AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included ...AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.展开更多
AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configurati...AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configuration.METHODS:Twenty eyes from 20 patients with idiopathic MH were enrolled.Optical coherence tomography angiography(OCTA)images were obtained before,2 wk,1,and 3 mo after vitrectomy with internal limiting membrane peeling.Preoperative foveal avascular zone(FAZ)area and perimeter and regional vessel density(VD)in both layers were compared according to the 3-month best-corrected visual acuity(BCVA).RESULTS:The BCVA improved from 0.98±0.59(log MAR,Snellen 20/200)preoperatively to 0.30±0.25(Snellen 20/40)at 3 mo postoperatively.The preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA<20/32 group(all P<0.05).A significant reduction was observed in FAZ parameters and all VDs 2 wk postoperatively.Except for deep perifoveal VD,all VDs recovered only to their preoperative values.The postoperative FAZ parameters were lower during follow-up.Decreases in preoperative deep VDs were correlated with worse postoperative BCVA(Pearson’s r=-0.667 and-0.619,respectively).A larger FAZ perimeter(Spearman’s r=-0.524)and a lower deep perifoveal VD preoperatively(Pearson’s r=0.486)were associated with lower healing stage.CONCLUSION:The status of the deep vasculature may be an indicator of visual acuity in patients with a closed MH.Except for the deep perifoveal region,VD recovers only to preoperative levels.展开更多
AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.M...AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.展开更多
AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This mul...AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior 展开更多
AIM: To elucidate the association of treatment modality to vitreoretinal fibrosis and traction retinal detachment(TRD) in Coats' disease.METHODS: A PubMed search for Coats' disease with included studies descri...AIM: To elucidate the association of treatment modality to vitreoretinal fibrosis and traction retinal detachment(TRD) in Coats' disease.METHODS: A PubMed search for Coats' disease with included studies describing eyes with clinical features and treatment course of Coats' disease. Binary logistic regression with fibrosis at presentation and treatment type as independent variables was performed to determine predictors of TRD historically(since 1921) and in the antivascular endothelial growth factor(VEGF) era(since2007). Odds ratios(OR) with 95% confidence intervals(CI)reported.RESULTS: Of 175 articles described 1183 eyes. Vitreoretinal fibrosis increased from presentation(5.4%) to follow-up(15.5%) and TRD increased from 0.44% to 3.9% at follow up. Laser was protective against vitreoretinal fibrosis(OR0.6, 95%CI 0.4-0.9) but TRD was borderline(OR 0.6, 95%CI0.3-1.1). Cryotherapy showed a higher association with TRD(OR 1.9, 95%CI 1.0-3.7) than with vitreoretinal fibrosis(OR 0.8, 95%CI 0.5-1.2). Similarly, intravitreal anti-VEGF alone was not associated with fibrosis(OR 1.1, 95%CI 0.6-1.8) nor TRD(OR 1.1, 95%CI 0.5-2.6) but the combination of laser and anti-VEGF therapy was protective [Fibrosis: 0.1(0.03, 0.35); TRD: 0.05(0.01, 0.23)] compared to anti-VEGF plus cryotherapy(P<0.001). Disease stage ≤2 B or ≥3 A was not associated with TRD.CONCLUSION: Vitreoretinal fibrosis and TRD increase after treatment in Coats' disease. The combination of antiVEGF agents and cryotherapy may lead to higher risk for TRD. Presence of pre-treatment fibrosis is the highest risk factor for post-treatment worsening of vitreoretinal fibrosis and TRD.展开更多
AIM: To report the effectiveness and safety of primary 23-Gauge (G) vitreoretinal surgery for rhegmatogenous retinal detachment (RRD). · METHODS: In this retrospective study, 49 eyes of 49 consecutive patients wh...AIM: To report the effectiveness and safety of primary 23-Gauge (G) vitreoretinal surgery for rhegmatogenous retinal detachment (RRD). · METHODS: In this retrospective study, 49 eyes of 49 consecutive patients who underwent primary 23-G transconjunctival sutureless vitrectomy (TSV) for RRD between January 2007 and July 2009 at our institution were evaluated. · RESULTS: Mean follow-up time was 8.9±7.7 months (1-28 months). Retinal reattachment was achieved with a single operation in 47(95.9%) of 49 eyes. In two eyes (4.1%), retinal redetachment due to new breaks was successfully treated with reoperation using the 23-G TSV system. Mean logMAR visual acuity was 2.01±0.47 preoperatively and 1.3±0.5 postoperatively (P <0.001, Paired t -test). Mean preoperative intraocular pressure (IOP) was 14.1±2.8mmHg. Mean postoperative IOP was 12.3±3.6mmHg at 1 day, 13.1±2.1mmHg at 1 week, 14.3±2.2mmHg at 1 month. Iatrogenic peripheral retinal break was observed in 1 eye(2.0%) intraoperatively. No sutures were required to close the scleral or conjunctival openings, and no eyes required convertion of surgery to 20-G vitrectomy. · CONCLUSION: Primary 23-G TSV system was observed to be effective and safe in the treatment of RRD.展开更多
AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival su...AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.展开更多
Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. T...Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose （FBG） and at 2 h after each meal （post prandial glucose, PBG; 09：00, 13：00, and 19：00 h） after periocular dexamethasone injection. Differences among three groups were determined by q tests. Results The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection （i.e., PBG at 13：00 h）, and were significantly increased at 29：00 h after injection （P〈0.05）. BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups （P〉0.05）, except for PBG at 19：00 h on day 2 after injection （P〈0.05）. Conclusion Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.展开更多
AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL...AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.展开更多
We evaluated the clinical efficacy of free internal limiting membrane(ILM) flap transplantation for the treatment of large macular hole over 500 μm in 42 consecutive patients. Quantified evaluation of the post-operat...We evaluated the clinical efficacy of free internal limiting membrane(ILM) flap transplantation for the treatment of large macular hole over 500 μm in 42 consecutive patients. Quantified evaluation of the post-operative macular anatomy restoration was performed by spectral-domain optical coherence tomography in the 12 mo follow-up. The results showed 41 eyes achieved successful closure(97.6%). Postoperative best corrected visual acuity, ellipsoid layer, and external limiting membrane disruption were significantly improved at all follow-up time points. The central foveal thickness was significantly higher at 1 mo. We concluded that free ILM flap transplantation proves to be effective to achieve anatomical and functional improvement for the treatment of large macular hole.展开更多
AIM： To evaluate the outcomes of vitreoretinal surgery for four different phenotypes of X-linked retinoschisis （XLRS）. METHODS： This study included thirty-one eyes of 25 patients who developed XLRS with severe...AIM： To evaluate the outcomes of vitreoretinal surgery for four different phenotypes of X-linked retinoschisis （XLRS）. METHODS： This study included thirty-one eyes of 25 patients who developed XLRS with severe complications. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All of the patients underwent standard three-port pars plana vitrectomy. All of the eyes were divided into 4 groups before surgery according to a modified classification scheme, with the first three groups as follows： group A, with foveal cystic schisis; group B with macular lamellar schisis; and group C with foveolamellar changes. Peripheral schisis was not present in these 3 groups; however, group D was a complex group with both macular and peripheral changes. One year after surgery, we analyzed the best corrected visual acuity and postoperative anatomical and functional outcomes of these 4 groups. RESULTS： There were 7 eyes in group A （22.6%）, 1 eye in group B （3.2%）, 15 eyes in group C （48.4%） and 8 eyes in group D （25.8%）. Postoperative anatomical and functional outcomes were satisfactory at the last visit, while the mean visual acuity was increased to 0.27±0.11, with a significant difference （t=-1.049, P=0.000） compared with the results before surgery （0.1±0.08）. Visual acuity was improved in 23 eyes （74.2%）. Complications were found in three eyes： two eyes with proliferative vitreoretinopathy and traction retinal detachment 10 and 12mo after surgery, respectively; and one eye with vitreous hemorrhage 15mo after surgery. These eyes were in groups C and D. The retinas remained attached in these 3 eyes after reoperation. CONCLUSION： We should pay greater attention to XLRS with foveolamellar changes because it is the most changeable phenotype. Once complications occur, vitreoretinal surgery can significantly improve visual acuity and restore the anatomic structure of the展开更多
This study examined the clinical features of complications of congenital retinoschisis and the clinical efficacy of vitreoretinal surgery in the treatment of these complications.The clinical efficacy of surgical treat...This study examined the clinical features of complications of congenital retinoschisis and the clinical efficacy of vitreoretinal surgery in the treatment of these complications.The clinical efficacy of surgical treatments was retrospectively analyzed in 10 patients with congenital retinoschisis（10 eyes） complicated with rhegmatogenous retinal detachment（n=5）,vitreous hemorrhage（n=2） and macula-involving schisis（n=1）.All the patients suffered foveal and peripheral schisis.They were treated with scleral buckling（n=1） or vitrectomy（n=9）.After the surgical treatment,the retina was reattached in patients with rhegmatogenous retinal detachment;the refractive media became transparent in those with vitreous hemorrhage;the visual acuity in 80% of patients was improved;no remarkable progression of schisis was found;no severe operative complications occurred.It was concluded that vitreoretinal surgery in the treatment of complications of congenital retinoschisis is safe and effective,and helps improve and maintain the visual function.展开更多
AIM: To assess the presenting clinical features, time from presentation to diagnosis and association with central nervous system(CNS) lymphoma in patients with vitreoretinal lymphoma.METHODS: Retrospective case series...AIM: To assess the presenting clinical features, time from presentation to diagnosis and association with central nervous system(CNS) lymphoma in patients with vitreoretinal lymphoma.METHODS: Retrospective case series of patients diagnosed with vitreoretinal lymphoma between 2009 and 2011 at a single center.RESULTS: Fifteen eyes in 9 patients were included. Common presenting ocular symptoms included blurred vision(78%) and worsening floaters(44%) with an average symptom duration prior to presentation of 88.4 d(range 7-365 d). Common ophthalmic exam findings were vitreous haze(89%) and subretinal lesions(56%). The average time from presentation to diagnosis was 56.3 d(range 16-180 d). All patients were diagnosedwith large B-cell lymphoma according to pathology results. Lymphoma was restricted to the eye in 33%, while 67% of patients had CNS involvement. Of the patients with secondary vitreoretinal lymphoma, 67% initially presented with CNS lymphoma while 33% initially presented with vitreoretinal lymphoma. Of the patients with CNS involvement, memory loss(67%) was the most common presenting symptom.CONCLUSION: Vitreoretinal lymphoma most commonly presents with symptoms of blurred vision and/or worsening floaters and vitreous haze on exam. The average time from presentation to diagnosis may be decreasing with increased awareness among clinicians.展开更多
AIM: To determine whether intravitreal dexamethasone(DEX) implant induces posterior vitreous detachment or not. METHODS: We retrospectively reviewed 810 eyes of 405 patients who underwent intravitreal DEX implantation...AIM: To determine whether intravitreal dexamethasone(DEX) implant induces posterior vitreous detachment or not. METHODS: We retrospectively reviewed 810 eyes of 405 patients who underwent intravitreal DEX implantation due to macular edema caused by diabetic and retinal venous occlusion in our clinic. The eyes having no injection were determined as the control group. The examination findings of the patients before the injection and 3 mo after the injection and optical coherence tomography(OCT) images were scanned. The pre-injection OCT findings and OCT findings of the patients having no posterior vitreous detachment(PVD) and determined to have partial PVD were compared. RESULTS: The separation in vitreoretinal adhesion and total PVD development of DEX-injected 56/208(26.9%) eyes were statistically greater in comparison with the 12/129(9.3%) eyes that had not been injected(P=0.001). PVD development was observed more in the patients that were younger, had larger macula thickness and lower visual acuity. CONCLUSION: It can be stated that intravitreal DEX implant induces PVD development. Prospective, controlled studies are required in order to determine prognosis of vitreoretinal disease in PVD-developed patients and in non-PVD-developed patients.展开更多
Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinica...Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinical diagnosis challenging. Vitreous cells, subretinal lesions and imaging techniques are essential for clinical diagnosis. Importantly, cytopathology/histopathology identification of malignant cells is the gold standard for the diagnosis of PVRL. In addition, molecular detection of immunoglobulin heavy chain (IgH) or T cell receptor (TCR) gene rearrangements, immunophenotyping for cell markers, and cytokine analysis of interleukine-10 elevation are often used as adjunct procedures. Current management of PVRL involves local radiation, intravitreal chemotherapy (methotrexate and rituximab), with or without systemic chemotherapy depending on the involvement of non-ocular tissues. In cases with concomitant PCNSL, systemic high-dose methotrexate/rituximab based therapy in conjunction with local therapy, whole brain radiotherapy and/or autologous stem cell transplantation is considered. Although PVRL normally responds well to initial treatment, high rates of relapse and CNS involvement usually lead to poor prognosis and limited survival. A professional team of medical experts in ophthalmologists, ocular pathologists, neuro-oncologists and hemato-oncologists is essential for optimizing patient management.展开更多
AIM:To compare the efficacy of vitrectomy combined with air or silicone oil in the treatment of idiopathic macular hole(IMH).METHODS:According to the results of high-definition optical coherence tomography(HD-OCT),75 ...AIM:To compare the efficacy of vitrectomy combined with air or silicone oil in the treatment of idiopathic macular hole(IMH).METHODS:According to the results of high-definition optical coherence tomography(HD-OCT),75 cases(75 eyes)of IMH in stage II-IV(Gass stage)in the General Hospital of Chinese PLA from January 2017 to December 2019 were collected for this retrospective study.The best corrected visual acuity(BCVA)and minimum diameter of IMH(MMHD)were measured.Eyes underwent vitrectomy combined with internal limiting membrane peeling operation,and were divided into disinfection air group(30 eyes)and silicone oil group(45 eyes)according to the intraocular tamponade.For MMHD≤400μm(MMHD1),there were 23 eyes in air group and 16 eyes in silicone oil group.For MMHD2>400μm(MMHD2),there were 7 eyes in air group and 29 eyes in silicone oil group.One month after surgery,the closure rates of IMH and BCVA were compared and analyzed.According to HD-OCT,the closure shape was graded with A(bridge closure)and B(good closure).RESULTS:The closure rates of air group and silicone oil group were 86.67%and 95.56%respectively with no significant difference(P>0.05);For MMHD1,those of air group and silicone oil group were 95.65%and 100%respectively with no significant difference(P>0.05);For MMHD2,those of air group and silicone oil group were 57.14%and 93.10%respectively,and those of the silicone oil group were higher than the air group(P<0.05).There was no significant difference in the closure shape grade between MMHD1 air group and silicone oil group(P>0.05).The proportion of Grade B in MMHD2 silicone oil group was higher than that in the air group(P<0.05).BCVA of each group after operation was better than that before operation,and there was no significant difference between air group and silicone oil group.While among them,MMHD1 air group was better than silicone oil group(P<0.05),and there was no significant difference between MMHD2 air group and silicone oil group(P>0.05).CONCLUSION:For smaller IMH(≤400μm),the efficacy of v展开更多
文摘AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.
基金Supported by the National Natural Science Foundation of China(No.81900910,No.81700884)Natural Science Foundation of Zhejiang Province(No.LQ19H120003,No.LGF21H120005)+1 种基金Key Project Jointly Constructed by Zhejiang Pronvince and Ministry(No.WKJ-ZJ-2037)Basic Scientific Research Project of Wenzhou(No.Y20210194)。
文摘AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configuration.METHODS:Twenty eyes from 20 patients with idiopathic MH were enrolled.Optical coherence tomography angiography(OCTA)images were obtained before,2 wk,1,and 3 mo after vitrectomy with internal limiting membrane peeling.Preoperative foveal avascular zone(FAZ)area and perimeter and regional vessel density(VD)in both layers were compared according to the 3-month best-corrected visual acuity(BCVA).RESULTS:The BCVA improved from 0.98±0.59(log MAR,Snellen 20/200)preoperatively to 0.30±0.25(Snellen 20/40)at 3 mo postoperatively.The preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA<20/32 group(all P<0.05).A significant reduction was observed in FAZ parameters and all VDs 2 wk postoperatively.Except for deep perifoveal VD,all VDs recovered only to their preoperative values.The postoperative FAZ parameters were lower during follow-up.Decreases in preoperative deep VDs were correlated with worse postoperative BCVA(Pearson’s r=-0.667 and-0.619,respectively).A larger FAZ perimeter(Spearman’s r=-0.524)and a lower deep perifoveal VD preoperatively(Pearson’s r=0.486)were associated with lower healing stage.CONCLUSION:The status of the deep vasculature may be an indicator of visual acuity in patients with a closed MH.Except for the deep perifoveal region,VD recovers only to preoperative levels.
基金Supported by the National Natural Science Foundation of China (No.81770972,No.81970843)。
文摘AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.
基金Supported by the Program of Shanghai Academic/Technology Research Leader(No.21XD1402700)the Clinical Research Plan of Shenkang Hospital Development Center of Shanghai(No.SHDC2022CRD001).
文摘AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior
基金Unrestricted institutional grant from Research to Prevent Blindness
文摘AIM: To elucidate the association of treatment modality to vitreoretinal fibrosis and traction retinal detachment(TRD) in Coats' disease.METHODS: A PubMed search for Coats' disease with included studies describing eyes with clinical features and treatment course of Coats' disease. Binary logistic regression with fibrosis at presentation and treatment type as independent variables was performed to determine predictors of TRD historically(since 1921) and in the antivascular endothelial growth factor(VEGF) era(since2007). Odds ratios(OR) with 95% confidence intervals(CI)reported.RESULTS: Of 175 articles described 1183 eyes. Vitreoretinal fibrosis increased from presentation(5.4%) to follow-up(15.5%) and TRD increased from 0.44% to 3.9% at follow up. Laser was protective against vitreoretinal fibrosis(OR0.6, 95%CI 0.4-0.9) but TRD was borderline(OR 0.6, 95%CI0.3-1.1). Cryotherapy showed a higher association with TRD(OR 1.9, 95%CI 1.0-3.7) than with vitreoretinal fibrosis(OR 0.8, 95%CI 0.5-1.2). Similarly, intravitreal anti-VEGF alone was not associated with fibrosis(OR 1.1, 95%CI 0.6-1.8) nor TRD(OR 1.1, 95%CI 0.5-2.6) but the combination of laser and anti-VEGF therapy was protective [Fibrosis: 0.1(0.03, 0.35); TRD: 0.05(0.01, 0.23)] compared to anti-VEGF plus cryotherapy(P<0.001). Disease stage ≤2 B or ≥3 A was not associated with TRD.CONCLUSION: Vitreoretinal fibrosis and TRD increase after treatment in Coats' disease. The combination of antiVEGF agents and cryotherapy may lead to higher risk for TRD. Presence of pre-treatment fibrosis is the highest risk factor for post-treatment worsening of vitreoretinal fibrosis and TRD.
文摘AIM: To report the effectiveness and safety of primary 23-Gauge (G) vitreoretinal surgery for rhegmatogenous retinal detachment (RRD). · METHODS: In this retrospective study, 49 eyes of 49 consecutive patients who underwent primary 23-G transconjunctival sutureless vitrectomy (TSV) for RRD between January 2007 and July 2009 at our institution were evaluated. · RESULTS: Mean follow-up time was 8.9±7.7 months (1-28 months). Retinal reattachment was achieved with a single operation in 47(95.9%) of 49 eyes. In two eyes (4.1%), retinal redetachment due to new breaks was successfully treated with reoperation using the 23-G TSV system. Mean logMAR visual acuity was 2.01±0.47 preoperatively and 1.3±0.5 postoperatively (P <0.001, Paired t -test). Mean preoperative intraocular pressure (IOP) was 14.1±2.8mmHg. Mean postoperative IOP was 12.3±3.6mmHg at 1 day, 13.1±2.1mmHg at 1 week, 14.3±2.2mmHg at 1 month. Iatrogenic peripheral retinal break was observed in 1 eye(2.0%) intraoperatively. No sutures were required to close the scleral or conjunctival openings, and no eyes required convertion of surgery to 20-G vitrectomy. · CONCLUSION: Primary 23-G TSV system was observed to be effective and safe in the treatment of RRD.
文摘AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.
文摘Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose （FBG） and at 2 h after each meal （post prandial glucose, PBG; 09：00, 13：00, and 19：00 h） after periocular dexamethasone injection. Differences among three groups were determined by q tests. Results The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection （i.e., PBG at 13：00 h）, and were significantly increased at 29：00 h after injection （P〈0.05）. BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups （P〉0.05）, except for PBG at 19：00 h on day 2 after injection （P〈0.05）. Conclusion Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.
文摘AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.
基金Supported by Hebei Science and Technology Department(Project to Benefit the People No.16277717D)Natural Science Foundation of Hebei Province(No.H2015206249)Second Hospital of Hebei Medical University(No.2h1201508)
文摘We evaluated the clinical efficacy of free internal limiting membrane(ILM) flap transplantation for the treatment of large macular hole over 500 μm in 42 consecutive patients. Quantified evaluation of the post-operative macular anatomy restoration was performed by spectral-domain optical coherence tomography in the 12 mo follow-up. The results showed 41 eyes achieved successful closure(97.6%). Postoperative best corrected visual acuity, ellipsoid layer, and external limiting membrane disruption were significantly improved at all follow-up time points. The central foveal thickness was significantly higher at 1 mo. We concluded that free ILM flap transplantation proves to be effective to achieve anatomical and functional improvement for the treatment of large macular hole.
文摘AIM： To evaluate the outcomes of vitreoretinal surgery for four different phenotypes of X-linked retinoschisis （XLRS）. METHODS： This study included thirty-one eyes of 25 patients who developed XLRS with severe complications. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All of the patients underwent standard three-port pars plana vitrectomy. All of the eyes were divided into 4 groups before surgery according to a modified classification scheme, with the first three groups as follows： group A, with foveal cystic schisis; group B with macular lamellar schisis; and group C with foveolamellar changes. Peripheral schisis was not present in these 3 groups; however, group D was a complex group with both macular and peripheral changes. One year after surgery, we analyzed the best corrected visual acuity and postoperative anatomical and functional outcomes of these 4 groups. RESULTS： There were 7 eyes in group A （22.6%）, 1 eye in group B （3.2%）, 15 eyes in group C （48.4%） and 8 eyes in group D （25.8%）. Postoperative anatomical and functional outcomes were satisfactory at the last visit, while the mean visual acuity was increased to 0.27±0.11, with a significant difference （t=-1.049, P=0.000） compared with the results before surgery （0.1±0.08）. Visual acuity was improved in 23 eyes （74.2%）. Complications were found in three eyes： two eyes with proliferative vitreoretinopathy and traction retinal detachment 10 and 12mo after surgery, respectively; and one eye with vitreous hemorrhage 15mo after surgery. These eyes were in groups C and D. The retinas remained attached in these 3 eyes after reoperation. CONCLUSION： We should pay greater attention to XLRS with foveolamellar changes because it is the most changeable phenotype. Once complications occur, vitreoretinal surgery can significantly improve visual acuity and restore the anatomic structure of the
文摘This study examined the clinical features of complications of congenital retinoschisis and the clinical efficacy of vitreoretinal surgery in the treatment of these complications.The clinical efficacy of surgical treatments was retrospectively analyzed in 10 patients with congenital retinoschisis（10 eyes） complicated with rhegmatogenous retinal detachment（n=5）,vitreous hemorrhage（n=2） and macula-involving schisis（n=1）.All the patients suffered foveal and peripheral schisis.They were treated with scleral buckling（n=1） or vitrectomy（n=9）.After the surgical treatment,the retina was reattached in patients with rhegmatogenous retinal detachment;the refractive media became transparent in those with vitreous hemorrhage;the visual acuity in 80% of patients was improved;no remarkable progression of schisis was found;no severe operative complications occurred.It was concluded that vitreoretinal surgery in the treatment of complications of congenital retinoschisis is safe and effective,and helps improve and maintain the visual function.
基金Supported by Unrestricted departmental funding from Research to Prevent Blindness(New York,NY)
文摘AIM: To assess the presenting clinical features, time from presentation to diagnosis and association with central nervous system(CNS) lymphoma in patients with vitreoretinal lymphoma.METHODS: Retrospective case series of patients diagnosed with vitreoretinal lymphoma between 2009 and 2011 at a single center.RESULTS: Fifteen eyes in 9 patients were included. Common presenting ocular symptoms included blurred vision(78%) and worsening floaters(44%) with an average symptom duration prior to presentation of 88.4 d(range 7-365 d). Common ophthalmic exam findings were vitreous haze(89%) and subretinal lesions(56%). The average time from presentation to diagnosis was 56.3 d(range 16-180 d). All patients were diagnosedwith large B-cell lymphoma according to pathology results. Lymphoma was restricted to the eye in 33%, while 67% of patients had CNS involvement. Of the patients with secondary vitreoretinal lymphoma, 67% initially presented with CNS lymphoma while 33% initially presented with vitreoretinal lymphoma. Of the patients with CNS involvement, memory loss(67%) was the most common presenting symptom.CONCLUSION: Vitreoretinal lymphoma most commonly presents with symptoms of blurred vision and/or worsening floaters and vitreous haze on exam. The average time from presentation to diagnosis may be decreasing with increased awareness among clinicians.
文摘AIM: To determine whether intravitreal dexamethasone(DEX) implant induces posterior vitreous detachment or not. METHODS: We retrospectively reviewed 810 eyes of 405 patients who underwent intravitreal DEX implantation due to macular edema caused by diabetic and retinal venous occlusion in our clinic. The eyes having no injection were determined as the control group. The examination findings of the patients before the injection and 3 mo after the injection and optical coherence tomography(OCT) images were scanned. The pre-injection OCT findings and OCT findings of the patients having no posterior vitreous detachment(PVD) and determined to have partial PVD were compared. RESULTS: The separation in vitreoretinal adhesion and total PVD development of DEX-injected 56/208(26.9%) eyes were statistically greater in comparison with the 12/129(9.3%) eyes that had not been injected(P=0.001). PVD development was observed more in the patients that were younger, had larger macula thickness and lower visual acuity. CONCLUSION: It can be stated that intravitreal DEX implant induces PVD development. Prospective, controlled studies are required in order to determine prognosis of vitreoretinal disease in PVD-developed patients and in non-PVD-developed patients.
基金This work was supported by State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University[2014QN09]the National Eye Institute Intramural Research Program.
文摘Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinical diagnosis challenging. Vitreous cells, subretinal lesions and imaging techniques are essential for clinical diagnosis. Importantly, cytopathology/histopathology identification of malignant cells is the gold standard for the diagnosis of PVRL. In addition, molecular detection of immunoglobulin heavy chain (IgH) or T cell receptor (TCR) gene rearrangements, immunophenotyping for cell markers, and cytokine analysis of interleukine-10 elevation are often used as adjunct procedures. Current management of PVRL involves local radiation, intravitreal chemotherapy (methotrexate and rituximab), with or without systemic chemotherapy depending on the involvement of non-ocular tissues. In cases with concomitant PCNSL, systemic high-dose methotrexate/rituximab based therapy in conjunction with local therapy, whole brain radiotherapy and/or autologous stem cell transplantation is considered. Although PVRL normally responds well to initial treatment, high rates of relapse and CNS involvement usually lead to poor prognosis and limited survival. A professional team of medical experts in ophthalmologists, ocular pathologists, neuro-oncologists and hemato-oncologists is essential for optimizing patient management.
文摘AIM:To compare the efficacy of vitrectomy combined with air or silicone oil in the treatment of idiopathic macular hole(IMH).METHODS:According to the results of high-definition optical coherence tomography(HD-OCT),75 cases(75 eyes)of IMH in stage II-IV(Gass stage)in the General Hospital of Chinese PLA from January 2017 to December 2019 were collected for this retrospective study.The best corrected visual acuity(BCVA)and minimum diameter of IMH(MMHD)were measured.Eyes underwent vitrectomy combined with internal limiting membrane peeling operation,and were divided into disinfection air group(30 eyes)and silicone oil group(45 eyes)according to the intraocular tamponade.For MMHD≤400μm(MMHD1),there were 23 eyes in air group and 16 eyes in silicone oil group.For MMHD2>400μm(MMHD2),there were 7 eyes in air group and 29 eyes in silicone oil group.One month after surgery,the closure rates of IMH and BCVA were compared and analyzed.According to HD-OCT,the closure shape was graded with A(bridge closure)and B(good closure).RESULTS:The closure rates of air group and silicone oil group were 86.67%and 95.56%respectively with no significant difference(P>0.05);For MMHD1,those of air group and silicone oil group were 95.65%and 100%respectively with no significant difference(P>0.05);For MMHD2,those of air group and silicone oil group were 57.14%and 93.10%respectively,and those of the silicone oil group were higher than the air group(P<0.05).There was no significant difference in the closure shape grade between MMHD1 air group and silicone oil group(P>0.05).The proportion of Grade B in MMHD2 silicone oil group was higher than that in the air group(P<0.05).BCVA of each group after operation was better than that before operation,and there was no significant difference between air group and silicone oil group.While among them,MMHD1 air group was better than silicone oil group(P<0.05),and there was no significant difference between MMHD2 air group and silicone oil group(P>0.05).CONCLUSION:For smaller IMH(≤400μm),the efficacy of v
