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AIM: To comparatively analyze the efficacy and safety between 25-gauge(25G+)and 27G+ micro-invasive vitrectomy for the treatment of vitreoretinal diseases.METHODS: The clinical data of 89 cases(89 eyes)of vitreoretinal disease who received vitrectomy at our hospital from March 2019 to April 2022 were retrospectively analyzed. They were divided into two groups according to surgery. A total of 45 cases(45 eyes)who received 25G+ micro-invasive vitrectomy were included in group A, and 44 cases(44 eyes)who received 27G+ micro-invasive vitrectomy were included in group B. Vitrectomy time, operation time, preoperative and postoperative best corrected visual acuity(BCVA), intraocular pressure, subjective comfort evaluation results and complications of the both groups were analyzed.RESULTS: There were no differences in vitrectomy time of the two groups(P>0.05), while the operation time of group B was shorter than that of group A(35.50±14.27min vs. 41.73±14.25min, P=0.042). The postoperative BCVA of the two groups were better than that before operation(P<0.05), while there was no significant difference between two groups(P>0.05). The postoperative intraocular pressure of the two groups was lower than that before operation(P<0.05), and it was slightly lower than group B at 1 and 7d after operation(P<0.05). As for the subjective comfort evaluation results, the scores of group A was higher than that of group B at 1d after operation(6.13±1.20 vs. 3.45±1.17, P<0.001); and there were no differences between two groups at 7d after operation(2.18±1.01 vs. 1.93±0.87, P=0.215). During the follow-up, 7(16%)eyes of incision leakage occurred in group A, of which 6(13%)eyes were transient hypotony, and 10(22%)eyes had conjunctival chemosis. In the group B, there was no incision leakage and transient hypotony, while conjunctival chemosis occurred in 2(4%)eyes at 1d after operation.CONCLUSION: Both 25G+ and 27G+ micro-invasive vitrectomy can improve visual acuity, stabilize intraocular pressure and be safe in patients with vitreoretinal disease. However, 27G+ micro-invasive vitrectomy has less leakage, stable intraocular pressure, shorter operation time and lower incidence of conjunctival chemosis.
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Peripheral retinal degeneration is a typical lesion in ophthalmic clinical practice. Each type of degeneration affects distinct retinal layers and may lead to sight-threatening complications. Due to its specific location, where current ophthalmic imaging technologies have difficulties observing, the pathogenesis remains unclear despite previous works. This review outlines the characteristics of peripheral retinal degeneration by different wide-field imaging technologies, including ultra-wide field fundus imaging, wide field spectral domain optical coherence tomography, optical coherence tomography angiography and fundus fluorescein angiography, as well as new perspectives on their pathogenesis or pathological characteristics so as to provide new ideas for clinical diagnosis and management. Due to the small size of sample and the lack of prospective and long-term observation of multimodal imaging, it is still impossible to comprehensively evaluate the progression and risk of different types of degeneration. Therefore, it is expected that wide-field multimodal imaging technology will be more widely applied to study the mechanism of peripheral retinal degeneration and guide the clinical practice options.
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@#AIM: To observe the clinical effect of combined anterior and posterior segment surgery in the treatment of vitreoretinal diseases with cataract and the influence on visual acuity recovery and complications after surgery. <p>METHODS: The clinical data of 94 patients(94 eyes)with vitreoretinal diseases complicated with cataract treated in the hospital during the period from January 2016 to December 2017 were collected retrospectively. Fifty of them treated by vitrectomy combined with phacoemulsification were included in Group A, and the other 44 cases treated by one-stage vitrectomy and two-stage phacoemulsification were included in Group B. The improvement rate of visual acuity, best corrected visual acuity(BCVA), changes of intraocular pressure(IOP)and incidence of complications after surgery were compared between the two groups. <p>RESULTS: There was no significant difference in the improvement rate of visual acuity between Group A and Group B(<i>P</i>>0.05). The logMAR BCVA of Group B at the last follow-up was significantly better than that of Group A(0.59±0.17 <i>vs</i> 0.78±0.28, <i>P</i><0.05), but there was no significant difference in IOP between the two groups before and after surgery(<i>P</i>>0.05). The incidence of anterior chamber inflammatory response in Group A was significantly higher than that in Group B(52% <i>vs</i> 20%, <i>P</i><0.05), but there was no significant difference between the two groups in other complications, such as transient high IOP or rubeosis iridis(<i>P</i>>0.05). <p>CONCLUSION: Both concurrent anterior and posterior segment surgery and stage surgery are safe and effective in the treatment of vitreoretinal diseases with cataract. The surgical field of the former is clearer and it is easier to operate while the latter can alleviate the anterior chamber inflammatory response, with certain advantages in improvement of postoperative visual acuity. The appropriate surgical method should be chosen according to the patient's condition.
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AIM:To analyze of refractive status after vitrectomy combined with phacoemulsification in patients with vitreoretinal disease and cataract.METHODS:A total of 150 patients with vitreoretinal disease and cataract were treated in our hospital from January 2014 to November 2016.According to the random number table method they were divided into two groups:combination group (75 cases) with vitrectomy combined with phacoemulsification,the control group (75 cases)with vitrectomy first,then phacoemulsification surgery.The recovery of visual acuity and the change of the axial length of the eyes were observed.The patients were followed up for 6mo,and the postoperative complications were recorded.RESULTS:After treatment,number of patients in the two groups with visual acuity ≥ 0.1 were significantly improved compared with before treatment (P＜0.05),and the percent in combination group was 95％,higher than 63％ in the control group (P＜0.05).There were no significant changes in the axial length before and after the operation in the two groups (P＞0.05),and there was no significant difference between the groups before and after treatment (P＞0.05).The refractive status of combination group shifted to myopia,that of control group shifted to hyperopia,two groups had no statistically significant difference on numerical prediction (P ＜ 0.05).The difference was statistically significant on the actual values (P＜0.05).The complication rate in the combination group was 24％,which was lower than 40％ in the control group,and the difference was statistically significant (P＜0.05).CONCLUSION:Vitrectomy combined with phacoemulsification on vitreoretinal diseases with cataract patients is effective,and safety,clinical application value is higher.
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Objective To study on the effect of joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract.Methods 78 vitreoretinal diseases patients complicated with cataract(86 eyes)were recruited.All the cases accepted vitrectomy and cataract extraction at the same time.The vision improving situation and postoperative complications of the treatment were analyzed.Results After the joint surgery of anteriorposterior,the visual improvement rate was 88.4％(76/86 eyes),and with unchanged vision in 7.0％,and decreased vision in 4.7％.In 4 patients with decreased vision,1 case was a secondary neovascular glaucoma,and 2 cases were macular hemorrhage or hiatus,1 case was a retinal detachment.In phase Ⅰ,72 eyes did not implant artificial lens,63 eyes(87.5％)got postoperatively improved vision,and 14 eyes implanted artificial lens,and all of them got improved vision(100.0％),and the difference was not statistically significant(P ＞ 0.05).The total postoperative complication rate was 10.5％(9/86 eyes).Conclusion Joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract had determined curative effect and lower complication rate,which deserved further study and widely using.
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PURPOSE: To describe the prevalence of vitreoretinal diseases in the Korean population 50 years or older at a health screening center. METHODS: The participants of this study included 11,180 adults 50 years of age and older who visited the Health Promotion Center of Kangbuk Samsung Hospital from January to December 2006. Digital images of non-mydriatic fundus photographs were examined. We calculated the sex- and age-adjusted prevalence of vitreoretinal diseases using the direct standardized method based on the number of resident registrations. RESULTS: The age- and sex-adjusted prevalence of vitreoretinal diseases in Korean adults 50 years of age and older was 9.9%. The prevalence of vitreoretinal diseases significantly increased with age (P=0.000). There was no significant gender difference in the prevalence of vitreoretinal diseases (p=0.553). Age-related macular degeneration was the most common vitreoretinal disease, with an age- and sex-adjusted prevalence of 5.2%. Epiretinal membrane, retinal vein occlusion, and diabetic retinopathy were common vitreoretinal diseases in that order, and the age- and sex-adjusted prevalences were 1.5%, 1.1%, and 0.9%, respectively. CONCLUSIONS: The prevalence of vitreoretinal diseases in a screened Korean population 50 years and older was 9.9%. Vitreoretinal diseases are a major ophthalmic problem in Korea. As the Korean population continues to age and the prevalence of diabetes increases, further investigations about the epidemiology and prevention of vitreoretinal diseases are needed.
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Adult , Humans , Diabetic Retinopathy , Epiretinal Membrane , Health Promotion , Korea , Macular Degeneration , Mass Screening , Prevalence , Retinal Vein OcclusionABSTRACT
We performed this study to identify the biomicroscopic variations of posterior vitreous detachment(PVD)and to evaluate the clinical relationship of the vitreoretinal pathology and variations of PVD. Three hundred eyes with PVD were examined with biomicroscope using a 3CCD camera and a personal computer developed by us. The biomicroscopic variations were classifed as complete PVD with collapse, complete PVD without collapse, partial PVD with TPVC(thickened posterior vitreous cortex), or partial PVD without TPVC. In each type, the following pathologies were frequently observed :in complete PVD with collapse(150 eyes), age related changes without vitreoretinal diseases(72 eyes, 48%)and high myopia(41 eyes, 27.3%), in complete PVD without collapse(96 eyes), age related changes without vitreoretinal diseases(33 eyes, 34.3%), nonproliferative diabetic retinopathy(20 eyes, 20.8%), high myopia(15 eyes, 15.6%), branch retinal vein occlusion(14 eyes, 14.5%), in partial PVD with TPVC(36 eyes), proliferative diabetic retinopathy(18 eyes, 50%)and uveitis(10 eyes, 27.7%)and in partial PVD without TPVC(18 eyes), age related changes without vitreoretinal diseases(9 eyes, 50%). The type of PVD was significantly associated with the prevalence of each vitreoretinal disease(P<0.001). Biomicroscopic variations of PVD can be classified into four types, which was useful to evaluate the certain vitreoretinal disorders.