Ten surgical pearls adapted from ancient Chinese allusions in managing severe proliferative diabetic retinopathy
10.3980/j.issn.1672-5123.2025.5.02
- VernacularTitle:典故赋能眼科手术:从传统策略中提炼严重增殖性糖尿病视网膜病变手术要领
- Author:
Zhe CHEN
1
,
2
,
3
;
Chan WU
1
,
2
,
3
;
Yan ZHOU
1
,
2
,
3
;
Shiqun LIN
1
,
2
,
3
;
Xingyu XIAO
1
,
2
,
3
;
Rongping DAI
1
,
2
,
3
Author Information
1. Department of Ophthalmology, Peking Union Medical College Hospital
2. Beijing Key Laboratory of Fundus Diseases Intelligent Diagnosis & Drug/Device Development and Translation
3. Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
surgical pearls;
ancient Chinese allusions;
Chinese idioms;
proliferative diabetic retinopathy;
pars plana vitrectomy
- From:
International Eye Science
2025;25(5):698-705
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To summarize 10 surgical pearls for managing proliferative diabetic retinopathy(PDR)adapted from the ancient Chinese allusions and analyze the application of these pearls in a real-world fashion.METHODS: Retrospective, noncomparative, interventional study. Ten surgical pearls were summarized and adapted from the ancient Chinese philosophy. Totally 346 cases(443 eyes)that underwent pars plana vitrectomy(PPV)at our hospial from January 2016 to February 2024 were selected. Flexible combinations of these pearls were applied according to the specific condition of each patient during surgeries. The efficacy and safety were analyzed, as well as the application frequencies according to the existence of tractional retinal detachment or not.RESULTS: A total of 473 times of surgeries were performed on all the patients. According to ancient Chinese allusions, ten surgical pearls were summarized from these surgeries. All PPVs went smoothly with the application of different combinations. Finally, almost all proliferative membranes were successfully peeled except for 10 patients(11 eyes), who went through strategy No.10(minimal membranectomy)that, only necessary relaxation incisions were made with most of the proliferative membranes left on purpose. The final visual acuities were mostly improved or stable(1.92±0.83 LogMAR preoperatively vs 1.16±0.85 LogMAR postoperatively, P<0.01). Postoperative complications mainly included early inflammatory responses in the anterior chamber and nuclear sclerosis. Recurrent vitreous hemorrhage, retinal detachment, and hyphema or neovascular glaucoma occurred in 1.9%(9/473), 3.2%(15/473), 0.4%(2/473)and 0.4%(2/473)times of PPVs, respectively. After 12/473(2.5%)times of PPVs, retinal detachment at the macular area still existed, and multiple times of subsequent PPVs were conducted. Final retinal attachment at the macular area was realized in 98.9% eyes. Those 5 unattached eyes were with heavily reproliferated membranes and subsequent tractional retinal detachment recurrence under the oil, and three of them were scleral buckled additionally.CONCLUSION:These 10 surgical strategies and technique pearls were mostly effective and safe in the management of severe PDR patients. They were relatively easy to be memorized and applicated once the meaning of each Chinese idiom was understood. One can use different combinations flexibly according to a patient's specific condition.
