ABSTRACT
Objective To summarize the experience of intraoperative care for the patients undergoing microsurgery via retrosigmoid keyhole approach, so as to improve the treatment effect and minimize complications. Method The clinical records on the intraoperative care of 100 patients undergoing microsurgery via retrosigmoid keyhole approach were retrospectively analyzed. Result Using the keyhole technique and small incision, the cerebellopontine angle lesions were exposed clearly. Moreover, the proper intraoperational cooperation shortened the duration of operation, reduced bleeding and minimized postoperative complications such as cerebrospinal fluid otorrhea, intracranial infection, intracranial hemorrhage, and subcutaneous hydrops. Conclusion Proper operational postures and intraoperative cooperation can make full use of the limited space of the microsurgery via retrosigmoid keyhole approach and ensure the success of the operation.
ABSTRACT
BACKGROUND: Therapeutic effect on pterygium mainly focuses on studying surgical technique, assistant therapy methods,and recurrence rate following excision of pterygium; however, whether race factor is associated with occurrence, development, and recurrence of pterygium remains still unknown.OBJECTIVE: To compare the therapeutic outcomes in different race patients with pterygium treated using corneal limbal stem cell autograft combining with excision of pterygium.DESIGN, TIME AND SETTING: Retrospective case analysis, performed in the Department of Ophthalmology, Zhongshan Hospital Affiliated to Xiamen University between January 2000 and June 2006. PARTICIPANTS: 1 44 (152 eyes) primary cases were collected from Xiamen and 54 (54 eyes) relapsed Negroes were from Africa. There were no significant differences in age, sex, and pterygium length between the two groups (P 0.05).METHODS: 198 subjects were treated by excision of pterygium under a microscope, in which pterygium tissue was not found on the surface of cornea. A free transplantation of the superotemporal limbus with an adjacent piece of thin conjunctiva was placed in the excision area. All cases were followed-up to grade the appearances of the sites 6 weeks, 6 and 12 months after excision (grade 1 implied normal appearance, and grade 4 implied the relapse). MAIN OUTCOME MEASURES: Relapse, pterygium grading, and complication after corneal limbal stem cell autograft combining with excision of pterygium. RESULTS: No relapse was found at 6 weeks after operation. The recurrence rate of Chinese Han people and Africa black people were 6.6% and 14.8% respectively at 6 months, and 11.8% and 24.5% at 12 months. There was significant difference in the recurrence rate between the two races (t=4.607, P= 0.032). In addition, there were significant differences in the pterygium grading between the two groups at 6 weeks (x2=15.608, P < 0.01 ), and Chinese people recovered better. Contrarily, there was no statistical difference at 6 months and 12 months (x2=4.401, 6.206; P 0.05). Few complications were found except superficial scar of cornea and persistent irritation of ocular surface. CONCLUSION: Limbal stem cell autograft combining with excision of pterygium under a microscope can completely remove pterygium with minimal invasion, light postoperative response and low rate of recurrence. The relapse of black cases is higher than Chinese patients.