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      Endo-Illumination-Aided Scleral Buckling Combined with Intravitreal Injection of Hyaluronate for Treatment of Rhegmatogenous Retinal Detachment

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          Abstract

          Purpose: To evaluate the efficacy and safety of 25-gauge illumination-aided scleral buckling (SB) combined with hyaluronate injection for the treatment of rhegmatogenous retinal detachment (RRD). Methods: Forty-five cases were included in this retrospective study. Twenty-five cases of the treatment group received SB with the aid of endo-illumination and noncontact wide-angle viewing system combined with hyaluronate injection after subretinal fluid drainage, while 20 cases of the control group received conventional SB with binocular indirect ophthalmoscope combined with air injection. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and complications were observed and recorded. Results: The mean operation duration of the treatment group (42.06 ± 16.77 min) was significantly shorter than that of the control group (50.19 ± 21.61 min, p = 0.042). Only 1 case of the control group underwent a second surgery, and the final reattachment ratios of the 2 groups were both 100%. BCVA improved in both the treatment group (from 0.91 ± 0.79 to 0.42 ± 0.58 logMAR, p < 0.001) and the control group (from 0.82 ± 0.70 to 0.41 ± 0.37 logMAR, p = 0.001). The improvements of BCVA of the treatment group and control group were –0.49 ± 0.38 and –0.42 ± 0.46 logMAR, with no significant difference ( p = 0.594). There was no significant difference in IOP and complications between the 2 groups. Conclusions: 25-gauge endo-illumination-aided SB combined with hyaluronate injection was safe and effective for RRD.

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          Most cited references 16

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          The Classification of Retinal Detachment with Proliferative Vitreoretinopathy

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            Vitreous substitutes: a comprehensive review.

            Vitreoretinal disorders constitute a significant portion of treatable ocular disease. Advances in vitreoretinal surgery have included the development and characterization of suitable substitutes for the vitreous. Air, balanced salt solutions, perfluorocarbons, expansile gases, and silicone oil serve integral roles in modern vitreoretinal surgery. Vitreous substitutes vary widely in their properties, serve different clinical functions, and present different shortcomings. Permanent vitreous replacement has been attempted with collagen, hyaluronic acid, hydroxypropylmethylcellulose, and natural hydrogel polymers. None, however, have proven to be clinically viable. A long-term vitreous substitute remains to be found, and recent research suggests promise in the area of synthetic polymers. Here we review the currently available vitreous substitutes, as well those in the experimental phase. We classify these compounds based on their functionality, composition, and properties. We also discuss the clinical use, advantages, and shortcomings of the various substitutes. In addition we define the ideal vitreous substitute and highlight the need for a permanent substitute with long-term viability and compatibility. Finally, we attempt to define the future role of biomaterials research and the various functions they may serve in the area of vitreous substitutes. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Scleral Buckling with a Non-Contact Wide-Angle Viewing System

              Purpose: To assess the outcome of scleral buckling surgery using a non-contact wide-angle viewing system for fundus visualization in patients with rhegmatogenous retinal detachment without proliferative vitreoretinopathy. Patients and Methods: Sixteen eyes of 16 patients underwent scleral buckling using a non-contact wide-angle viewing system combined with a 25-gauge illumination fibre inserted into the sclera at the pars plana. Results: The mean age of the patients was 53.6 ± 13.7 years and the mean follow-up time was 13.4 ± 2.8 months. Retinal reattachment was achieved in 13 of the 16 eyes (81%). Three eyes underwent vitrectomy with silicone oil injection because of development of proliferative vitreoretinopathy in 2 eyes and scleral perforation due to excessive indentation during cryoretinopexy in 1 eye. Two eyes developed limited subretinal haemorrhage during subretinal fluid drainage. Conclusion: Simultaneous use of a non-contact wide-angle viewing system combined with a 25-gauge light fibre illumination for fundus visualization brings the advantages of microsurgery and indirect ophthalmoscopy into scleral buckling surgery.
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2020
                July 2020
                17 January 2020
                : 243
                : 4
                : 316-322
                Affiliations
                Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
                Author notes
                *Zhijun Wang, Department of Ophthalmology, China-Japan Friendship Hospital, 2 Yinghua East Road, Chaoyang District, Beijing 100029 (China), E-Mail wangzhijuncj@sina.com
                Article
                504714 Ophthalmologica 2020;243:316–322
                10.1159/000504714
                31955164
                © 2020 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Tables: 3, Pages: 7
                Categories
                New Technologies in Ophthalmology

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