Introduction: This study aimed to compare anatomical outcomes of air and perfluoropropane gas (C3F8) tamponade in pars plana vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD). Methods: In this retrospective study, data were gathered from 578 patients (578 eyes) with RRD. The follow-up records of all 578 patients that underwent primary vitrectomy for RRD with air or C3F8 were examined and analyzed. Surgical outcomes of the two groups were compared. Results: A total of 342 eyes were treated with air and 236 with C3F8. The mean follow-up period was 37.65 ± 2.33 months. Baseline and preoperative clinical characteristics were similar between groups, but the period to intraocular bubble disappearance (p < 0.0001), intraocular pressure on the first postoperative day (p < 0.0001), number of cases with intraocular pressure >21 mm Hg within 3 days post-surgery (p < 0.0001), and the number with intraocular pressure >21 mm Hg during follow-up (p = 0.0002) differed significantly between groups. Primary reattachment rates for air and C3F8 groups were 95.03% and 95.34%, respectively. Clinical characteristics were similar in those with and without successful reattachment, and the frequency of new or unclosed breaks was similar between the two groups. There was no significant difference in two groups according to the presence or absence of inferior retinal breaks and inferior detached quadrants. Univariate and multivariate logistic regression identified no risk factor for surgical failure. Conclusions: Air showed equivalent effects to C3F8, with a shorter period to intraocular bubble disappearance, less risk of postoperative intraocular hypertension, and less expense.

Chen, Chong MD; Hu, Guangyi MD, PhD; Chen, Feng'e MD; Liu, Kun MD, PhD; Yu, Suqin MD; Xu, Xun MDEditor(s): Grewal, Dilraj; Valikodath, Nita; Justin, Grant A. Author Information

Abstract Background To investigate the prevalence and predictors of retinal breaks reopening after vitrectomy with air tamponade in rhegmatogenous retinal detachment (RRD). Methods A retrospective cohort study was conducted in Shanghai General Hospital. Chart review was performed among 1715 patients with primary RRD who received pars plana vitrectomy (PPV) with air tamponade as initial management. Patients were followed up for recurrence. The clinical features of the eyes with retinal breaks reopening were recorded. Logistic regression was constructed to investigate the predictors for breaks reopening. Results A total of 137 (7.99%) patients had recurrent retinal detachment after PPV with air tamponade. The causes of surgery failure included new or missed retinal breaks (48.9%), reopening of original tears (43.8%) and proliferative vitreoretinopathy (7.3%). The median time to recurrence for the patients with breaks reopening was 18.0 days. Multivariate logistic regression indicated that the presence of retinal break(s) ≥ 1.5 disc diameters (DD) (odds ratio [OR]: 2.68, 95% confidence interval [CI]: 11.04–6.92, P = 0.041), and shorter period for restricted activities (OR: 0.94, 95% CI: 0.89–0.99, P = 0.020) were the independent predictors for breaks reopening. Conclusions Breaks reopening is an important cause for retinal redetachment after PPV with air tamponade in primary RRD. The first 2–4 weeks after surgery is the “risk period” for breaks reopening. Special attention should be paid for patients with retinal break(s) ≥ 1.5 DD. A prolonged period for restricted activities is recommended.

Background To investigate the long-term surgical outcomes and prognostic factors of foveal detachment (FD) in pathological myopia. Methods This retrospective observational study included 59 patients with FD (61 eyes) who underwent pars plana vitrectomy at Shanghai General Hospital between June 2017 and July 2018 with follow-up for at least 24 months. Comprehensive ophthalmic examinations, including best-corrected visual acuity (BCVA) and swept-source optical coherence tomography, were assessed. Preoperative myopic maculopathy was evaluated according to the ATN classification. Results FD completely resolved in 59 of 61 eyes (96.7%). Mean duration of retinal reattachment was 12.10 ± 8.10 months. Mean logMAR BCVA improved from 1.34 ± 0.52 to 0.83 ± 0.43 at 24 months postoperatively ( P < 0.001). Secondary macular hole occurred in 8 eyes (13.1%) with a mean period of 3.4 ± 4.1 weeks after primary surgery. In regression analyses, baseline myopic atrophy maculopathy (MAM) ( B = 0.213, P = 0.005) and vitreomacular traction (VMT) ( B = 0.292, P = 0.007) were adverse prognostic factors for postoperative BCVA. A more severe MAM revealed a delay in retinal reattachment ( B = 5.670, P = 0.002). FD eyes with VMT (OR = 1.309, P = 0.003) or outer lamellar macular hole (O-LMH) (OR = 1.369, P < 0.001) were risk factors for postoperative secondary macular hole. Conclusions Vitrectomy was effective in the long-term for treating FD. Careful consideration is needed for those with VMT or O-LMH due to the high risk of secondary macular hole after vitrectomy. FD eyes with more severe MAM tended to have poorer postoperative BCVA and extended periods of retinal reattachment.

Purpose: Takayasu arteritis (TA) is a systemic granulomatous large vessel vasculitis that involves mainly the aorta and its primary branches, and occurs most commonly in young females. Ocular manifestations of TA include small vessels dilation, microaneurysm, arteriovenous anastomosis, retinal ischemia and retinopathy. However, no specific and effective treatments for Takayasu retinopathy is applied. This case aimed to demonstrate the role of anti-VEGF (vascular endothelial growth factor) therapy in treating Takayasu retinopathy. Observations: We herein reported an 18-year-old Asian woman who presented with typical wreath-like arteriovenous anastomosis around the disc in the right eye and vitreous hemorrhage in the left eye. The stenosis and occlusion of bilateral subclavian arteries, carotid arteries and other proximal arteries on angiography confirmed the diagnosis of TA. Meanwhile, elevated ESR and CRP revealed that TA was in the active stage. We applied anti-VEGF therapy in treating Takayasu retinopathy specially to inhibit neovascularization. Additionally, vitreous extraction was conducted in the left eye after the treatment of anti-VEGF therapy. Conclusions and importance: This is the first report of effective application of anti-VEGF therapy in inhibiting wreath-like arteriovenous anastomosis and improving vitrectomy in TA.

Background Free internal limiting membrane (ILM) flap tamponade technique is an alternative choice for treating large idiopathic macular holes (IMHs). However, the functional recovery related to this surgical approach is not well-characterized. This study aimed to evaluate morphological and microperimetric outcomes 6 months after free ILM flap tamponade technique for large IMHs. Methods Twenty-two patients (22 eyes) with large IMHs (minimal diameter > 400 μm) were retrospectively enrolled in this study. All patients underwent 23-gauge pars plana vitrectomy with ILM peeling and free ILM flap tamponade procedures. Snellen best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and MP-1 microperimetry were measured at baseline and 6 months after surgery. Associations of postoperative BCVA with retinal sensitivity were detected. Results Macular hole closure was achieved in 21 eyes (95.5%). Dislodgement of free ILM flap was found in non-closed eye. Mean logMAR BCVA improved from 1.10 ± 0.33 at baseline to 0.67 ± 0.32 at 6 months postoperatively ( P < 0.001). The mean overall macular sensitivity and foveal fixation stability increased respectively from 8.58 ± 3.05 dB and 65.64 ± 17.28% before surgery to 11.55 ± 2.72 dB and 78.59 ± 13.00% at 6 months after surgery ( P < 0.001). The mean change in foveal sensitivity (within 2°) was significantly greater than the change achieved for peri-foveal sensitivity (2° to 10°) by 1.50 ± 2.62 dB ( P = 0.014). Linear regression analysis showed that postoperative logMAR BCVA was significantly associated with duration of symptom ( B = 0.063, P = 0.001), preoperative logMAR BCVA ( B = 0.770, P = 0.000), preoperative peri-foveal ( B = − 0.065, P = 0.000) and foveal sensitivity ( B = − 0.129, P = 0.000). Moreover, multiple regression model revealed that preoperative foveal sensitivity was independently associated with postoperative logMAR BCVA ( B = − 0.430, P = 0.040). Conclusions Vitrectomy combined with ILM peeling and free ILM flap tamponade technique results in effective morphological and functional recovery for large IMHs. Preoperative foveal sensitivity might be a prognostic indicator for postoperative BCVA.

Purpose Diabetic retinopathy (DR), a neurovascular disease, is one of the leading causes of blindness in working-age adults. Long noncoding RNAs (lncRNAs) have attracted attention as indicators for DR. This study aimed to characterize the role of lncRNA human testis development-related gene 1 (TDRG1) and its modulation of vascular endothelial growth factor (VEGF) in deteriorating DR. Methods Tissue samples were obtained from patients with epiretinal membranes (EMs) or proliferative DR, and human retinal microvascular endothelial cells (HRECs) were cultured with high-glucose medium to mimic DR as the in vitro model. The expression of lncRNA TDRG1 and VEGF was determined by immunofluorescence staining, Western blotting, and RT-qPCR. Transfection of small-interfering RNA was conducted to knock down target gene expression. HREC functions were evaluated by cell viability, fluorescein isothiocyanate (FITC)-dextran extravasation, migration, and tube formation assays under different conditions. Results LncRNA TDRG1 and VEGF were found to be co-expressed and significantly upregulated in fibrovascular membranes (FVMs) from DR patients compared to those from EM patients. In the in vitro model, hyperglycemic treatment markedly increased the expression of lncRNA TDRG1 and VEGF at the mRNA and protein levels, which promoted cell proliferation and migration, enhanced permeability, and disrupted tube formation of HRECs. However, knockdown of lncRNA TDRG1 or VEGF notably decreased the expression of VEGF and reversed the impaired functions of high-glucose-treated HRECs. Conclusions LncRNA TDRG1 promoted microvascular cell dysfunction via upregulating VEGF in the progression of DR and may serve as a potential therapeutic target in DR treatment.

Aim To identify the potential metabolite markers in diabetic retinopathy (DR) by using gas chromatography coupled with time-of-flight mass spectrometry (GC-TOFMS). Methods GC-TOFMS spectra were acquired from vitreous and aqueous humor (AH) samples of patients with DR and non-diabetic participants. Comparative analysis was used to elucidate the distinct metabolites of DR. Metabolic pathway was employed to explicate the metabolic reprogramming pathways involved in DR. Logistic regression and receiver-operating characteristic analyses were carried out to select and validate the biomarker metabolites and establish a therapeutic model. Results Comparative analysis showed a clear separation between disease and control groups. Eight differentiating metabolites from AH and 15 differentiating metabolites from vitreous were highlighted. Out of these 23 metabolites, 11 novel metabolites have not been detected previously. Pathway analysis identified nine pathways (three in AH and six in vitreous) as the major disturbed pathways associated with DR. The abnormal of gluconeogenesis, ascorbate-aldarate metabolism, valine-leucine-isoleucine biosynthesis, and arginine-proline metabolism might weigh the most in the development of DR. The AUC of the logistic regression model established by d-2,3-Dihydroxypropanoic acid, isocitric acid, fructose 6-phosphate, and l-Lactic acid in AH was 0.965. The AUC established by pyroglutamic acid and pyruvic acid in vitreous was 0.951. Conclusions These findings have expanded our understanding of identified metabolites and revealed for the first time some novel metabolites in DR. These results may provide useful information to explore the mechanism and may eventually allow the development of metabolic biomarkers for prognosis and novel therapeutic strategies for the management of DR.

PURPOSE:We determined vitreous and serum levels of high mobility group box-1 (HMGB-1) in patients with proliferative diabetic retinopathy (PDR) and elucidate their relationship with receptor for advanced glycation end products (RAGE), vascular endothelial growth factor (VEGF) and interleukin-1β (IL-1β).METHODS:In this cross-sectional study, patients with PDR who underwent vitrectomy were enrolled, and the control group included non-diabetic eyes. Vitreous and serum samples were analysed for HMGB-1, RAGE, VEGF and IL-1β by ELISA. We investigated the correlation between serum and vitreous levels of each cytokine, and we analysed the influence of intravitreal anti-VEGF treatment prior to vitrectomy on the cytokine levels in PDR.RESULTS:Of 78 eyes of 78 patients enrolled consecutively, there were 32 PDR eyes and 46 control eyes. The serum levels were higher in diabetic than in non-diabetic subjects for HMGB-1, RAGE, VEGF and IL-1β (all p < 0.001), respectively. Similarly, the vitreous levels were higher in diabetic than in non-diabetic subjects for HMGB-1 (p < 0.001), RAGE (p = 0.001), VEGF (p < 0.001) and IL-1β (p < 0.001), respectively. We found a positive correlation between serum and vitreous levels of HMGB-1 in patient with PDR (p = 0.047, R = 0.353). There was a negative correlation between serum and vitreous levels of VEGF in patient with PDR (p = 0.001, R = -0.546). For the subgroup analysis, we detected that the vitreous levels of RAGE were significantly lower in patients who underwent anti-VEGF injection prior to vitrectomy than those who did not (p < 0.001).CONCLUSIONS:Our findings suggest that HMGB-1 is involved in PDR disorders, and it may be a novel therapeutic target to inhibit progression of PDR.

Background: To identify the ocular trauma pattern in the north Bund area of Shanghai. Methods: This is a retrospective, cross-sectional study. Patients between January 2016 and December 2018 with trauma in one eye and being hospitalized for at least one day in Shanghai General Hospital were selected in this study. All patients received first evaluation at the emergency room, followed by careful eye examination by one of attending ophthalmologists and reevaluation by one of the authors. Demographics and related patient’s clinical data at the time when trauma occurred were recorded, including age, gender, occupation, cause and type of trauma, location and size of injury, type of surgery, and hospitalization time. Results: 206 patients were reviewed. We found that gender and age are two mutually correlated risk factors for ocular trauma. We also identified occupation as a major risk factor, which is closely associated with penetrating/ intraocular foreign body injuries. Moreover, season change adds an additional layer of risk factor for ocular trauma, showing a significantly higher peak of ocular trauma percentage in hot summer months. Furthermore, retinal detachment and vitreous hemorrhage were identified as two prevailed types of complications. Importantly, we found that complications, along with location and/or size of injuries, determine the visual outcomes. Conclusions: We identified a clear ocular trauma pattern in the north Bund area of Shanghai. Importantly, complications, location and/or size of injuries determine the visual outcomes. Our findings pinpoint risk factors for ocular trauma, which predict visual outcomes and might be further applied in eye injury prevention.

Background/Aims: We intended to investigate the significance of microRNA-146a, Notch2 and IL-6 on Graves ophthalmopathy (GO) and the relationships among them. Methods: About 27 GO patients were incorporated in this study, including 13 patients with inactive GO and14 patients with active GO. Another 15 patients who had previously received strabismus orthopedics or ophthalmectomy due to trauma were selected as the control population. QRT-PCR assay was used to detect microRNA-146a and Notch2 expression levels in plasma. MTT assay and flow cytometry were respectively used to assess the viability and mitosis of the fibroblasts isolated from orbital connective tissue. Double antibody sandwich enzyme-linked immunosorbent assay (ELISA) was employed to detect serum IL-6 levels. The dual luciferase reporter gene assay was used to verify the targeting relationship between microRNA-146a and Notch2. Results: Compared with the control group, the relative expression of miR-146a was significantly increased whereas the relative expression of Notch2 was significantly decreased (all P < 0.05) in GO patients compare with the control. Notch2 can be directly targeted by microRNA-146a. The over-expression of miR-146a markedly facilitated Orbital Fibroblasts (OFs) viability and mitosis whereas markedly suppressed cell apoptosis (all P < 0.05). Exogenous microRNA-146a mimics could down-regulat the expression of Notch2 and up-regulate IL-6 (P < 0.05). The inhibition of microRNA-146 resulted in the elevated expression of Notch2 and decreased expression of IL-6 (P < 0.05). Conclusion: MicroRNA-146a may increase the IL-6 levels and exacerbate GO by directly targeting Notch2.

O-linked N-acetylglucosamine (O-GlcNAc) glycosylation is an important form of post-translational protein modification, mainly intracellular. It is closely related to cellular signaling pathways, and is involved in signal transduction, gene transcription and other important biological processes. Studies have found that O-GlcNAc glycosylation is directly related with diabetic retinopathy (DR), further studies may help us to uncover the DR mechanism, and develop new strategies for the diagnosis and treatment of this disease. Key words: Diabetic retinopathy/etiology; Acetylglucosamine; Glycosylation; Review

Objective. To observe the fellow eye in patients undergoing surgery on one eye for treating myopic traction maculopathy. Methods. 99 fellow eyes of consecutive patients who underwent unilateral surgery to treat MTM were retrospectively evaluated. All patients underwent thorough ophthalmologic examinations, including age, gender, duration of follow-up, refraction, axial length, intraocular pressure, lens status, presence/absence of a staphyloma, and best-corrected visual acuity (BCVA). Fundus photographs and SD-OCT images were obtained. When feasible, MP-1 microperimetry was performed to evaluate macular sensitivity and fixation stability. Results. At an average follow-up time of 24.7 months, 7% fellow eyes exhibited partial or complete MTM resolution, 68% stabilized, and 25% exhibited progression of MTM. Of the 38 eyes with “normal” macular structure on initial examination, 11% exhibited disease progression. The difference in progression rates in Groups 2, 3, and 4 was statistically significant. Refraction, axial length, the frequency of a posterior staphyloma, chorioretinal atrophy, initial BCVA, final BCVA, and retinal sensitivity all differed significantly among Groups 1–4. Conclusions. Long axial length, chorioretinal atrophy, a posterior staphyloma, and anterior traction contribute to MTM development. Patients with high myopia and unilateral MTM require regular OCT monitoring of the fellow eye to assess progression to myopic pre-MTM. For cases exhibiting one or more potential risk factors, early surgical intervention may maximize the visual outcomes.

The authors report a case of optical coherence tomography angiography (OCTA) features of retina and choriocapillaris before and after the surgical removal of a subfoveal perfluorocarbon liquid (PFCL) bubble. Before the surgery, the fovea avascular zone (FAZ) of both superficial and deep inner retinal layers (SRL/DRL) dramatically enlarged. However, after the removal, the FAZ continually decreased in both layers, even becoming close to normal in size. The abnormal choriocapillaris dark areas were also undetectable. Before and after surgery, the angle of the maximum FAZ diameter constantly remained horizontal and within normal limit in the SRL, forming an oval-shaped FAZ. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1062-1066.].

Aims To evaluate the prevalence of metamorphopsia after successful rhegmatogenous retinal detachment (RRD) surgery and determine the independent predictors of metamorphopsia. Methods A cross-sectional, comparative study. The study included 380 eyes of 357 patients who underwent a successful RRD surgery between 2009 and 2015. The presence of metamorphopsia was tested with an Amsler grid and the foveal microstructure was scanned with high-resolution spectral-domain optical coherence tomography (OCT) at a follow-up visit. Medical records were reviewed for preoperative and intraoperative factors associated with postoperative visual recovery. Results The mean follow-up period was 35.1±19.6 months. The prevalence of metamorphopsia in our study was 46.58% (177/380), whereas in macula-off cases this number increased to 56.69% (144/254). Stepwise logistic regression analysis indicated that younger age at the diagnosis (OR=0.97, p<0.01), preoperative macula-off status (OR=3.34, p<0.01), postoperative presence of subretinal fluid (SRF) (OR=3.58, p=0.01) and disrupted external limiting membrane (ELM) junction (OR=1.79, p=0.02) were the independent predictors for metamorphopsia after surgery. The abnormal foveal microstructures after successful surgeries mainly included six types: disrupted inner segment/outer segment (133 eyes, 35.00%), disrupted ELM (131 eyes, 34.47%), epiretinal membrane (44 eyes, 11.58%), SRF (26 eyes, 6.84%), macular hole (9 eyes, 2.37%) and cystoid macular oedema (6 eyes, 1.58%). Conclusions Considering metamorphopsia, special attention should be paid to young patients and/or the cases with involvement of macula. High-resolution OCT is informative in detecting anatomic abnormalities after RRD surgery. The postoperative presence of SRF and disrupted ELM line are independent predictors of metamorphopsia.

Objective To observe the macular structure changes and its relationship with visual function in patients with idiopathic macular hole (IMH).Methods Forty-seven patients (47 eyes) with IMH who underwent pars plana vitrectomy were enrolled in this study.All patients were examined including best corrected visual acuity ( BCVA ), slit-lamp microscopy, indirect ophthalmoscopy, B-scan ultrasonography,optical coherence tomography (OCT) and MP-1.All the patients underwent a standard three-port pars plana vitrectomy.The BCVA,mean light sensitivity (MS) in macular area,macular hole diameter,the photoreceptor inner and outer segment (IS/OS) junction defect,external limiting membrane (ELM) defect were observed on the 1st,3rd and 6th months after surgery,and then the relationship of IS/OS junction defect,ELM defect,sensitive and BCVA were analyzed.Results The 1st,3rd and 6th months after surgery,the logarithm of minimal angle of resolution (logMAR) BCVA (t=16.4,35.7,20.7; P＜0.05) and MS (t=-13.8,-17.9,-2.5; P＜0.05) were improved significantly; the macular hole diameter (t=7.7,7.7,7.7; P＜0.05),IS/OS junction defect (t=24.1,19.3,27.4; P＜0.05) and ELM (t=20.5,6.7,15.8; P＜0.05) defect were decreased significantly.Preoperative IS/OS junction defect and ELM defect were both related to sensitive (r=-0.55,-0.53; P＜0.05),but uncorrelated with BCVA (r=0.13,0.13; P＞0.05).IS/OS junction defect and ELM defect 1st,3rd and 6th months after surgery were both related to MS and BCVA (P ＜ 0.05). Conclusions The logMAR BCVA and MS increase,while IS/OS junction and defect ELM defect decrease after surgery in IMH patients. IS/OS junction defect and ELM defect after surgery were both related to sensitive and BCVA.

OBJECTIVE:To identify the correlation between serum-based differentially expressed proteins and pathological myopia.METHODS:It was a case-control study. The serum of 30 pathological myopia patients and 30 age- and gender-matched normal controls were collected from Shanghai First People's Hospital affiliated to Shanghai Jiaotong University. These patients were divided into 4 groups including macular-off retinal detachment (8 cases), retinal geographic atrophy (5 cases), macular hole (11 cases) and choroidal neovascular (6 cases). The serum specimens of normal controls were used as immunogen to immune rabbits in order to prepare polyclonal antibodies. Purified by Protein A cartridge, these mixed antibodies were then combined with CNBr-activated Sepharose so as to synthesize affinity medium which was finally used to treat the serum specimens. According to the theory of antigen and antibody, common background proteins would be deleted. The remaining non-binding proteins were analyzed by capillary high-performance liquid chromatography and LTQ-MASS. Nonparametric statistical analysis was used to detect the correlation each differentially expressed protein.RESULTS:The result of HPLC and LTQ-MASS in 30 specimens of patients revealed 4 peaks of differentially expressed proteins including JTR (positive in 18 specimens, 60%), HP( positive in 11 specimens, 36.7%), HPX (positive in 10 specimens, 33.3%), APO (positive in 8 specimens, 26.7%). There were positive correlations between these 4 proteins (the correlation between TTR and HP, HPX, APO is r = 0.480, 0.577, 0.492; the correlation between HP and TTR, HPX, APO is r = 0.480, 0.783, 0.636; the correlation between HPX and TTR, HP, APO is r = 0.577, 0.783, 0.853; the correlation between APO and TTR, HP, HPX is r = 0.492, 0.636, 0.853; P < 0.05). In group of macular hole, TTR was positive expressed in 7 specimens while other differential proteins were low expression. In group of choroidal neovascular, TTR and HP were positive expressed in 6 specimens while HPX was significantly high in 5 specimens. In other two groups, the expression of 4 differential proteins was rather low.CONCLUSIONS:Screening molecular biomarkers by serum-based proteomics can efficiently exclude common proteins and find differential proteins correlated with pathological myopia. These differential proteins may become molecular biomarkers of pathological myopia in the future.

Objective To compare the clinical effects of silicone removal by sutureless 23G pars plana surgery and routine 20G pars plana surgery.Methods One hundred and seventy-four consecutive patients(174 eyes) with rhegmatogenous retinal detachment undergoing single silicone removal were selected,and were divided into sutureless 23G pars plana surgery group(23G group,79 eyes) and routine 20G pars plana surgery group(20G group,95 eyes).The duration of surgery,visual acuity,intraocular pressure and complications after surgery were recorded and analysed.Results The mean duration of follow-up was(11.5±5.5) months(6 to 18 months).The mean duration of silicone removal in 23G group was(16.5±4.2) min,while that in 20G group was(35.2±7.4) min,and there were significant differences between two groups(P0.01).There was no significant difference in best corrected visual acuity between two groups(P0.05).Intraocular pressure in 23G group was significantly lower than that in 20G group 1 d and 3 d after surgery(P0.05).The incidence of conjunctival inflammation in 23G group was significantly lower than that in 20G group(P0.05) during follow-up.There was no significant difference in incidences of choroidal detachment,recurrent retinal detachment,vitreous opacity and vitreous hemorrhage between two groups after surgery(P0.05).Conclusion Compared with routine 20G pars plana surgery,silicone removal by sutureless 23G pars plana surgery is time-saving,with less complications after surgery,which may have definite prospects in clinical application.