Objective To evaluate the 25-gauge (25G) transconjunctival sutureless vitrectomy system (TSV25G) for macular diseases. Methods The clinical data of 18 patients with macular diseases treated by the TSV25G were retrospectively analyzed. The 18 patients included 13 men and 5 women, aged from 25 to 73 years. The disease course ranged from 3.5 to 10 months, including 8 epiretinal membrane, 3 idiopathic macular hole, 3 tranumatic macular hole with submacular heamorrhage, 2 vitreo-macular tractional syntrome and 2 diabetic macular edema. The surgical parameter installation was as follows: high speed cutter with rate of 1500 cuts per minute; the maximum aspiration with a TSV25G were 500-550 mmHg (1 mm Hg=0.133 kPa); the BSS bottle height was 40-50 cm; the intraocular pressure was 29-35 mmHg during the surgery. The postoperative follow-up period was 2.5-10 months. Results Eighteen patients had undergone the vitrectomy successfully with the operative time of 26-44 minutes (mean 35 minutes). No complication was found. Water leakage of the puncture site was found in 1 patient and was sewed up with 8-0 absorbable sutures. The mean time of inpatients were 3.5 days postoperatively. In the postoperative follow-up in 18 patients, the macular edema disappeared totally in 12 patients 3-6 months after the operation; the visual distortion disappeared in 10 and alleviated in 2; the visual acuity regained (0.8 or more) in 6 (33.3%), not changed in 4, and improved in 2. Conclusion TSV25G was safe, time-saving, and effective for macular diseases.

Anti-vascular dndothelial growth factor (VEGF) drugs have open up a new treatment channel for ocular neovascular diseases.A lots of clinical data has proved that anti VEGF drugs are effective and safe.But we should also notice that long-term and excessive usage of anti-VEGF drugs brings some new problems and complications,and even affect the normal ocular physiological process of the angiogenesis and retinal blood flow.So,it is necessary to pay attention to the problems and potential risks of excessive usage of anti VEGF therapies for ocular neovascular disease.

Diabetic mellitus affects the global public health.World Health Organization(WHO) predicted the number of diabetic patients in the world will reach 221 million in 2010.In China,there are over 40 million diabetic patients at present,and the number of diabetic patients grows about 1.2 million each year.Diabetic retinopathy is one of the most severe complications in diabetic patients,and it is also a leading cause of acquired blindness among the adults.Approximately 45% to 58% of diabetic patients have different degree of diabetic retinopathy,and the prevalence of diabetic retinopathy is increasing year by year in pace with the prolongation of the course of diabetic mellitus.Regular screening for early stage diabetic retinopathy is an important means to decrease the visual loss in diabetic patients,therefore,it is inperative to establish a unified international classification for the severity degrees of diabetic retinopathy which would be widely accepted by ophthalmologists all over the world,and a system for early screening,periodic inspection and assessment of patient's conditions.In this way,ophthalmologists can evaluate the progression of diabetic retinopathy scientifically.Through clinical studies under the guidance of the evidence-based medicine,and by selecting the reasonable therapeutic regimens,early screening,periodic inspection,follow-up and treatments would become rational,and blindness rate would be lowered in diabetic patients.Therefore,early discovery and accurate evaluation of diabetic retinopathy,with timely selection of rational therapeutic regimens under the guidance of evidence-based medicine are the primary tasks to prevent and cure diabetic retinopathy,and to avert or revert diabetic blindness,and also important responsibilities of ophthalmologists.

Objective To obtain an overview on the current status of ophthalmology in recent 5 years for founding a baseline for the future researches of ophthalmology.Methods The ophthalmological literature of recent 5 years was retrieved and analyzed with informatics methods,the development of ophthalmology was summarized in the exploitation of new equipments,the application of new drugs and new technologies,and the advance in clinical examination,diagnosis and treatment.Results In recent 5 years,ophthalmology had made rapid development in basic,clinical and applied researches,and had achieved impressive results in the following areas:artificial crystal materials,design and implantation techniques,surgery for myopia and refractive diseases,development in glaucoma drugs,minimally invasive surgery for treatment of vitreoretinal diseases,therapy for the choroidal neovascularization in age-related macular degeneration and macular edema,experimental study in optic nerve injury and nerve regeneration,retinal stem cell transplantation,research in tissue engineering and artificial cornea,and so on.Conclusions The overall level of ophthalmological development is in the forefront among the advances in life sciences in China.More attention should be paid to the war injury of the eye,military medical protection,basic and clinical research in optic nerve injury and regeneration,and the researches on microsurgery and minimally invasive surgery in the field of ophthalmology,myopia and refractive surgery,fundus and optic nerve diseases should be emphasized.

Objective To evaluate the result of an improved suturing technic to replace ciliary body in traumatic cyclodialysis. Methods 39 cases diagnosed by gonioscope and ultrasound biomicroscope (UBM) as traumatic cycodialysis were surgically treated, and the relative parameters were retrospectively analyzed statistically. Results 3-6 months after the operation, the vision of 21 patients (87.18%) was improved over 0.3, and the intraocular pressure (IOP) increased and maintained at 8-21mmHg in 87.2% cases. The anterior chamber was deepened or returned to normal, and the fundus was improved to various degrees in the majority of patients. Conclusion The improved direct suturing was an effective method for traumatic cyclodialysis, and UBM could be used to make a definite diagnosis of cycodialysis.

Objective To investigate the expression of gap junction(GJ) protein Cx43 in normal cat ciliary body and its corresponding changes in location and quantity in traumatic anterior proliferative vitreoretinopathy (aPVR) model at different time points and under different intraocular pressure (IOP). Methods In a cat model of chronic hypotony after traumatic aPVR IOP was measured before and after trauma. Similar measurement was done in healthy cats. The location and content of Cx43 of ciliary epithelium was determined with immunohistochemistry technique separately in normal group and 24h, 3d, 1w, 2w and 4w after trauma in the experimental group. Results Cx43 was located between the bi-epithelium of ciliary body of the normal cat, forming GJ to communicate between PE and NPE. However, in the aPVR model, Cx43 appeared between PE cells also, and was up-regulated obviously at 24h, At 1w, Cx43 was seen to be distributed diffusely between all epithelial cells reaching the maximum level. Its level descended gradually after 2w and 4w. The IOP raised slightly after 24h and then gradually fall. The changes in Cx43 quantity was basically parallel to ?IOP within 3d and after 1w. Conclusion In cat ciliary body Cx43 from the direct transportation channels for aqueous materials between PE and NPE. Its changes in location and quantity bore close relation ship with the formation of hypotony after aPVR.

Five eyes of acute retinal necrosis(ARN) with multiple retinal breaks and retinal detachment were treated by closed vetrectomy combined with encircling buckle, gas/fluid exchange, endolaser and cryotherapy. After operation, the detached retinas reattached in 4 eyes, and among them the visual acuity was 0.2 in 1 eye, and better than 0.05 in 3 eyes. The follow-up duration in 5 eyes was from 6 to 18 months and recurrent retinal detachment was found in one eye.

Objective To observe the changes of electroretinogram(ERG) in temporary traumatic ocular hypotension and to detect the possible mechanism. Method The rabbit model with ocular hypotenstion was made. At the 2nd, 4th, 8th, 16th week after trauma, the ocular tension and ERG was examined. Result Amplitude of b wave in treated group was 2.5 times as high as that in the control at the 2nd week after trauma, and then decrease to 1.5 times as high as that in the control at the 16th week. Conclution Higher amplitude of b-wave of ERG in rabbit with ocular hypotension may be related to blood circulation congestion, which might lead to accumulation of the metabolic toxin.

ObjectiveTo investigate the etiological factors of endophthalmitis and evaluate the outcomes of vitrectomy for endophthalmitis.MethodsFrom January 1999 to December 2001, 53 consecutive patients (54 eyes ), 38 men and 15 women, diagnosed as endophthalmitis were retrospectively evaluated. The patients′ ages ranged from 1 year to 74 years (mean 32 years). Two patients (2 eyes) with mild inflammation received antibiotic medication therapy, 5 patients (5 eyes) with no light perception and severe inflammation underwent evisceration, and the other 46 patients (47 eyes) underwent pars plana vitrectomy. Postoperative follow-up ranged from 2 to 32 months (mean 10.5 months). ResultsEndophthalmitis was diagnosed as resulting from penetrating injury in 32 eyes (59.26%), endogenous endophthalmitis in 8 eyes (14.81%), cataract surgery in 7 eyes (12.96%), glaucoma surgery in 2 eyes (3.70%), vitrectomy in 3 eyes (5.56%), radial keratotomy in 1 eye (1.85%), and unknown reason in 1 eye (1.85%). The postoperative visual acuities (VA) of these patients increased significantly (P=0.003). The VA of the patients underwent vitrectomy in 3 days was obviously better than those after 3 days (P=0.014), and the VA of the patients underwent vitrectomy in 7 days was obviously beter than those after 7 days (P=0.021). Thirty-seven eyes (68.52%) had functional success (VA≥0.02), 47 eyes (87.04%) had anatomical success (VA

Objective To investigate the effect of retinectomy 360? for severe ocular rupture and evaluate the related factors associated with prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone Ⅰ in 5 eyes, zone Ⅰ-Ⅱ in 8 eyes,zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes, zone Ⅲ in 7 eyes, zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes and zone Ⅲ in 7 eyes. The presenting visual acuity was in grade 4 (0. 02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360? retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes. Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrhage in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76. 9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70. 0%) had corrected visual acuity of 0. 02 or more, including 7 (35. 0%) had 0. 05 or more, 3 had 0. 1 or more, and 1 had the best visual acuity of 0. 3. Conclusion Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.