Objective To observe the clinical efficacy of external-route microsurgery for retinal detachment (RD). Methods In 36 patients (36 eyes) with single rhegmatogenous RD, the silica gel piece and/or buckling bands were preplaced, and drainage of subretinal fluid, retinal cryotherapy, e xamination of locating the holes, and intraocular injection of gas were performe d under surgical microscope. The surgical effects were compared with those of ot her simultaneous 37 patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmscope. Results The simultaneous intraoperative observation of the fundus details and the sclera through the microscope was excellent in all cases. Under the surgical microscope, the reaction of r etinal cryotherapy was clearly visible without any serious surgical sequela. The observation of reaction of retinal cryotherapy and the orientation of the holes were not affected by mild opacity of the refractive media. Retinal reattachment was achieved in 31 eyes after the primary surgery and in 3 eyes after the secon dary surgery, with the final rate of rettachment of 94%. The best-corrected vi sual acuity was ＜0.1 in 6 eyes (16.7%), 0.1-0.4 in 15 eyes (41.7%), and ≥ 0.5 in 15 eyes(41.7%). The results were similar to those of the patients underwent surgery under indirect ophthalmoscope.Conclusion The external route microsurgery is simple, convenient, reliable, and effective. (Chin J Ocul Fundus Dis，2004，20：369-373)
Objective To investigate the effect of hepatocyte growth factor (HGF) on the barrier function of retinal peigment epithelium (RPE) and to detect the pathological mechanism of retinal detachment (RD) induced by over expression of HGF in RPE. Methods Sub-retina injection of E1/E3deleted adenoviral vectors encoding HGF (Ad CMV.HGF) and green fluorescent protein (Ad CMV.GFP) in adult pigmented rabbits [5times;104 plaque-forming units (pfu)/eye] to set up the model of retinal detachment. The ocular fundus and pathological changes were observed 3, 7, 14, and 28 days after injection. The expression level of HGF in retina and vitreous body was detected by immunohistochemistry and enzyme linked immunosorbent assay (ELISA). Results In the control eyes injected with AdCMV.GFP, expression of GFP only detected in RPE monolayer. The eyes injected with AdCMV.HGF had b HGF immune positive action in RPE cells at the injection site. The expression level of HGF in vitreous body reached the peak 7 days after injection and decreased to the basic level 28 days after injection. Chronic RD and chronic choroidal inflammation were found in the eyes injected with AdCMV.HGF within the time frame of HGF expression. Proliferative RPE cells were found in subretinal space in the region of RD, and multilayered cellular membranes developed in some eyes. Conclusion Over expression of HGF in RPE may induce chronic serous RD with subretinal proliferation of RPE, which suggests that HGF should be further studied as a target for therapeutic intervention in RD. (Chin J Ocul Fundus Dis, 2007, 23: 193-197)
Objective To investigate the clinical characteristics of retinal degeneration (RD) with retinal holes and the therapeutic effect of argon laser therapy. Methods The data of argon laser therapy in 210 RD patients (224 eyes) with retinal holes who underwent the treatment in our department were retrospectively analyzed, which was compared with the data of argon laser therapy in 173 RD patients (198 eyes) without retinal holes. Results In RD patients with retinal holes, 89.7% of the patients were less than 60 years old (53.3% males and 46.7% females). Grid-like degeneration was found in 65.6% of the patients in whom 87.5% had the range of degeneration less than 1 quardrant. There were oval-shaped holes in 60.7% of the patients and accompanied with limited rhegmatogenous retinal detachment (LRRD) in 23.7%. Compared with RD patients without retinal holes, the ratio of patients with the age ofge;35 years, cystic degeneration, retinal lengthways small plica, and subjective symptoms was higher in RD patients with retinal holes; while the therapeutic effect of argon laser therapy on patients with LRRD was obviously less than whom without retinal holes (Plt;0.01 ). Conclusions RD with retinal holes often occurs in youth, most of whom have grid-like degeneration with the range of le;1 qua drant. The major types of retinal holes are oval-shaped degeneration without retinal detachment. There was no sex difference in RD patients with retinal holes and most of the patients have no subjective symptoms. The therapeutic effect of prophylactic argon laser therapy on RD patients with retinal holes but no retinal detachment is satisfying. (Chin J Ocul Fundus Dis, 2006, 22: 39-41)
Purpose To evaluate the safety and efficacy of draining subretinal fluid with transchoroidal probing by using the traditional needling and diode endolaser probing. Methods The investigation included 70 consecutive patients(74 eyes) with rhegmatogenous retinal detachment undergoing scleral buckling surgery.Seventy cases were randomly divided into 2 groups,group A 34 cases(36 eyes)with the needle drainage procedure and group B 36 cases(38 eyes) with the diode probe respectively.The safety and efficacy were compared in between the 2 groups. Results No operative failure was found in these 2 groups.In group A,subretinal hemorrhage occurred in 3 eyes,and retinal incarceration,retinal preforation in one eye. No significant complication occurred in group B. Conclusion Diode laser drainage has the advantage in that it may reduce the incidence of operative complication with drainage.This technique might be used in any case requiring drainage of subretinal fluid especially of rhegmat ogenous retinal detachment in cases of shallow retinal detachment. (Chin J Ocul Fundus Dis,1998,14:202-203)
Objective To evaluate the successful rate of surgical treatment of retinal detachment due to macular hole in high myopia, and to analyze the relative reasons. Methods Eleven eyes of 11 high myopic patients with retinal detachment due to macular hole underwent vitrectomy combined with the adjunct of 18% C3F88or silicone oil. Strict prone position was conducted at least 2 weeks postoperatively. Results Macular hole closed and retina reattached in 10 eyes. Visual acuity was increased in 10 eyes, and no change in 1 eye. Postoperative complications mainly included nuclear sclerosis of the lens(1 eye), intraocular pressure elevation (1 eye), fibrosis exudates (2 eyes)，and diplopia (1 eye). Conclusion The use of vitrectomy combined with the adjunct of 18% C3F8or silicone oil is a safe and effective method in treating retinal deta chment due to macular hole in high myopia. Preoperative careful examination of o cular fundus, rational surgical design, and better surgical expertise are basic factors in treating this disease. (Chin J Ocul Fundus Dis, 2001,17:90-92)
Objective To evaluate the curative effects of vitreoctomy or simple scleral buckling on retinal multiple-tear detachment associated with tracted anterior flap. Methods The clinical data of 89 eyes in 89 patients with retinal multiple-tear detachment associated with tracted anterior flap diagnosed in Jan, 1999-Jan, 2002 were retrospectively analyzed. In the 89 patients, 41 had undergone vitreoctomy and 48 had undergone scleral buckling without vitrectomy. In the duration of 2- to 36-month follow-up with the mean of (11.02±7.90) months, visual acuity, retinal reattached rate and postoperative complication were examined and the results in the 2 groups were compared. Results In 41 eyes underwent vitreocotmy, successful reattachment was found in 38 (92.7% ); visual acuity increased in 33 (80.5%), didn′t change in 6 (14.6%), and decreased in 2 (4.9%); leakage of flocculent membrane in anterior chamber occured was found in 2 (4.9%), complicated cataract in 3 (7.3%),and severe proliferative vitreoretinopathy (PVR) in 3 (7.3%). In 48 eyes underwent scleral buckling, 41 (85.4%) had success reattachment; visual acuity increased in 36 (75.0%), didn′t change in 4 (8.3%), and decreased in 8 (16.7%); leakage of flocculent membrane in anterior chamber was found in 6 (12.5%), complicated cataract in 9 (18.8 %), and severe PVR in 8 (16.7%). Conclusion There isn′t any difference of the success rate of the surgery between vitrectomy and scleral buckling for retinal multiple-tear detachment associated with tracted anterior flap.The better visual acuity and less complications are found in the vitrectomy gro up than those in the scleral buckling group. (Chin J Ocul Fundus Dis，2004，20：209-211)
Objective To evaluate the efficacy and its affecting factors of silicone oil as an introocular tamponade for copmlicated retinal detachments in children(le;14 years). Methods We analysed retrospectively 34 cases(36 eyes) of complicated retinal detachments in children, who were performed with pars plana vitrectomy combined with silicone oil tamponade from June 1993 to November 1997. Results After 3-21 months of follow-up, the detached retinas in 19 eyes(52.7%) were reattached, in 10 eyes(27.8%) partially reattached and in 6 eyes (16.7%) redetached, 1 eye(2.8) had a media opacity that precluded evaluation of the retina. Postoperative visual acuity was less than 0.05 in 12 eyes(33.3%), and 0.05-0.2 in 20 eyes(55.6%), 2 cases(4 eyes) could not tell their visions(11.1%). Conclusion Silicone oil tamponade is an effctive therapy for complicated retinal detachments in children. The major cause of surgical fai;ure was development of recurrent proliferative vetrioretinopathy. (Chin J Ocul Fundus Dis,1999,15:7-8)
Objective To find out about the characteristics and prognosis of retinal detachment due to ocular contusion.Methods The clinical data of 36 patients(36 eyes)with retinal detachment due to ocular contusion were retrospectively analyzed.Results There were 3 eyes(8．3％)with huge retinal hole(≥90°)，4 eyes(11．1％)oral tear of ora serrata retinae，4 eyes(11．1％)with macular hole，3 eyes(8.3％)with tractive retinal detachment，and 22 eyes(61．2％)with retinal hole(lt;90°)at other positions(including temporal peripheral hole in 9，nasal peripheral hole in 5，and posterior polar hole in 8).Proliferative vitreoretinopathy(PVR)was found in a11 patients withConclusions Retinal detachment due to ocular contusion often go with PVR．The interval from contusion to retinal detachment varies from days to months.Visual prognosis can be good when retinal detachment is diagnosed and treated in time． (Chin J Ocul Fundus Dis，2004，20：1-66)
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)
ObjectiveTo investigate the therapeutic effects of scleral buckling operations on treating longstanding retinal detachment with subretinal proliferation.MethodsThe clinical data of 36 patients (40 eyes) with long-standing retinal detachment with subretinal proliferation who had undergone scleral buckling operation were retrospectively analyzed, and the clinical features, therapeutic methods and curative effects were summarized.ResultsThe diagnosis of long-standing retinal detachment mainly based on the examination of ocular fundus. The features of the affected eyes were: flat retinal detachment, thin and transparent retina, and formation of subretinal cords. In 40 eyes undergone scleral encircling and buclking, 36 (90%) had one-off successful operation, and the visual acuities over 0.05 were found in 77.5% of the whole eyes.ConclusionsScleral encircling and buckling procedures can be used to treat long-standing retinal detachment with subretinal proliferation with fairish cured rate. (Chin J Ocul Fundus Dis, 2005,21:150-152)