AIM:Tocomparetheeffectsandcomplicationsof direc cyclopexy (DC) versus vitrectomy, endophotocoagulation, and gas/silicone oil endotamponade (VEE) treatment in patients with cyclodialysis and persistent hypotony.METHODS...AIM:Tocomparetheeffectsandcomplicationsof direc cyclopexy (DC) versus vitrectomy, endophotocoagulation, and gas/silicone oil endotamponade (VEE) treatment in patients with cyclodialysis and persistent hypotony.METHODS: This is a prospective, comparative, non-randomized clinical trial which includes 52 patients with cyclodialysis and persisting hypotony. Fifty-two patients suffering from cyclodialysis and persistent hypotony in one eye were divided into 2 groups (groups DC and VEE) and treated, respectively, with direct cyclopexy or vitrectomy, endophotocoagulation, and gas/silicone oil endotamponade. The patients were followed up for 12 months. Assessments included best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV) and subjective rating of the pain caused by the treatments.RESULTS: After a follow-up of 12 months, significan improvement was seen in postoperative mean BCVA, IOP, ACD and ACV in both treatment groups (which were not significantly different from each other). The success rates for the treatments were not significantly different (DC: 50.0% vs VEE: 62.5% , P =0.383). Postoperative morbidity of cataract and subjective pain rating were significantly higher in the VEE group vs the DC group (P =0.003 and P 【0.001 respectively).CONCLUSION: DC and VEE were effective surgica procedures in treating patients with cyclodialysis and persistent hypotony. Patients had better tolerance to DC treatment and VEE was more likely lead to cataract complications. Taking into consideration the ease of the operation, success rate, and patient comfort, DC treatment seems preferable to VEE treatment in patients with simple cyclodialysis. While VEE has the advantage of treating patients with cyclodialysis combined with vitreous hemorrhage.展开更多
AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a re...AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.展开更多
·AIM: To report outcomes of endoscopy-assisted vitrectomy(EAV) in patients with chronic hypotony following severe ocular trauma or vitrectomy.·METHODS: This was a retrospective, noncomparative case series. C...·AIM: To report outcomes of endoscopy-assisted vitrectomy(EAV) in patients with chronic hypotony following severe ocular trauma or vitrectomy.·METHODS: This was a retrospective, noncomparative case series. Ciliary bodies were evaluated using ultrasound biomicroscopy pre-operatively and direct visualisation intraoperatively. All selected individuals(seven patients/seven eyes) underwent EAV. Removal of ciliary membrane and traction, gas/silicone oil tamponade(GT/SOT), and scleral buckling(SB) were performed in selected eyes. Outcome measurements mainly included intraocular pressure(IOP) and best-corrected visual acuity(BCVA).·RESULTS: Seven eyes from 7 male aphakic patients with a mean age of 45(range, 20-68)y were included in this study;the average follow-up time was 12(9-15)mo. GT was performed in 2 eyes;membrane peeling(MP) and SOT in 2 eyes;and MP, SOT, and SB in 3 eyes. The mean preand post-operative IOP were 4.5(range, 4.0±0.11 to 4.8±0.2) mm Hg and 9.9(range, 5.6±0.17 to 12.1±0.2) mm Hg at 52wk(12mo), respectively. BCVA improved in six eyes;one eye still showed light perception, and no bulbi phthisis was observed.·CONCLUSION: Endoscopy offers improved judgment and recognition and has an improved prognosis for chronic hypotony. Therefore, endoscopy can be an effective and promising operative technique for chronic traumatic hypotony management.展开更多
The study compared anatomical and functional outcome of a novel technique of encirclage and cryotherapy with the conventional argon laser in the management of traumatic cyclodialysis cleft in 19 patients(10: encirclag...The study compared anatomical and functional outcome of a novel technique of encirclage and cryotherapy with the conventional argon laser in the management of traumatic cyclodialysis cleft in 19 patients(10: encirclage and 9: argon laser). The postoperative anatomical success was taken as rise in intraocular pressure(IOP) more than 6 mm Hg or the closure of cleft on gonioscopy or ultrasound biomicroscopy(UBM). Visual outcome was measured as change in logMAR visual acuity. Traumatic cataract and hypotony were present in majority. IOP>6 mm Hg was noted in 90% of encirclage group and in 77.70% of argon laser group. Two cases had non-closure of cleft. Encirclage is comparable to argon laser in terms of anatomical and functional success with possible advantage of single procedure and use in cases with failed laser.展开更多
AIMTo determine the effectiveness of pharmacological and interventional treatment of hypotony and flat anterior chamber (FAC) resulting from glaucoma filtration surgery.METHODSWe retrospectively examined the medical r...AIMTo determine the effectiveness of pharmacological and interventional treatment of hypotony and flat anterior chamber (FAC) resulting from glaucoma filtration surgery.METHODSWe retrospectively examined the medical records of fifty-two trabeculectomy patients (52 eyes) who developed postoperative hypotony and FAC. The management and associated complications of hypotony, changing intraocular pressure (IOP) and best corrected visual acuity (BCVA) were evaluated.RESULTOf the 52 patients with hypotony, 29 (56%) had a grade 1 FAC, 21 (40%) had a grade 2 FAC, and only 2 had a grade 3 FAC. There was no significant difference between the mean preoperative IOP and the mean IOP at three and six months after surgery. Thirteen eyes (25%) required antiglaucomatous medication three months after surgery. The mean BCVA at 6mo after surgery was significantly reduced as compared with the mean preoperative BCVA.CONCLUSIONHypotonia and FAC following trabeculectomy are associated with troublesome complications that require pharmacological and/or surgical treatment. Thus, close follow-up is essential for affected patients.展开更多
AIM: To evaluate the incidence and risk factors of hypotony in patients with blunt ocular trauma. METHODS: The medical records of 145 patients with blunt ocular trauma were reviewed. Hypotony was defined as an average...AIM: To evaluate the incidence and risk factors of hypotony in patients with blunt ocular trauma. METHODS: The medical records of 145 patients with blunt ocular trauma were reviewed. Hypotony was defined as an average intraocular pressure (IOP) of 5mmHg or less for three times. RESULTS: Among these 145 patients, hypotony was noted in 10 (6.9%) patients. The rate of hypotony in patients with ciliochoroidal detachment was 66.7% (2 out of 3 eyes), and 5.6% (8 out of 142 eyes) in patients without ciliochoroidal detachment,the difference was statistically significant (P=0.003). The rate of hypotony in patients with traumatic retinal detachment was 18.5% (5 out of 27 eyes), and 4.2% (5 out of 118 eyes) in patients without traumatic retinal detachment, the difference was statistically significant (P=0.026). The rate of hypotony in the patients with anterior proliferative vitreoretinopathy was 42.9% (3 out of 7 eyes) and 5.1% (7 out of 138 eyes) in the patients without anterior proliferative vitreoretinopathy, the difference was statistically significant(P=0.002). CONCLUSION: Ocular hypotension is a complication of blunt ocular trauma. The risk factors include ciliochoroidal detachment, traumatic retinal detachment, and anterior proliferative vitreoretinopathy.展开更多
目的:探讨外伤性睫状体解离及其并发症的临床治疗效果。方法:我院1993-01/2003-06共收治钝挫伤所致的外伤性睫状体解离19例(19眼),男12例,女7例,年龄6～44(平均25)岁。就诊时眼压为0～10平均2.42)mmHg。14例行睫状体显微缝合固定术,其中...目的:探讨外伤性睫状体解离及其并发症的临床治疗效果。方法:我院1993-01/2003-06共收治钝挫伤所致的外伤性睫状体解离19例(19眼),男12例,女7例,年龄6～44(平均25)岁。就诊时眼压为0～10平均2.42)mmHg。14例行睫状体显微缝合固定术,其中3例联合巩膜环扎局部冷凝;4例行改良的睫状体缝合固定术—平行于角巩膜缘、不切透深层巩膜,并重叠缝合。3例行保守治疗,2例行氩激光光凝。结果:在14例行睫状体显微缝合固定术病例中,一次手术成功者9例(64.3%);二次手术成功者3例21.4%);三次手术成功者2例(14.3%)。术后随访时间1月～8a,平均眼压11.24mmHg,较术前有明显提高(Wilcoxon-Mann-Whitney, P =0.0052)。最后随访视力较术前有明显提高(Wilcoxon signrank, P =0.012)。结论:睫状体缝合固定术是有效的治疗外伤性睫状体解离的手段;改良的手术方法可进一步提高成功率;超声生物显微镜可准确诊断外伤性睫状体解离,对手术成功有重要帮助。展开更多
文摘AIM:Tocomparetheeffectsandcomplicationsof direc cyclopexy (DC) versus vitrectomy, endophotocoagulation, and gas/silicone oil endotamponade (VEE) treatment in patients with cyclodialysis and persistent hypotony.METHODS: This is a prospective, comparative, non-randomized clinical trial which includes 52 patients with cyclodialysis and persisting hypotony. Fifty-two patients suffering from cyclodialysis and persistent hypotony in one eye were divided into 2 groups (groups DC and VEE) and treated, respectively, with direct cyclopexy or vitrectomy, endophotocoagulation, and gas/silicone oil endotamponade. The patients were followed up for 12 months. Assessments included best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV) and subjective rating of the pain caused by the treatments.RESULTS: After a follow-up of 12 months, significan improvement was seen in postoperative mean BCVA, IOP, ACD and ACV in both treatment groups (which were not significantly different from each other). The success rates for the treatments were not significantly different (DC: 50.0% vs VEE: 62.5% , P =0.383). Postoperative morbidity of cataract and subjective pain rating were significantly higher in the VEE group vs the DC group (P =0.003 and P 【0.001 respectively).CONCLUSION: DC and VEE were effective surgica procedures in treating patients with cyclodialysis and persistent hypotony. Patients had better tolerance to DC treatment and VEE was more likely lead to cataract complications. Taking into consideration the ease of the operation, success rate, and patient comfort, DC treatment seems preferable to VEE treatment in patients with simple cyclodialysis. While VEE has the advantage of treating patients with cyclodialysis combined with vitreous hemorrhage.
文摘AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.
基金Supported by the Guangdong Province Natural Science Foundation (No.2019A1515011732)Guangzhou Science and Technology Foundation of Guangdong Province (No.202002030413)。
文摘·AIM: To report outcomes of endoscopy-assisted vitrectomy(EAV) in patients with chronic hypotony following severe ocular trauma or vitrectomy.·METHODS: This was a retrospective, noncomparative case series. Ciliary bodies were evaluated using ultrasound biomicroscopy pre-operatively and direct visualisation intraoperatively. All selected individuals(seven patients/seven eyes) underwent EAV. Removal of ciliary membrane and traction, gas/silicone oil tamponade(GT/SOT), and scleral buckling(SB) were performed in selected eyes. Outcome measurements mainly included intraocular pressure(IOP) and best-corrected visual acuity(BCVA).·RESULTS: Seven eyes from 7 male aphakic patients with a mean age of 45(range, 20-68)y were included in this study;the average follow-up time was 12(9-15)mo. GT was performed in 2 eyes;membrane peeling(MP) and SOT in 2 eyes;and MP, SOT, and SB in 3 eyes. The mean preand post-operative IOP were 4.5(range, 4.0±0.11 to 4.8±0.2) mm Hg and 9.9(range, 5.6±0.17 to 12.1±0.2) mm Hg at 52wk(12mo), respectively. BCVA improved in six eyes;one eye still showed light perception, and no bulbi phthisis was observed.·CONCLUSION: Endoscopy offers improved judgment and recognition and has an improved prognosis for chronic hypotony. Therefore, endoscopy can be an effective and promising operative technique for chronic traumatic hypotony management.
文摘The study compared anatomical and functional outcome of a novel technique of encirclage and cryotherapy with the conventional argon laser in the management of traumatic cyclodialysis cleft in 19 patients(10: encirclage and 9: argon laser). The postoperative anatomical success was taken as rise in intraocular pressure(IOP) more than 6 mm Hg or the closure of cleft on gonioscopy or ultrasound biomicroscopy(UBM). Visual outcome was measured as change in logMAR visual acuity. Traumatic cataract and hypotony were present in majority. IOP>6 mm Hg was noted in 90% of encirclage group and in 77.70% of argon laser group. Two cases had non-closure of cleft. Encirclage is comparable to argon laser in terms of anatomical and functional success with possible advantage of single procedure and use in cases with failed laser.
文摘AIMTo determine the effectiveness of pharmacological and interventional treatment of hypotony and flat anterior chamber (FAC) resulting from glaucoma filtration surgery.METHODSWe retrospectively examined the medical records of fifty-two trabeculectomy patients (52 eyes) who developed postoperative hypotony and FAC. The management and associated complications of hypotony, changing intraocular pressure (IOP) and best corrected visual acuity (BCVA) were evaluated.RESULTOf the 52 patients with hypotony, 29 (56%) had a grade 1 FAC, 21 (40%) had a grade 2 FAC, and only 2 had a grade 3 FAC. There was no significant difference between the mean preoperative IOP and the mean IOP at three and six months after surgery. Thirteen eyes (25%) required antiglaucomatous medication three months after surgery. The mean BCVA at 6mo after surgery was significantly reduced as compared with the mean preoperative BCVA.CONCLUSIONHypotonia and FAC following trabeculectomy are associated with troublesome complications that require pharmacological and/or surgical treatment. Thus, close follow-up is essential for affected patients.
文摘AIM: To evaluate the incidence and risk factors of hypotony in patients with blunt ocular trauma. METHODS: The medical records of 145 patients with blunt ocular trauma were reviewed. Hypotony was defined as an average intraocular pressure (IOP) of 5mmHg or less for three times. RESULTS: Among these 145 patients, hypotony was noted in 10 (6.9%) patients. The rate of hypotony in patients with ciliochoroidal detachment was 66.7% (2 out of 3 eyes), and 5.6% (8 out of 142 eyes) in patients without ciliochoroidal detachment,the difference was statistically significant (P=0.003). The rate of hypotony in patients with traumatic retinal detachment was 18.5% (5 out of 27 eyes), and 4.2% (5 out of 118 eyes) in patients without traumatic retinal detachment, the difference was statistically significant (P=0.026). The rate of hypotony in the patients with anterior proliferative vitreoretinopathy was 42.9% (3 out of 7 eyes) and 5.1% (7 out of 138 eyes) in the patients without anterior proliferative vitreoretinopathy, the difference was statistically significant(P=0.002). CONCLUSION: Ocular hypotension is a complication of blunt ocular trauma. The risk factors include ciliochoroidal detachment, traumatic retinal detachment, and anterior proliferative vitreoretinopathy.
文摘目的:探讨外伤性睫状体解离及其并发症的临床治疗效果。方法:我院1993-01/2003-06共收治钝挫伤所致的外伤性睫状体解离19例(19眼),男12例,女7例,年龄6～44(平均25)岁。就诊时眼压为0～10平均2.42)mmHg。14例行睫状体显微缝合固定术,其中3例联合巩膜环扎局部冷凝;4例行改良的睫状体缝合固定术—平行于角巩膜缘、不切透深层巩膜,并重叠缝合。3例行保守治疗,2例行氩激光光凝。结果:在14例行睫状体显微缝合固定术病例中,一次手术成功者9例(64.3%);二次手术成功者3例21.4%);三次手术成功者2例(14.3%)。术后随访时间1月～8a,平均眼压11.24mmHg,较术前有明显提高(Wilcoxon-Mann-Whitney, P =0.0052)。最后随访视力较术前有明显提高(Wilcoxon signrank, P =0.012)。结论:睫状体缝合固定术是有效的治疗外伤性睫状体解离的手段;改良的手术方法可进一步提高成功率;超声生物显微镜可准确诊断外伤性睫状体解离,对手术成功有重要帮助。
