Objective To compare the axial length (AL) measured by Lenstar and contact AScan in the patients with idiopathic macular hole and study the correlation between the difference of the two measurements and the foveal thickness measured by optical coherence tomography (OCT). Methods Twenty-seven eyes of 26 idiopathic macular hole patients (IMH group) and 27 eyes of 25 patients with mild cataract (control group) were enrolled in this study. Foveal thickness was measured with 3D OCT. The AL was measured by Lenstar and contact A-Scan, and the consistency of the two measurements was determined by Bland-Altman analysis. The correlation between the difference of the two measurements and foveal thickness was analyzed by Pearson correlation analysis. Results Mean foveal thickness of IMH and control eyes were （372.85±60.02） μm and （243.44±22.50） μm, respectively. The difference between the foveal thickness of the two groups was highly significant (t=-10.490，P＜0.001). In the IMH group, the AL measured by Lenstar and contact A-Scan were (23.20±1.12) mm and (23.18±1.13) mm, respectively, the difference between the two measurements was not statistically significant (t=-0.549，P=0.588), whereas in the control group, the AL was (23.41±0.72) mm by Lenstar and (23.33±0.74) mm by contact A-Scan, the two measurements were significantly different (t=-4.832，P＜0.001). However, no correlation was found by Pearson correlation analysis between the difference of the two measurements and the foveal thickness in either IMH or control group (r=0.181，-0.141;P＞0.05). ConclusionsAlthough there is no difference of axial length measurements using Lenstar and contact A-Scan in IMH eyes, in clinical measurements the results of two instruments should be taken into comprehensive consideration.
ObjectiveTo compare the results of internal limiting membrane (ILM) peeling with and without ILM transplantation to treat idiopathic macular hole (IMH) with hole form factor (HFF)<0.6. MethodsForty patients (40 eyes) of IMH with HFF<0.6 who underwent pars plana vitrectomy (PPV) were enrolled in this study. 20 eyes was performed PPV combined with ILM peeling (ILM peeling group), the other 20 eyes was performed PPV combined with ILM peeling and ILM transplant (ILM transplant group). The follow-up was ranged from 3 to 6 months with an average of 4 months. The changes of closing rate of hole, best corrected visual acuity (BCVA), photoreceptor inner segment/outer segment (IS/OS) junction defect diameter and amplitude of wave P1 of ring 1 and ring 2 by multifocal electroretinogram (mfERG) were comparatively analyzed for the two groups. ResultsIn 3 months after surgery, the IMH closing rate was 70% (14/20) in the ILM peeling group, and 100% (20/20) in the ILM transplant group, the difference between these two groups was significant (χ2=7.059, P<0.05). Postoperative BCVA was improved obviously in the two groups compared to preoperative BCVA, the difference was significant (t=4.017, 4.430; P<0.05). The rate of BCVA improvement in the ILM peeling group and ILM transplant group were 80% and 85%, the difference was not significant (χ2=0.173, P>0.05). The rate of significantly BCVA improvement in the ILM peeling group and ILM transplant group were 35% and 70%, the difference was significant (χ2=4.912, P<0.05). IS/OS junction defect (t=6.368, 6.635; P<0.05) and amplitude of wave P1 of ring 1 (t=2.833, 4.235) and ring 2 (t=2.459, 4.270) by mfERG in the two groups were improved after operation. The differences of postoperative IS/OS junction defect (t=2.261, P<0.05) and amplitude of wave P1 of ring 2 between the two groups were significant (t=2.282, P<0.05), but the differences of postoperative amplitude of wave P1 of ring 1 between two groups was not different (t=1.800, P>0.05). ConclusionPPV combined with ILM peeling and ILM transplantation can significantly improve the closure rate and vision of IMH with HFF<0.6.
ObjectiveTo analyze the surgical effect, postoperative complications and effects on the body inflammatory response of laparoscopic gastroduodenal perforation repair, and to further evaluate the efficacy of laparoscopic perforation repair. MethodsWe retrospectively analyzed the clinical data of 123 patients with gastroduodenal ulcer perforation treated between February 2010 and February 2015. Among the patients, 65 underwent laparoscopic gastroduodenal ulcer perforation repair (laparoscopic group), and 58 underwent routine open gastroduodenal ulcer perforation repair (open group). Then, we compared the surgical effects (average bleeding volume, ambulation time, postoperative ventilation time, postoperative hospital stay), postoperative complications (wound infection, wound dehiscence, gastroduodenal fistula, abdominal abscess, intestinal obstruction), inflammatory reaction[preoperative and 1, 3, 5-day postoperative white blood cells (WBC) count, peripheral blood procalcitonin (PCT), C-reactive protein (CRP)] between the two groups. ResultsPatients in both the two groups underwent the surgery successfully. No patients in the laparoscopic group were transferred to open surgery. Compared with the open surgery, surgical bleeding volume, ambulation time, anal exhaust time and postoperative hospital stay of the laparoscopic group were significantly different (P < 0.05). Postoperative complications rate of the laparoscopic group was significantly lower than that of the open group (P < 0.05). One and 3-day WBC, PCT and CRP after surgery increased obviously in both the two groups. The above three indicators on the fifth day after surgery were not significantly different from those before the surgery in the laparoscopic group (P > 0.05), while they were significantly different from those before the surgery in the open group (P < 0.05). ConclusionsCompared with open perforation repair, laparoscopic perforation repair surgery is superior for its better surgical effects, fewer postoperative complications and lighter inflammatory response. It is a safe, effective and minimally-invasive treatment for gastroduodenal perforation.
Purpose To evaluate the surgical effect of idiopathic macular hole (IMH)，with optical coherence tomography (OCT)． Methods To measure the diameter of holes and hole halos，the thickness of hole in edge，the changes of hole pattern in 19 cases (19 eyes) with IMH using OCT． Results By quantitatively measuring，OCT showed that after surgery the mean hole diameter lessened from （570．95plusmn;264．59 ）mu;m to （337．05plusmn;335．95）mu;m．The mean diameter of hole halo lessened from （1043．53plusmn;278．80）mu;m to （695．00plusmn;483．00）mu;m and the mean thickness of the hole edge thinned from （389．78plusmn;60．58）mu;m to （298．78plusmn;109．80）mu;m．In 17 eyes the holes become closed or reduced in size or the hole halo，and thinned in hole edge．The anatomic successful rate of the surgery is 89%． Conclusion OCT can objectively，accurately and effectively judge the anatomic effect of IMH surgery． (Chin J Ocul Fundus Dis，2000，16：71-138)
Objective To evaluate the safety and efficacy of brilliant blue G (BBG) assisted internal limiting membrane (ILM) peeling on pathological myopic macular holes with retinal detachment.Methods This is a prospective and noncontrolled study. Twenty-seven high myopia patients （27 eyes） with macular holes and retinal detachment were enrolled. Routine examination was performed, including the best corrected visual acuity （BCVA）, intraocular pressure, slit lamp microscope with +90 D pre-set lens, A- or B-ultrasound,optical coherence tomography (OCT) and visual field. All patients received vitrectomy with BBG-assisted ILM peeling and C3F8 gas tamponade. The 5 followup visits were at the first day, the seventh day, the first month, the third month and the sixth month after surgery. The BCVA, intraocular pressure, visual field, macular hole and retinal reattachment were comparatively analyzed.Results The ILM of all patients were peeled completely by BBG staining. There were no major complications such as corneal edema, anterior chamber reaction, elevated intraocular pressure, visual field defects. At the first month after surgery, macular hole closed and retina reattached in 26 eyes （96.3%）, the macular hole did not close and retina redetached in one eye （25.9%）. At the sixth month after surgery, BCVA of 25 eyes （92.6%） increased, two eyes （7.4%） didnprime;t change, the difference was statistically significant （t＝6.08，Plt;0.05）.Conclusions BBG can fully stain ILM without any side effects. Vitrectomy with BBG-assisted ILM peeling is a safe and effective treatment for pathological myopic macular holes with retinal detachment.