Enzyme modified biodegradable plastic preparation and performance in anaerobic co-digestion with food waste.

A modified biodegradable plastic (PLA/PBAT) was developed by through covalent bonding with proteinase K, porcine pancreatic lipase, or amylase, and was then investigated in anaerobic co-digestion mixed with food waste. Fluorescence microscope validated that enzymes could remain stable in modified the plastic, even after co-digestion. The results of thermophilic anaerobic co-digestion showed that, degradation of the plastic modified with Proteinase K increased from 5.21 ± 0.63 % to 29.70 ± 1.86 % within 30 days compare to blank. Additionally, it was observed that the cumulative methane production increased from 240.9 ± 0.5 to 265.4 ± 1.8 mL/gVS, and the methane production cycle was shortened from 24 to 20 days. Interestingly, the kinetic model suggested that the modified the plastic promoted the overall hydrolysis progression of anaerobic co-digestion, possibly as a result of the enhanced activities of Bacteroidota and Thermotogota. In conclusion, under anaerobic co-digestion, the modified the plastic not only achieved effective degradation but also facilitated the co-digestion process.

Clinical Value of Clip-and-Snare Assisted Endoscopic Submucosal Resection in Treatment of Rectal Neuroendocrine Tumors.

Introduction: The aim of the study was to introduce a new endoscopic technology, clip-and-snare assisted endoscopic submucosal resection (CS-ESMR), for treatment of rectal neuroendocrine tumors (NETs) and then to investigate the therapeutic value of CS-ESMR. Methods: In this retrospective study, 67 patients who underwent endoscopic treatment of rectal NETs from March 2017 to December 2021 were analyzed. According to the endoscopic resection methods (endoscopic mucosal resection [EMR], CS-ESMR, and endoscopic submucosal dissection [ESD]), the cases were divided into CS-ESMR group (27 cases), ESD group (31 cases), and EMR group (9 cases). The pathological R0 resection rate and the incidence of adverse events (bleeding and perforation) were compared among the three groups. Results: There was a significant difference about the pathological R0 resection between the CS-ESMR group and the EMR group and between the CS-ESMR group and the ESD group (both p < 0.05). Compared with ESD group, the procedure time, intraoperative bleeding, and the cost of CS-ESMR group are significantly decreased (p < 0.001, p < 0.05, p < 0.001, respectively). Conclusion: CS-ESMR may be a safe and effective treatment for rectal NETs with a diameter of less than 10 mm, without muscularis propria invasion and metastasis.

Blockade LAT1 Mediates Methionine Metabolism to Overcome Oxaliplatin Resistance under Hypoxia in Renal Cell Carcinoma.

Hypoxic microenvironment and metabolic dysregulation of tumor impairs the therapeutic efficacy of chemotherapeutic drugs, resulting in drug resistance and tumor metastasis, which has always been a challenge for the treatment of solid tumors, including renal cell carcinoma (RCC). Herein, starting from the evaluation of methionine metabolism in RCC cells, we demonstrated that the increased methionine accumulation in RCC cells was mediated by L-type amino acid transporter 1 (LAT1) under hypoxia. Glutathione (GSH), as a methionine metabolite, would attenuate the therapeutic efficacy of oxaliplatin through chemical chelation. Reducing methionine uptake by LAT1 inhibitor JPH203 significantly enhanced the sensitivity of RCC cells to oxaliplatin by reducing GSH production in vitro and in vivo. Therefore, we proposed an effective and stable therapeutic strategy based on the combination of oxaliplatin and LAT1 inhibitor, which is expected to solve the resistance of RCC to platinum-based drugs under hypoxia to a certain extent, providing a meaningful insight into the development of new therapeutic strategies and RCC treatment.

Acetylshikonin exerts anti-tumor effects on non-small cell lung cancer through dual inhibition of STAT3 and EGFR.

BACKGROUND: Lung cancer is one of the most common types of malignant tumor. It has one of the highest morbidity and mortality rates worldwide, and approximately 85% of cases are non-small cell lung cancer (NSCLC). Clinically, several EGFR inhibitors have been used to treat NSCLC, but resistance can develop. Studies have shown that cross talk between signal transducer and activator of transcription 3 (STAT3) and epidermal growth factor receptor (EGFR) can mediate drug resistance. Acetylshikonin has obvious antitumor effects, but the mechanism of action is still unclear. PURPOSE: To analyze the antitumor activity of acetylshikonin in lung cancer and clarify its molecular mechanism. METHODS: Methyl thiazolyl tetrazolium (MTT), colony formation and 5-ethynyl-2'-deoxyuridine (EDU) assays were performed to examine the effects of acetylshikonin in inhibiting the proliferation of NSCLC cells (PC-9, H1975 and A549). Scratch wound and transwell assays were used to evaluate the migration and invasion of NSCLC cells. Flow cytometry was employed to determine whether acetylshikonin could induce apoptosis. Proteome sequencing was used to identify the targets of acetylshikonin. Immunofluorescence staining and western blotting were utilized to verify the inhibition of STAT3 and EGFR phosphorylation. A xenotransplantation model was established to evaluate the efficacy of acetylshikonin in nude mice. RESULTS: Our data demonstrated that acetylshikonin significantly decreased the survival rate of human NSCLC cells, increased the apoptotic rate and inhibited cell migration dose-dependently. Immunofluorescence staining and western blotting analyses revealed that acetylshikonin inhibited EGFR and STAT3 pathways. Acetylshikonin also inhibited tumor growth in a xenograft model better than inhibitors of EGFR and STAT3. CONCLUSION: Acetylshikonin has anti-cancer effects on NSCLC cells by inhibiting EGFR and STAT3, indicating that acetylshikonin may be a new antitumor drug to treat NSCLC.

Pars plana subcapsulotomy to remove condense subcapsular opacification in combined surgery of silicone oil removal and phacoemulsification.

PURPOSE: Because of the direct contact of intravitreal silicone oil (SO) with the subcapsular membrane, cataract is one of the main SO-related complications. In a group of patients, condense subcapsular opacification occurs, which adds difficulty and risk when having sequential treatment of it. The aim of the current study is to assess the long-term outcomes of pars plana subcapsulotomy to remove condense subcapsular opacification in combined surgery of SO removal and phacoemulsification. METHODS: Retrospective cohort study. Consecutive patients who were scheduled to have combined surgery of SO removal and phacoemulsification, and with condense subcapsular opacification were included. After phacoemulsification and SO removal, circular subcapsulotomy (diameter = 3-5 mm) was performed with a 23-/25-gauge vitrectomy probe on each subject during the combined surgery. Main outcomes were pre- and postoperative best-corrected visual acuity (BCVA), intra- and postoperative complications. RESULTS: One hundred and twenty patients (120 eyes) were included. Postoperative logMAR BCVA at day 1, week 1, month 1, and final follow-up examinations was 1.0 ± 0.5, 0.7 ± 0.4, 0.6 ± 0.4, and 0.6 ± 0.3, respectively. Statistically significant median differences of logMAR BCVA occurred between the preoperative examination and each postoperative follow-up examination (all p < 0.001). The sharpest median increase in logMAR BCVA occurred between the day 1 and week 1 postoperative examinations (p < 0.001). CONCLUSIONS: For condense subcapsular opacification caused by SO tamponade, pars plana subcapsulotomy with a 23-/25-gauge vitrectomy probe during combined surgery of SO removal and phacoemulsification is effective and safe to have surgical management of it. The systemic approach enables patients to experience rapid and long-lasting vision rehabilitation in a single procedure.

Inflammasome-Driven Interleukin-1α and Interleukin-1ß Production in Atherosclerotic Plaques Relates to Hyperlipidemia and Plaque Complexity.

CANTOS (Canakinumab Antiinflammatory Thrombosis Outcome Study) confirmed interleukin (IL)-1ß as an appealing therapeutic target for human atherosclerosis and related complications. However, there are serious gaps in our understanding of IL-1 production in atherosclerosis. Herein the authors show that complex plaques, or plaques derived from patients with suboptimally controlled hyperlipidemia, or on no or low-intensity statin therapy, demonstrated higher recruitable IL-1ß production. Generation of mature IL-1ß was matched by IL-1α release, and both were attenuated by inhibition of NLR family pyrin domain containing 3 or caspase. These findings support the inflammasome as the main pathway for IL-1α/ß generation in atherosclerosis and high-intensity lipid-lowering therapies as primary and additional anti-IL-1-directed therapies as secondary interventions in high-risk patients.

Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis.

PURPOSE: To evaluate pre-operative and post-operative morphologic characteristics in idiopathic macular epiretinal membrane (ERM) by optical coherence tomography angiography (OCTA). METHODS: Thirty-three subjects with unilateral idiopathic ERM were enrolled and the contralateral eyes served as controls. Vascular parameters including superficial capillary plexus (SCP), deep capillary plexus (DCP), outer capillary plexus (OCP), and choroidal capillary plexus (CCP) were evaluated by OCTA. RESULTS: The superficial foveal avascular zone (FAZ) was significantly smaller in eyes with ERM (P < 0.0001). The vessel densities (VDs) were significantly increased in the fovea but dramatically decreased in the parafovea in SCP and DCP of ERM eyes (all P < 0.0001), in contrast to those in OCP and CCP. The blood flow was augmented in OCP but declined in choroid compared with the controls. In CCP, the mean foveal VD in ERM was significantly smaller (P = 0.023), whereas parafoveal VD did not significantly change (P = 0.66). At 6 months after surgery, flow area was decreased in OCP (P = 0.0007), and foveal and parafoveal VDs were significantly altered in all layers except the foveal VD in OCP and the choroid (all P < 0.05). The total and inner retinal thickness of the fovea and parafovea were correlated with pre-operative and post-operative visual outcomes, respectively. Smaller FAZ and greater interocular differences between post-operative and fellow eyes in FAZ were associated with worse post-operative visual outcomes. CONCLUSIONS: OCTA provides a better display of the vascular network of the retina and choroid to evaluate the severity and surgical prognosis of ERM patients.

Comparative Study of 27-Gauge Versus 25-Gauge Vitrectomy With Air Tamponade in the Treatment of Myopic Foveoschisis.

BACKGROUND AND OBJECTIVE: To compare the surgical outcome of 27-gauge pars plana vitrectomy (PPV) with 25-gauge PPV and evaluate the efficacy of air tamponade for the treatment of myopic foveoschisis (MF). PATIENTS AND METHODS: Sixty eyes of 60 consecutive patients were recruited to undergo vitrectomy, internal limiting membrane (ILM) peeling, and air tamponade for treatment of MF. These eyes were divided into two groups: the 27-gauge group (n = 29) and the 25-gauge group (n = 31). RESULTS: There were no significant differences in the mean operating time (P = .32), the mean time for vitrectomy (P = .20), and the suturing rate(P = .46) between the 27-gauge group and the 25-gauge group. At the final follow-up, anatomical resolution rate did not differ between the two groups (P = .65). CONCLUSION: The 27-gauge vitrectomy system is as efficient and feasible as the 25-gauge system for the treatment of MF. Air tamponade can provide good postoperative anatomic resolution of MF. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e135-e142.].

ERV1/ChemR23 Signaling Protects Against Atherosclerosis by Modifying Oxidized Low-Density Lipoprotein Uptake and Phagocytosis in Macrophages.

BACKGROUND: In addition to enhanced proinflammatory signaling, impaired resolution of vascular inflammation plays a key role in atherosclerosis. Proresolving lipid mediators formed through the 12/15 lipoxygenase pathways exert protective effects against murine atherosclerosis. n-3 Polyunsaturated fatty acids, including eicosapentaenoic acid (EPA), serve as the substrate for the formation of lipid mediators, which transduce potent anti-inflammatory and proresolving actions through their cognate G-protein-coupled receptors. The aim of this study was to identify signaling pathways associated with EPA supplementation and lipid mediator formation that mediate atherosclerotic disease progression. METHODS: Lipidomic plasma analysis were performed after EPA supplementation in Apoe-/- mice. Erv1/Chemr23-/- xApoe-/- mice were generated for the evaluation of atherosclerosis, phagocytosis, and oxidized low-density lipoprotein uptake. Histological and mRNA analyses were done on human atherosclerotic lesions. RESULTS: Here, we show that EPA supplementation significantly attenuated atherosclerotic lesion growth induced by Western diet in Apoe-/- mice and was associated with local cardiovascular n-3 enrichment and altered lipoprotein metabolism. Our systematic plasma lipidomic analysis identified the resolvin E1 precursor 18-monohydroxy EPA as a central molecule formed during EPA supplementation. Targeted deletion of the resolvin E1 receptor Erv1/Chemr23 in 2 independent hyperlipidemic murine models was associated with proatherogenic signaling in macrophages, increased oxidized low-density lipoprotein uptake, reduced phagocytosis, and increased atherosclerotic plaque size and necrotic core formation. We also demonstrate that in macrophages the resolvin E1-mediated effects in oxidized low-density lipoprotein uptake and phagocytosis were dependent on Erv1/Chemr23. When analyzing human atherosclerotic specimens, we identified ERV1/ChemR23 expression in a population of macrophages located in the proximity of the necrotic core and demonstrated augmented ERV1/ChemR23 mRNA levels in plaques derived from statin users. CONCLUSIONS: This study identifies 18-monohydroxy EPA as a major plasma marker after EPA supplementation and demonstrates that the ERV1/ChemR23 receptor for its downstream mediator resolvin E1 transduces protective effects in atherosclerosis. ERV1/ChemR23 signaling may represent a previously unrecognized therapeutic pathway to reduce atherosclerotic cardiovascular disease.

Interferon Gamma Induces Reversible Metabolic Reprogramming of M1 Macrophages to Sustain Cell Viability and Pro-Inflammatory Activity.

Classical activation of M1 macrophages with lipopolysaccharide (LPS) is associated with a metabolic switch from oxidative phosphorylation to glycolysis. However, the generalizability of such metabolic remodeling to other modes of M1 macrophage stimulation, e.g. type II interferons (IFNs) such as IFNγ, has remained unknown as has the functional significance of aerobic glycolysis during macrophage activation. Here we demonstrate that IFNγ induces a rapid activation of aerobic glycolysis followed by a reduction in oxidative phosphorylation in M1 macrophages. Elevated glycolytic flux sustains cell viability and inflammatory activity, while limiting reliance on mitochondrial oxidative metabolism. Adenosine triphosphate (ATP) distributed by aerobic glycolysis is critical for sustaining IFN-γ triggered JAK (Janus tyrosine kinase)-STAT-1 (Signal Transducer and Activator of Transcription 1) signaling with phosphorylation of the transcription factor STAT-1 as its signature trait. Inhibition of aerobic glycolysis not only blocks the M1 phenotype and pro-inflammatory cytokine/chemokine production in murine macrophages and also human monocytes/macrophages. These findings extend on the potential functional role of immuno-metabolism from LPS- to IFNγ-linked diseases such as atherosclerosis and autoimmune disease.

Surgical outcomes of 27-gauge pars plana vitrectomy with short-term postoperative tamponade of perfluorocarbon liquid for repair of giant retinal tears.

PURPOSE: To investigate the use of 27-gauge pars plana vitrectomy (PPV) with short-term tamponade of perfluorocarbon liquid (PFCL) for repair of giant retinal tears (GRT). METHODS: Retrospective case series study. Consecutive patients with GRT were treated with 27-gauge PPV and short-term tamponade of PFCL for 7-10 days. PFCL was completely removed with a secondary surgery. RESULTS: Twenty-three eyes of 23 patients were included. All the patients achieved primary anatomic success. Preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 1.59 ± 0.58 (Snellen 20/778). Five (21.7%), nine (39.1%), eleven (47.8%) and fifteen (65.2%) eyes experienced vision improvement at the Month-1, Month-3, Month-6 and final follow-ups, respectively. The final logMAR BCVA was 0.84 ± 0.51 (Snellen 20/138), being statistically better than the preoperative one (P < 0.001). Surgical complications included foreign body response (n = 7), transient elevated intraocular pressure (n = 5), cataract formation/deterioration (n = 11) and posterior capsule opacity (n = 16). CONCLUSIONS: 27-Gauge PPV with short-term tamponade of PFCL is safe and effective for the repair of GRT. Side effects of the surgery mainly included foreign body response, transient elevated intraocular pressure, cataract formation/deterioration and posterior capsule opacity.

Combined 23-G Pars Plana Vitrectomy and Lensectomy in the Management of Glaucoma Associated with Nanophthalmos.

PURPOSE: To investigate the surgical results of 23-G pars plana vitrectomy (PPV) combined with lensectomy (PPL) in nanophthalmic patients with angle closure glaucoma. METHODS: This prospective nonrandomized study included consecutive patients with nanophthalmic glaucoma recruited for 23-G PPV combined with PPL. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), the number of antiglaucoma medications, and surgery-associated complications were recorded. Surgical success rates were evaluated at each follow-up. Prognostic factors for success were also assessed using logistic regression analysis. RESULTS: This study enrolled 21 eyes of 21 patients. The mean follow-up was 18.6 ± 7.0 months. At the final follow-up visit, the mean IOP was significantly reduced (from 47.4 ± 5.7 to 18.6 ± 3.6 mm Hg). The mean number of antiglaucoma medications dropped from 5 to 0. BCVA improved in 3 (14.3%) eyes. The complete success rate (IOP >6 and <21 mm Hg without antiglaucoma medication) was 71.4, 66.7, and 71.4% at the 6-month, 12-month, and final follow-up visit, respectively. CONCLUSIONS: Nanophthalmic glaucoma can be effectively managed with the combined surgery of 23-G PPV and PPL. IOP control was achieved with elimination of pupillary block and deepening of the anterior chamber. This surgical procedure proved to be safe in eyes with a potential risk of vision-threatening complications.

Pars plana vitrectomy with partial tamponade of filtered air in Rhegmatogenous retinal detachment caused by superior retinal breaks.

BACKGROUND: To investigate the anatomic and functional outcomes of pars plana vitrectomy (PPV) with partial tamponade of filtered air for rhegmatogenous retinal detachment (RRD) caused by superior retinal breaks. METHODS: Retrospective, comparative, consecutive case series study. Patients with RRD caused by superior retinal breaks undergone PPV with partial tamponade (Group A) and whole tamponade (Group B) of filtered air were included. The main outcomes were primary and final success rates, best corrected visual acuity (BCVA), and rate of postoperative cataract surgery. RESULTS: Forty-one patients (41 eyes) were included in Group A and 36 patients (36 eyes) were included in Group B. There were no significant differences in primary or final success rates between Groups A and B (P = 0.618 and P = 1.000, respectively). The patients in Group A experienced quicker postoperative vision improvement (from the Week 1 follow-up) than the patients in Group B (from the Month 3 follow-up). The postoperative cataract surgery rate of Group A (7/31) was lower than that of Group B (13/26) (P = 0.031). CONCLUSIONS: PPV with partial tamponade of air is effective in achieving a high anatomic success rate, quicker postoperative vision improvement, and lower rate of postoperative cataract surgery in RRD caused by superior retinal breaks.

Effects of GSK2606414 on cell proliferation and endoplasmic reticulum stress­associated gene expression in retinal pigment epithelial cells.

GSK2606414 is a novel, highly selective inhibitor of protein kinase R­like endoplasmic reticulum kinase (PERK). GSK2606414 and its analogues have recently been demonstrated to delay tumor growth and prevent neurodegeneration. The present study investigated the effects of GSK2606414 on proliferation, apoptosis, and the expression of activating transcription factor 4 (ATF4), CCAAT/enhancer­binding protein homologous protein (CHOP) and vascular endothelial growth factor (VEGF) in human retinal pigment epithelial (RPE) cells under endoplasmic reticulum (ER) stress. ARPE­19 human RPE cells were treated with 0.01­50 µM GSK2606414, and ER stress was induced by thapsigargin (TG) treatment. Cell proliferation was assessed using the Cell Counting kit­8 cell viability assay. Apoptosis was detected by Annexin­V/propidium iodide double staining using flow cytometry. Western blot analysis was used to measure eukaryotic initiation factor 2α (eIF2α) phosphorylation levels. ATF4, CHOP and VEGF mRNA expression levels were assessed using reverse transcription­quantitative polymerase chain reaction. GSK2606414 treatment inhibited RPE cell proliferation in a dose­dependent manner, however it did not induce apoptosis. In addition, GSK2606414 treatment inhibited eIF2α phosphorylation and reduced CHOP and VEGF mRNA expression levels in RPE cells under TG­induced ER stress. To the best of our knowledge, the present study is the first to demonstrate that GSK2606414 has a potential antiproliferative effect in RPE cells in vitro. This effect appeared to be achieved via inhibition of the PERK/ATF4/CHOP signaling pathway and suppression of VEGF expression levels.

Surgical outcomes of 23-gauge transconjunctival pars plana vitrectomy combined with lensectomy for glaucomatous eyes with extremely shallow anterior chamber and cataract.

BACKGROUND: Glaucoma combined with an extremely shallow anterior chamber and cataracts remains as a complex condition to deal with. And the emergence of microincision vitrectomy surgery (MIVS) system may provide an ideal option for the treatment of that. We report a clinical study of surgical outcomes of 23-gauge transconjunctival pars plana vitrectomy (PPV) combined with lensectomy in the treatment of glaucomatous eyes with extremely shallow anterior chamber and cataract. METHODS: Prospective, nonrandomized and noncomparative case series study. Consecutive patients with secondary glaucoma, extremely shallow anterior chamber and cataract were recruited to have combined surgeries of 23-gauge transconjunctival pars plana vitrectomy and lensectomy. The main outcomes were best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), number of anti-glaucoma medications and surgery-associated complications. RESULTS: Seventeen consecutive patients with secondary glaucoma, extremely shallow anterior chamber and cataract were recruited. The mean follow-up was 21.2 ± 8.8 months. Postoperatively, there was no significant improvement of BCVA (P = 0.25). The mean intraocular (IOP) decreased significantly from 43.14 ± 6.53 mmHg to 17.29 ± 1.80 mmHg (P < 0.001), and the mean depth of anterior chamber increased significantly from 0.507 ± 0.212 mm to 3.080 ± 0.313 mm (P < 0.001). The mean number of anti-glaucoma medications decreased from 4.1 ± 0.8 to 0.6 ± 0.8 (P < 0.001). No severe vision-threatening intra- or post-operative complications occurred. CONCLUSIONS: Glaucoma with an extremely shallow anterior chamber and cataract can be managed well with the combined surgeries of 23-gauge pars plana vitrectomy and lensectomy. The surgical procedure is an effective and safe method to resolve the pupillary block and deepen the anterior chamber.

A machine-independent method to have active removal of 5,000 centistokes silicone oil using plastic infusion tube and 23-gauge microcannulas.

BACKGROUND: To describe one modified method of having machine-independent removal of 5,000 centistokes silicone oil through 23-gauge trocar-cannulas. METHODS: Consecutive patients with silicone oil tamponade for more than four months and with complete retinal reattachment were included. Two 23-gauge trocars were used to make sclerotomies while the microcannulas remained in situ for intravitreous infusion and silicone oil drainage. A short section of infusion tube was connected with a 10 ml syringe's needle adapter. The other side was attached to the conjunctiva surface and covered the cannula's cap inside to form a closed space for silicone oil drainage. The main outcomes were duration for complete removal of silicone oil and intra- and postoperative complications. RESULT: There were totally twenty cases (20 eyes) included. The mean time for draining out the silicone oil was 4.54 ± 0.78 minutes. Intraoperatively, flute needle was introduced additionally in seven cases to achieve complete removal. No cases experienced postoperative visual acuity deterioration or refractory hypotony. No significant residual oil bubbles were observed. No retinal redetachment occurred throughout the follow-ups. CONCLUSION: The modified method of using an infusion tube and 23-gauge trocar-cannulas can achieve quick and complete removal of high viscosity silicone oil.

A SURGICAL APPROACH TO LARGE SUBRETINAL HEMORRHAGE USING PARS PLANA VITRECTOMY AND 360° RETINOTOMY.

PURPOSE: To evaluate the surgical approach of pars plana vitrectomy combined with 360° retinotomy and silicon oil tamponade in the treatment of patients with large subretinal hemorrhage. METHODS: Prospective, nonrandomized, and noncomparative case series study. Consecutive patients with breakthrough vitreous hemorrhage and massive subretinal hemorrahge were recruited to have combined surgery of pars plana vitrectomy with 360° retinotomy and silicone oil temponade. The main outcomes were best-corrected visual acuity, retina status, and postoperative complications. RESULTS: Twenty-one patients (21 eyes) were included. The mean follow-up was 19.9 ± 7.4 months. The mean preoperative thickness of subretinal hemorrhage was 4.25 ± 0.69 mm. All the patients were observed to have choroidal neovascularization during the surgical procedure. The mean logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) significantly improved from preoperatively 2.64 (hand movement) to 1.73 (7/400), 1.50 (6/200), 1.51 (6/200), and 1.45 (7/200) at 1 month, 3 months, 6 months after the initial surgery, and final follow-up. Postoperative complications included temporary higher intraocular pressure, silicone oil emulsification, lens opacification, epimacular membrane, retinal pigment epithelium loss, and subretinal fibrosis. At the end of the follow-up, retinas were all reattached without any recurrence of choroidal neovascularization. CONCLUSION: Pars plana vitrectomy combined with retinotomy and silicone oil tamponade is effective for eyes with breakthrough vitreous hemorrhage and massive subretinal hemorrahge.