论著

囊袋张力环植入对新一代 IOL 计算公式在高度近视患者中预测准确性的影响

Predictive accuracy and effect of capsular tension ring implantation with new generation intraocular lens calculation formulas in high myopia patients

:782-789
 
目的:探究囊袋张力环(CTR)植入对五种新一代人工晶状体(IOL)计算公式[Barrett Universal Ⅱ (BUⅡ), Emmetropia Verifying Optical (EVO), Kane, Pearl-DGS和Hill-RBF 2.0]在高度近视患者中预测准确性的影响。方法:前瞻性病例对照研究。观察2020年12月—2021年9月于陕西省眼科医院就诊的眼轴长度(axial length,AL)≥ 27.00 mm行白内障联合IOL(AR40E, 美国强生)植入术的患者。术眼随机分为植入CTR组(A组)和未植入CTR组(B组)。术前根据IOLMaster700测量眼部参数,使用BU Ⅱ公式计算所需IOL度数。记录术后1周、1个月及3个月实际等效球镜度(spherical equivalent,SE),计算并比较五种公式预测误差(prediction error,PE)和绝对屈光预测误差(absolute Error,AE)。将A组和B组分别分为A1组(27.00 mm ≤ AL ≤ 30.00 mm)和A2组(AL>30.00 mm);B1组(27.00 mm ≤ AL ≤ 30.00 mm)和B2组(AL >30.00 mm),分析不同AL范围内CTR植入对公式预测准确性的影响。结果:共纳入患者63例(89眼),年龄(55.93±10.17)岁,术前AL为(30.30±2.18)mm。A组、A1组及A2组术后不同时间SE值比较差异均无统计学意义(P>0.05),B组、B1组及B2组术后1周与1个月,术后1周与3月SE值分别比较差异有统计学意义(P<0.05),术后1个月与3个月比较,差异无统计学意义(P>0.05)。A组、B组、A1组、A2组、B1组和B2组各组中五种公式的AE值比较差异均无统计学意义(均P>0.05)。植入CTR后五种公式的预测误差变化比较差异无统计学意义(P>0.05)。结论:对于AL ≥27.00 mm的白内障患者,植入CTR组术后1周屈光度趋于稳定,未植入组术后1个月屈光度趋于稳定。CTR植入对五种公式预测准确性和选择无影响,五种计算公式均可正常选择。
Objective: To investigate the predictive accuracy and effect of capsular tension ring (CTR) implantation with five new generation intraocular lens (IOL) calculation formulas [Barrett Universal Ⅱ (BU Ⅱ), Emmetropia Verifying Optical(EVO), Kane, Pearl-DGS and Hill-RBF 2.0] in high myopia patients. Methods: This is a prospective case-control study. The patients were enrolled with an axial length (AL)≥27.00 mm, and underwent cataract surgery with AR40E IOL implantation at the Shaanxi Eye Hospital from December 2020 to September 2021. The patients were randomly assigned to the CTR implantation group (group A) and the non-CTR implantation group (group B). With the ocular parameters measured by the IOLMaster700, the IOL power was calculated with the BUⅡformula before surgery. The postoperative actual equivalent spherical diopter (SE) were recorded,and the predicted error (PE) and absolute error (AE) using the five formulas were recorded and compared at 1 week, 1 month, and 3 months, repsectively. Group A was divided to A1 (27.00 mm ≤ AL ≤ 30.00 mm) and A2 (AL>30.00 mm), and group B was divided to B1 (27.00 mm ≤ AL ≤ 30.00 mm) and B2 (AL>30.00 mm). The effects of CTR implantation and the accuracy of the formulas were analyzed with different AL ranges. Results: A total of 63 patients (89 eyes) were included, aged (55.93±10.17) years old, with preoperative AL (30.30± 2.18)mm. There was no statistically significant difference in SE between groups A, A1, and A2 (P>0.05) at different postoperative times. While there was a statistically significant difference in SE between groups B, B1, and B2 (P < 0.05) at 1 week and 1 month after surgery, and between 1 week and 3 months after surgery. There was no statistically significant difference between 1 month and 3 months after suergery (P>0.05). There was no significant difference in the AE using the five formulas among groups A, B, A1, A2, B1, and B2 (P>0.05). There was no statistically significant difference in prediction error changes among the five formulas after CTR implantation (P>0.05). Conclusion: For cataract patients with AL ≥ 27.00 mm, the refractionvalue in the CTR implantation group tended to stabilizeafter one week of surgery. While in the non-CTR implantation group, the refractionvalue tended to stabilize after one month. CTR implantation had no effect on the accuracy and selection of the five formula, and the five IOL calculation formulas can be normally selected.
论著

青光眼日间手术患者自我管理行为现状及相关因素分析

Influence factor of self-management among glaucoma patients undergoing day surgery

:129-136
 
目的:探讨青光眼日间手术患者的自我管理行为现状及影响因素分析。方法:采用便利抽样法选取2021年9月—2022年5月于广州市某三级甲等眼科专科医院就诊的223例青光眼日间手术患者。采用一般资料调查表、青光眼自我管理行为量表、慢性疾病自我效能量表和青光眼知识学习问卷进行问卷调查。结果:青光眼日间手术患者的自我管理行为得分为(54.03±6.95)分,其中生活调整维度得分最低。慢性病自我效能与自我管理行为呈正相关(r=0.368, P<0.001)。疾病知识与自我管理行为无显著相关性(r=0.077, P=0.252)。多因素线性回归分析结果显示,患者的文化程度(P<0.001)和自我效能(P=0.028)是自我管理行为的影响因素,可解释自我管理行为总变异的12.4%。结论:青光眼日间手术患者具有良好的自我管理行为,较低的自我效能和文化程度是自我管理行为的危险因素,因此应优先提高患者的自我效能,并提供个性化教育。

Objective: To determine self-management and its association with self-efficacy and knowledge among glaucoma patients undergoing day surgery. Methods: A total of 223 glaucoma patients were recruited from September 2021 to May 2022and they were investigated with the Glaucoma Self Management Questionnaire (GSMQ), The Self- Efficacy in Chronic Disease Scale (SECD-6), and the glaucoma knowledge questionnaire. Results: Of the 223 study participants, the study population had a total GSMQ score of 54.03±6.95 with the lowest score found in the life adjustment dimension. The total SECD-6 score was showing a significantly positive correlation with the total GSMQ score(r =0.368, <0.001). The total score of disease knowledge was without significant correlation with the total GSMQ score (=0.077, =0.252). Multivariate linear regression analysis showed that self-efficacy (<0.001) and education level was independently associated with self-management(=0.028). Conclusions: Glaucoma patients undergoing daytime surgery demonstrated good overall self-management, yet further improvement was required in terms of life adjustment. Low self-efficacy and educational level were identified as risk factors for self-management. Therefore, self-management programs should prioritize enhancing patients' self-efficacy and delivering individualized education.

论著

单中心神经眼科住院患者疾病谱及流行病学分析

Analysis of disease spectrum and epidemiology of inpatients with neuroophthalmic disease from single center

:190-198
 
目的:分析单中心神经眼科疾病谱及流行病学特点,为指导神经眼科疾病诊断和治疗提供基础。方法:纳入2010年1月1日—2021年12月31日中国人民解放军总医院神经眼科病区收治的神经眼科疾病患者,从电子病例系统检索和记录所有纳入病例的年龄、性别、地区分布及病种亚型分析。结果:共计7245例神经眼科患者纳入统计,其中男性3331例(46.0%)、女性3914例(54.0%),男女比例1∶1.2;年龄(38.2±17.5)岁。83.25%(6031/7245)为传入神经系统疾病,9.92%(719/7245)为传出神经系统疾病和眼眶疾病,6.83%(495/7245)未归类。病种分析显示,占比最高的是脱髓鞘性视神经炎(demyelinating optic neuritis,DON),为40.17%(2910/7245);占比第二的是非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION),为11.37%(824/7245);占比第三的是外伤性视神经病变5.15%(373/7245),其中7.85%(569/7245)表现为不明原因视神经萎缩。从年龄分布来看,DON和外伤性视神经病变患者中18~40岁者占比最高(分别为48.63%和44.24%),NAION患者中41~60岁者占比最高(66.14%),小于18岁的未成年患者在遗传性视神经病变中占比最高,比例为48.58%。在2226例DON患者中,视神经脊髓炎(neuromyelitis optica,NMO)/视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)比例最高,为60.02%;髓鞘少突胶质细胞糖蛋白抗体(myelinoligodendrocyte glycoprotein antibody,MOG-IgG)阳性视神经炎比例为11.68%;多发性硬化(multiple sclerosis,MS)和MS相关性视神经炎和慢性复发性炎性视神经病变(chronic recurrent inflammatory optic neuropathy,CRION)占比较低,分别是1.8%和2.25%。DON整体患者中,男女比例为1∶3.08;在NMO/NMOSD患者中男女比例为1∶8;MOG阳性视神经炎患者中,男女比例为4∶5;在非典型视神经炎患者中,男性比例高于女性,为1.28∶1;DON患者中,81.79%患者为中青年,MOG阳性视神经炎未成年患者可达41.15%。结论:DON和NAION是神经眼科传入系统疾病最常见两大病种。
Objective: To analyze the spectrum and epidemiological characteristics of neuro-ophthalmic diseases from single center, and to provide basis for guiding the diagnosis and treatment of neuro-ophthalmic diseases. Methods: Patients with neuro-ophthalmic diseases admitted to the neuro-ophthalmology ward of Chinese PLA General Hospital from January 1, 2010 to December 31, 2021 were enrolled. The age, gender, regional distribution and disease subtypes of all included patients were retrieved and recorded from the electronic case system. Results: A total of 7245 patients with neuro-ophthalmic diseases were enrolled, including 3331 males(46.0%)and 3914 females(54.0%), with a male to female ratio of 1:1.2. The average age was 38.2±17.5 years. 83.25%(6031/7245)were afferent nervous system diseases, 9.92% (719/7245)were efferent nervous system diseases and orbital diseases, and 6.83%(495/7245)were not classified. The ratio of demyelinating optic neuritis(DON)was the highest(40.17%,2910/7245), followed by nonarteritic anterior ischemic optic neuropathy(NAION)(11.37%,824/7245)and traumatic optic neuropathy(TON) (5.15%,373/7245). The ratio of optic nerve atrophy with unknown causes was 7.85%(569/7245). Characteristics of age distribution, the DON and TON were more common in 18-40 age group(the proportion were 48.63% and 44.24%,respectively), the NAION was common in 41-60 age group(66.14%), and the hereditary optic neuropathy was common in younger 18 age group (48.58%). In 2226 DON patients, the proportion of neuromyelitis optica(NMO)/neuromyelitis optica spectrum disorder(NMOSD)-optic neuritis(ON)was the highest(60.02%)and myelinoligodendrocyte glycoprotein antibody(MOG-IgG)ON was 11.68%, while multiple sclerosis(MS)-ON and chronic recurrent inflammatory optic neuropathy(CRION)were relatively low(1.8% and 2.25%,respectively). In DON patients, the male to female ratio was 1:3.08. In NMO/NMOSD-ON patients, the ratio of male to female was 1:8, and that of MOG-ON was 4:5. In atypical ON, the ratio of male to female was higher than that of female(1.28:1). In DON patients, 81.79% of patients were young and middle-aged, and the proportion of children with MOG-ON(less than 18 years old)was 41.15%.Conclusions: DON and NAION are the two most common diseases of neuro-ophthalmic afferent system.
综述

脑卒中后视野缺损患者干预方案范围综述

Intervention plan for visual field defects in patients with stroke: a scoping review

:462-470
 
目的:系统分析脑卒中后视野缺损患者干预方案的相关研究,识别、归纳及总结干预的具体内容、结局指标和干预效果,为临床实践及未来该领域研究提供参考。方法:采用范围综述研究框架,系统检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、CINAHL、Cochrane Library共9个数据库。检索时限为建库至2024年4月10日。对纳入文献进行筛选、汇总和分析。结果:最终纳入12篇文献,总结脑卒中后视野缺损患者干预方法及结局指标,干预方法包括替代性干预、补偿性干预、恢复性干预等,结局指标包括日常生活活动能力、日常生活扩展活动能力、阅读表现、视野检查等。结论:目前针对脑卒中后视野缺损患者的干预方案内容多样化、证据质量较低、结局指标不统一,有待进一步开展高质量研究探索最佳训练计划和规范结局指标。未来应不断改进、优化康复策略,建立最佳的多学科结构,制定科学、系统、个性化方案。
Objective: To systematically analyze the related studies on intervention schemes for patients with visual field defects after stroke, and to identify, summarize, and summarize the specific content, outcome indicators, and intervention effects, thereby providing a reference for clinical practice and future research in this field. Methods: Utilizing the scoping review method, a systematic search was conducted in 9 databases: CNKI, CQVIP, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science, Embase, CINAHL and the Cochrane Library. The search encompassed the period from the inception of each database to April 10, 2024. The selected literature was subsequrently screened, summarized, and analyzed. Results: A total of 12 articles were finally included, summarizing the intervention methods and outcome indicators for patients with visual field defects after stroke. The intervention methods comprised alternative intervention, compensatory intervention, and rehabilitative interventions. Outcome indicators include daily living activities, daily living extended activities, reading performance and visual field examination. Conclusion: Current intervention schemes for patients with visual field defects after stroke exhibit diverse content, charaterized by low evidence quality and inconsistent outcome indicators. Further high-quality research is needed to explore optimal training plans and standardize the outcome indicators. In the future, continuous improvement and optimization of rehabilitation strategies should be carried out to establish the best multidisciplinary framework and formulate scientific, systematic and individualized plans.
病例报告

准分子激光原位角膜磨镶术后白内障患者术后远视漂移一例

A case of hyperopic drift after cataract surgery in a patient with previous laser in situ keratomileusis

:874-879
 
该文报道了一例40岁女性患者,因“双眼渐进性视物模糊3个月”就诊。患者既往于2005年因高度近视行双眼准分子激光原位角膜磨镶术 (LASIK)。最佳矫正视力OD:0.2 (–11.00 DS/ –1.25 DC×170 °),OS:0.7 (–4.00 DS/ –0.75 DC×25 °)。双眼角膜透明,前房中深,晶状体混浊,豹纹状眼底伴后巩膜葡萄肿。诊断为双眼并发性白内障,并行右眼白内障超声乳化联合人工晶状体 (IOL) 植入术,术中植入+14.0 D IOL一枚,目标屈光度为–0.5 D。术后1周裸眼视力0.3,验光结果示右眼屈光度+2.75 DS,最佳矫正视力0.7。术后2周行右眼IOL置换术,由+14.0 D置换为+17.0 D。右眼术后1周裸眼视力0.8,验光结果示右眼屈光度–0.75 DC×15 °。

It is reported in this article that a 40-year-old female patient presented with "progressive blurred vision of both eyes for 3 months". The patient underwent bilateral laser in situ keratomileusis (LASIK) because of high myopia in 2005. It was recorded that her best corrected visual acuity was 0.2 (–11.00 DS/ –1.25 DC×170 °) in the right eye and 0.7 (–4.00 DS/ –0.75 DC×25 °) in the left, and clear cornea, normal anterior chamber, cloudy lens, tessellated fundus with posterior staphyloma in both eyes. The patient was diagnosed with bilateral complicated cataract. Phacoemulsification combined with intraocular lens (IOL, +14.0 diopter (D)) implantation was performed on the right eye, with the target –0.5D refractive diopter . One week after surgery, it was recorded that the uncorrected visual acuity of the right eye was 0.3, and the best corrected visual acuity was 0.7 (+2.75 DS). IOL replacement of the right eye was performed two weeks after surgery, the +14.0 D IOL was replaced by +17.0 D IOL. One week after surgery, the uncorrected visual acuity of the right eye was 0.8 (–0.75 DC×15 °).
论著

湿性老年性黄斑变性患者自我感受负担现状及影响因素研究

A study on status and influencing factors of self-perceived burden in patients with wet age-related macular degeneration

:441-448
 
目的:了解湿性老年性黄斑变性(age-related macular degeneration,AMD)患者自我感受负担(self-perceived burden,SPB)现状及其影响因素。方法:采用方便抽样法选取2021年1月至11月在中山大学中山眼科中心就诊的204例湿性AMD患者为研究对象,采用一般资料调查表、SPB量表、家庭支持自评量表、医学应对问卷对其进行测评。结果:患者SPB得分是(21.98±6.68)分,总体属于轻度SPB。湿性AMD患者的SPB水平与家庭支出(r=?0.326, P<0.001)和面对应对(r=?0.365, P<0.001)呈负相关,与回避(r=0.456, P<0.001)及屈服(r=0.310, P<0.001)应对方式呈正相关性。多重线性回归显示,独居、高龄、自费、双眼患病及采用回避应对的患者的SPB更高,而高文化水平、高家庭支持的患者SPB较轻。结论:湿性AMD患者有轻度SPB,但仍存在改善空间,医护工作者在工作中应重点关注高龄、文化程度低、家庭收入低、自费、独居、双眼患病及低视力的患者,及时进行心理疏导,减轻患者的SPB水平。
Objective: To understand the current status and influencing factors of self-preceived burden (SPB) in patients with wet age-related macular degeneration (AMD). Methods: 204 patiens with wet AMD who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from January to November 2021 were enrolled as the study subjects with convenience sampling method. A general information questionnaire, SPB scale, family support self-assessment scale, and medical coping questionnaire were collected from the subjects for assessment. Results: The patient’s SPB score was 21.98±6.68, which is generally mild SPB. The SPB level of patients with wet AMD was negatively correlated with family support (r=-0.326, P<0.001) and coping (r=?0.365, P<0.001), and were positively correlated with avoidance (r= 0.456,P<0.001), and surrender (r=0.310, P<0.001) coping style. Multiple linear regression showed that the patients who lived alone, were elder and self-funded, had binoclur diseases and used avoidance coping, had higher SPB. While the patients with high education and family support had lower SPB. Conclusions: It is still needed to pay attention to the patients with AMD having mild SPB. Medical workers should focus on patients with elder age, low education level, low family income, self-funded, living alone, binocular disease and low vision in their work, and provide timely psychological counseling to reduce the SPB level of patients.
综述

玻璃体切除术后白内障患者屈光预测误差来源的研究进展

Research progress on the sources of refractive prediction error in cataract patients after vitrectomy

:143-149
 
随着微创玻璃体切除术(pars plana vitrectomy,PPV)的广泛开展和手术技术的提高,患者对手术后视觉质量的要求越来越高。白内障是PPV术后最常见并发症,而具有玻璃体切除史的白内障患者屈光变异大,预测难度高。本文综述了生物测量误差、人工晶状体屈光力计算公式选择以及有效晶状体位置预测等影响有玻璃体切除手术史的白内障患者术后屈光误差的主要因素,旨在为降低这一类特殊人群白内障术后屈光误差提供参考。
With the widespread application of minimally invasive vitrectomy and the improvement of surgical techniques, the demands of patients for better postoperative visual quality are increasing. Cataract is the most common complication after vitrectomy, whereas the refractive outcomes of cataract patients with prior vitrectomy are viable and difficult to predict. In this paper, the main factors affecting postoperative refractive error of cataract patients with a history of vitrectomy, such as biometric error, selection of intraocular lens calculation formulas and prediction of effective lens position, were reviewed in order to provide reference for reducing postoperative refractive error of this special group of cataract patients.
综述

马凡综合征患者眼部生物学参数特点及其对视力的影响

Characteristics of ocular biological parameters and their impact on visual acuity in patients with Marfan syndrome

:374-380
 
马方综合征 (Marfan syndrome, MFS) 是一种由原纤维蛋白-1(fibrillin-1,FBN-1)突变引起的全身性遗传性疾病,FBN-1基因突变与MFS相关表型的联系相关,目前已报道的MFS常见的眼部表现包括角膜扁平、长眼轴、晶状体异位以及视网膜病变等异常,这些眼部异常将对MFS患者的视力产生影响,如角膜异常可影响角膜高阶像差的异常,可能导致近视或散光等屈光状态异常,从而影响视觉质量,损害视力清晰度。此外,MFS的眼底血管病变,也可能导致MFS患者的视力丧失,研究发现,MFS视网膜血管及脉络膜血管的密度较正常人减少,并与最佳矫正视力相关,由于光感受器的代谢与营养供应与视网膜及脉络膜血管息息相关,血管异常可能与视力损失相关。由于MFS患者存在视力损害的风险,其早期诊断和治疗尤为重要,因此,了解MFS眼部病变的特点及其对视力的影响,对制定针对MFS眼病的治疗方案具有重要的意义。另外,由于MFS眼部异常与FBN1基因突变相关,其基因突变类型多样,致病机制复杂,总结MFS眼部特点对其发病机制的继续探索有一定的指导作用,因此,文章拟就MFS患者眼部生物学参数特点及其对视力的影响这一领域国内外的相关研究进展进行综述。
Marfan syndrome (MFS) is a systemic hereditary disease caused by fibrillin-1 (FBN-1) mutations. FBN-1 gene mutations are associated with MFS-related phenotypes. Common ocular manifestations of MFS reported so far include corneal flattening, long axial length, ectopia lentis, and retinal abnormalities. These ocular abnormalities will affect the vision of MFS patients. For example, corneal abnormalities can affect abnormalities in corneal higher-order aberrations, which may lead to abnormal refractive states such as myopia or astigmatism, thereby affecting visual quality and compromising visual acuity. In addition, retinal vascular abnormalities may also lead to vision loss in MFS patients. Studies have found that the density of retinal and choroidal blood vessels in MFS patients is lower than that in normal individuals and is associated with best corrected visual acuity. Given the close relationship between the metabolism and nutrient supply of photoreceptors and retinal and choroidal vasculature, vascular abnormalities may be linked to visual impairment. Since MFS patients are at risk of visual impairment, early diagnosis and treatment are particularly important. Therefore, understanding the characteristics of ocular manifestations in MFS and their impact on vision is crucial for devising effective treatment strategies for MFS-related ocular conditions. Additionally, as ocular abnormalities in MFS are linked to mutations in the FBN1 gene, which exhibit diverse mutation types and complex pathogenic mechanisms, summarizing the ocular features of MFS can provide valuable insights for further exploration into its pathogenesis. Therefore, this article aims to review the progress of domestic and international research on the ocular biological parameters of MFS patients and their impact on vision.
论著

基于 OA-2000 测量的硅油取出联合白内障手术患者人工晶状体计算公式预测准确性分析

Prediction accuracy analysis of intraocular lens calculation formulas in patients undergoing silicone oil removal combined with cataract surgery based on OA-2000 measurement

:857-866
 
目的:在硅油取出联合白内障手术患者中,使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物测量,比较10种人工晶状体(IOL)屈光力计算公式的准确性。方法:回顾性分析2021年3月—7月于中山大学中山眼科中心接受硅油取出联合白内障手术的患者共62例(62眼),所有患者均使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物学参数测量。计算并比较新公式[Barrett Universal II (BUII)、Emmetropia Verifying Optical(EVO) 2.0、Hill-Radial Basis Function (Hill-RBF) 3.0、Hoffer QST、Kane、Pearl-DGS]及传统公式(Haigis、Hoffer Q、Holladay 1、SRK/T)的预测准确性,主要评价指标为绝对预测误差中位数(MedAE)及平均绝对预测误差(MAE)。按眼轴长度≤23 mm(组1),>23 mm且≤26 mm(组2)与>26 mm(组3)进行亚组分析。结果:6个新公式、Haigis、SRK/T公式均出现近视漂移(-0.47 ~-0.27 D,P<0.05),而HofferQ及Holladay 1公式无系统误差(P>0.05)。Kane公式的MedAE(0.55 D)及MAE(0.81 D)最小,但公式间比较差异无统计学意义(P>0.05)。组1中所有公式均出现近视漂移(-1.46~ -1.25 D,P<0.05),而其他亚组比较差异无统计学意义(-0.32 ~ 0.41 D,P>0.05)。在组1中,Pearl-DGS公式的MedAE(0.97 D)及MAE(1.26 D)最小,且优于Hill-RBF 3.0(P=0.01)及SRK/T公式(P=0.02);组2中,Kane公式具有最小的MedAE(0.44 D)及MAE(0.66 D);组3各个公式屈光预测准确性比较差异无统计学意义(P>0.05)。结论:在使用OA-2000进行术前生物测量时,Kane公式在接受硅油取出联合白内障手术患者中的预测准确性较高;而眼轴长度≤23 mm时,Pearl-DGS公式可能更为准确。
Objective: To compare the accuracy of 10 intraocular lens (IOL) power calculation formulas in patients undergoing combined silicone oil removal and cataract surgery, biometry is performed using the swept-source optical coherence tomography biometer OA-2000. Methods: A retrospective analysis. A total of 62 patients (62 eyes) who underwent combined silicone oil removal and cataract surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from March to July in 2021 were enrolled. Preoperative biometry was performed by OA-2000 in all patients. New-generation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO] 2.0, Hill-Radial Basis Function [Hill-RBF] 3.0, Hoffer QST, Kane and Pearl-DGS) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) were evaluated. The median absolute prediction error (MedAE) and mean absolute prediction error (MAE) were the main parameters used to assess accuracy. Subgroup analyses were performed based on the axial length of 23 mm and 26 mm. Results: Six new-generation formulas, Haigis, and SRK/T showed myopic shift (-0.47 ~ -0.27 D, P<0.05), while no systematic bias was found in Hoffer Q and Holladay 1 displayed (P>0.05). The smallest MedAE (0.55 D) and MAE (0.81 D) were found in Kane formula, but there was no statistically significant difference compared with other formulas (P>0.05). The myopic shift (-1.46 ~ -1.25 D, P<0.05) in eyes shorter than 23 mm were found in all formulas, while there was no significant systematic bias (-0.32 ~ 0.41 D, P>0.05) in other subgroups. In axial length shorter than 23 mm, the Pearl-DGS formula stated the smallest MedAE (0.97 D) and MAE (1.26 D), and was significantly more accurate than Hill-RBF 3.0 (P=0.01) and SRK/T (P=0.02). In eyes with an axial length between 23 mm and 26 mm, the Kane formula had the lowest MedAE (0.44 D) and MAE (0.66 D). No significant difference was found in eyes longer than 26 mm. Conclusion: The Kane formula showed the highest accuracy in patients undergoing combined silicone oil removal and cataract surgery measured by OA-2000, whereas the Pearl-DGS formula could be more accurate in eyes with an axial length shorter than 23 mm.
论著

眼科成人日间手术患者病区护理管理的最佳证据总结

Nursing management of ophthalmic postoperative adult intra-day ward: a systemic review

:571-579
 
目的:评价并汇总眼科成人日间手术患者病区护理管理的最佳证据,提高临床护理质量。方法:检索国内外数据库建库至2022年6月的日间手术患者病区护理管理的相关证据,包括系统评价、临床决策、证据总结、指南及专家共识。由2名研究人员独立对文献进行质量评价后,根据主题对证据进行提取和汇总。结果:根据纳入标准,共筛选出13篇文献,包括5篇专家共识、3篇证据总结、1篇循证实践、2篇系统评价、1篇指南。通过文献阅读、证据提取和归类,从日间手术护士准入资质、制定临床护理路径、院前管理、病历标准化、手术当日术前管理、术后管理、出院评估、康复及随访指导8个方面形成17条最佳证据。结论:该项目总结了眼科成人日间手术患者病区护理管理的最佳证据,可为护理管理者制定眼科日间手术病区流程方案、实践标准提供循证依据。
Objective: To evaluate and summarize the evidences of nursing management of ophthalmic postoperative adult patients intra-day ward, and improve the quality of clinical nursing. Methods: The related databases were searched from the  establishment to June 2022. The searching contents include systematic review, clinical decision-making, evidence  summary, guidelines and expert consensus on nursing management in postoperative patients intra-day wards at home  and aboard. Based on the theme, the evidences were extracted and summarized after independent literature quality  evaluation was conducted by 2 researchers. Results: Base on the inclusion criteria, a total of 13 pieces of literature were  selected, including 5 expert consensus, 3 evidence summaries, 1 evidence-based practice, 2 systematic reviews and 1  guideline. Through literature review, evidence extraction and classification, a total of 17 pieces of evidence on 8 aspects  were summarized, including admission qualifications for daytime surgical nurses, development of clinical nursing path,  pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative  management, discharge assessment, rehabilitation and follow-up guidance. Conclusion: This article summarized the  best evidence of nursing management for ophthalmic adult day surgery patients in intra-day ward,to provide scientific  evidences for nursing managers to develop ophthalmic intra-day ward guidelines and practical standards.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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