Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To observe the effect of amniotic homogenate on closing holes in experimental rhegmatogenous retinal detachment and investigate its mechanism. Methods Forty rabbits were randomly divided into group A, B, C and D with 10 rabbits in each group. Group A and C were the treatment groups, and group B and D were the control groups. All eyes of rabbits underwent pars plana vitrectomy, retinectomy, and fluidair exchange. The surface of the breaks was treated with 01 ml amniotic homogenate in experimental groups and 0.1 ml PBS in control groups. At the end of operation, 20% SF6 was tamponaded and the retina reattaced. The animals were executed 14 (group A and B) and 28 days (group C and D) after the surgery. The tissue sections were observed by light microscope, electron microscope and immunocytochemistry method. Results Fourteen days after the surgery, the retina reattached in 6 eyes in group A (60%) and 2 eyes in group B (20%) （P=0.021）. Twenty-eight days after the surgery, the retina reattached in 8 eyes in group C (80%) and 3 eyes in group D (30%) (P=0.046). The difference of the rate of retinal reattachment among the 4 groups were statistical significant (Plt;0.05). Light postoperative inflammation of ocular anterior segment was observed, which was controlled 3-5 days after treated with topical steroids. The result of light microscopy showed that the eyes in treatment groups had multilayer of fibroblastlike cells around the retinal breaks, adhering to the choroid and retinal pigment epithelial cells. The proliferative cells around the retinal breaks obvious less in control groups than that in the treatment groups, and the retina could not adhere to the choroid. The results of electron microscopy were the same as that of light microscopy. Immunohistochemistry staining of the fibroblastlike cells revealed positve glial fibrillary acidic protein, which suggested that the proliferative cells around the retinal breaks were retinal glial cells. Conclusions Amniotic homogenate helps to seal retinal breaks and promote retinal reattachment by stimulating the proliferation of retinal glial cells around the breaks.
The authom analysed the predisposing factors for macular pucker(MP) after retinal dotachment surgery.Thirteen clinlcal risk factors correlated with the development of MP were identified, As the incidence related to various factors was compared with reported in the literature,the most significant 3 risk factors of MP were: the obvious hemorrhage accumulated in maeular area, the macular hole treated with diathernly,and the patient lay on one's back for approximately 2 weeks during postoperative retard absorption of subretinal fluid in the eyes with preoperative PVR,This suggested that the direct or indirect damage of maeular area was the major cause of development of MP. （Chin J Ocul Fundus Dis,1993,9:8-10）
Objective To analyze the clinical risk factors of the occurrence of severe proliferative vitreoretinopathy (PVR) after scleral reattachment surgery. Methods A total of 4031 eyes of 4031 consecutive patients with reghmatogenous retinal detachment (RRD) and PVR (grade C1 or less), on whom the scleral buckling was performed, were retrospectively studied. Twenty-two clinical charac teristics of the patients (including the ocular tension, condition of lens and vitreous, characte ristics of retinal detachment, whether or not with choroidal detachment, et al) were recorded.In 4031 patients, 2660 were followed up for more than 3 months, and 72 (in PVR group) of the 2660 patients underwent the second surgery (vitre oretinal surgery) because of the occurrence of postoperative seve re PVR; in the other 2588 patients, 72 (72 eyes) with retinal reattachment for more than 3 months were selected randomly as the control. The data were analyzed in SPSS (10.0) software. Results Logistic regression analysis revealed that the significant risk factors for PVR were incomplete posterior vitreous detachment ( P＜0.001), intraocular pressure lt;7 mm Hg（1 mm Hg=0.133 kPa, P＜0.002）, and large retinal tear (gt;2 DD,P＜0.005). Conclusion Incomplete posterior vitreous detachment, intraocular pressure lt;7 mm Hg and large retinal tear of the patient with RRD may be the major risk factors for PVR. (Chin J Ocul Fundus Dis，2003，19：141-143)
OBJECTIVE:To investigate the treatment of retinal redetachment after vitrectomy and silicone oil tamponade. METHODS:Investigating retrospectively on the treatment effect of 8 cases of redetachment of retina with proliferative vitreoretinopathy(PVR) in which the retinas had been attached formerly after vetrectomy and silicone oil tamponade operation.The reoperative procedures included pars plana vitrectomy,membranes peeling,retinotomy,inner exchange of the fluid and silicone oil tampnade and subretinal membranes were removed out in 2 eyes. RESULTS:Six eyes had anatomical reattachment postoperatively and another 2 eyes still had inferior shallow retinal detachment.Visual acuity was improved in 6 patients and remained unchange in 2 patients. CONCLUSIONS:The cause of recurrent retinal detachment might be the formation of the proliferative epiretinal and subretinal membranes,and vitrectomy to release the traction of proliferative membranes and full fluid silicone oil exchange should do good to reattachment. （Chin J Ocul Fundus Dis,1996,12: 13-15 ）
Objective To investigate the interference effect of nerve growth factor (NGF) on apoptosis of retinal cells in experimental retinal detac hment (RD). Methods Twenty seven Sprague-Dawely rats were selected, and the left and right eyes were in the experimental control group and NGF group, respectively. After the RD model was set up by subretinal injection with sodium hyaluronate, 5mu;l NGF（1mu;g/mu;l）was injected into the vitreous body of the right eyes which were in the NGF group; 5mu;l PBS was injected into vitreous body of left eyes which were in the experimental control group. The injection was performed once every 4 days till the end of the observation period. The eye balls of the 27 rats were extrafted 1.5, 3, 6, 12 hours, 1 day, 2, 4, 8 , 16, and 32 days after the RD model was established. Another 2 rats were selected as the normal control, which underwent none of the injections but eyeball extraction at the end of the observation period. TUNEL and transmission electron microscopy were used to detect the apoptosis of the retinal cells. Cell counts and statis tical analysis were used to assess results. Results Typical apoptosis cells were observed in the early time of RD. Apoptosis was found in each retinal layers, especially in inner and outer nuclear layers. The number of apoptosis cells increased as the time of RD was prolonged（Plt;0.01）. It was also found that apoptosis cells in NGF group were less than that in the experimenta l control group（Plt;0.01）. Conclusion Intravitreous injection exogenous NGF may inhibit the apoptosis of retinal cells in experimental RD. (Chin J Ocul Fundus Dis, 2006, 22: 333-335)