Air tamponade in retinal detachment surgery followed by ultra-widefield fundus imaging system.

AIM: To report the surgical result of pars plana vitrectomy (PPV) with air tamponade for rhegmatogenous retinal detachment (RRD) by ultra-widefield fundus imaging system. METHODS: Of 25 consecutive patients (25 eyes) with fresh primary RRD and causative retinal break and vitreous traction were presented. All the patients underwent PPV with air tamponade. Visual acuity (VA) was examined postoperatively and images were captured by ultra-widefield scanning laser ophthalmoscope system (Optos). RESULTS: Initial reattachment was achieved in 25 cases (100%). The air volume was >60% on the postoperative day (POD) 1. The ultra-widefield images showed that the retina was reattached in all air-filled eyes postoperatively. The retinal break and laser burns in the superior were detected in 22 of 25 eyes (88%). A missed retinal hole was found under intravitreal air bubble in 1 case (4%). The air volume was range from 40% to 60% on POD 3. A double-layered image was seen in 25 of 25 eyes with intravitreal gas. Retinal breaks and laser burns around were seen in the intravitreal air. On POD 7, small bubble without effect was seen in 6 cases (24%) and bubble was completely disappeared in 4 cases (16%). Small oval bubble in the superior area was observed in 15 cases (60%). There were no missed and new retinal breaks and no retinal detachment in all cases on the POD 14 and 1mo and last follow-up. Air disappeared completely on a mean of 9.84d postoperatively. The mean final postoperative best-corrected visual acuity (BCVA) was 0.35 logMAR. Mean final postoperative BCVA improved significantly relative to mean preoperative (P<0.05). Final VA of 0.3 logMAR or better was seen in 13 eyes. CONCLUSION: PPV with air tamponade is an effective management for fresh RRD with superior retinal breaks. The ultra-widefield fundus imaging can detect postoperative retinal breaks in air-filled eyes. It would be a useful facility for follow-up after PPV with air tamponade. Facedown position and acquired visual rehabilitation may be shorten.

[The conversion of macular function in diabetic macular edema after vitreous surgery].

OBJECTIVE: To evaluate the conversion of macular function in diabetic macular edema (DME) after vitreous surgery. METHODS: Seventeen eyes of 16 patients were assessed after pars plana vitrectomy for DME. Multifocal electroretinogram (mfERG) techniques were used to evaluate the effects of treatment on macular visual function, and retinal foveal thickness was determined by optical coherence tomography before and after vitrectomy. Patients were followed up continually for 7 months. The correlation between the change of tomographic features and visual functions were analyzed. RESULTS: During the follow-up period, the retinal function in macular areas recovered and the foveal thickness decreased gradually. While compared with preoperative values, the response of positive wave (P1) have shown decreases in implicit time and increases in amplitude since the forth and fifth postoperative month respectively (P < 0.05). While compared between each postoperative period, the P1 responses have increased significantly since the forth postoperative month. The correlation between the increase of P1 amplitude in macular area and the decrease of retinal foveal thickness was significant (r = 0.954, P < 0.001). CONCLUSIONS: Macular function get improvement gradually in DME after vitreous surgery; The restoration of macular function is coincident with the reduction of macular edema.

[The effect of vitrectomy combined with full endocular panretinal photocoagulation in late proliferative diabetic retinopathy].

OBJECTIVE: To investigate the effect of vitrectomy combined with full endocular panretinal photocoagulation in patients with late stage of proliferative diabetic retinopathy (PDR). METHODS: Pars plana vitrectomy combined with full panretinal photocoagulation were undergone in 56 eyes (56 cases) with late stage of PDR, including 32 eyes with tractive retinal detachment. Preoperative and postoperative visual acuity, anterior segment by slit lamp and fundus examination by indirect ophthalmoscopy, as well as fluorescein angiography (FFA) were analyzed. RESULTS: Retina were reattached in 52 eyes. Vitreous hemorrhage, retinal bleeding, exudation and neovascular changes were not observed in these eyes. Non-irrigated areas were not found in 28/32 eyes in which FFA examination has been performed. Final visual acuity was improved in 52 eyes. CONCLUSION: Full endocular panretinal photocoagulation with low energy is an effective and safe procedure with low rate of complications for the late stage of PDR.