap obstruction and providing adequate aqueous flow.RESULTS：Our study group consisted of 8 eyes of 8 patients with neovascular glaucoma.Mean age of the subjects was 67.42±8.21 y and female/male ratio was 4/4.Mean preoperative IOP was 37±7.48 mm Hg.Mitomycin C augmented trabeculectomy was carried out on the subjects without any complications.The scleral flap closure is performed with three separate sutures;initially,our accordion suture through the center of the flap,and two releasable sutures on both corners.All the patients received removal of two side releasable sutures concomitant with pulling the accordion suture,without any complications.The average traction time was 3.5±0 wk postoperatively.The mean postoperative IOP was 11.37±2.72 mm Hg.No suture related complications were observed.CONCLUSION：This technique can be the suture of choice for filtering glaucoma surgery in experienced hands by its easy learning curve for precisely indicated patients.
