综述

白内障的分子病理改变

Molecular pathological changes of cataract

:663-668
 
白内障是世界范围内失明的主要原因。正常晶状体是富有弹性的形似双凸透镜的透明体,是机体内蛋白质含量最高的组织,由晶状体囊膜、晶状体上皮细胞、晶状体纤维和悬韧带构成。白内障为晶状体透明度下降,表现为晶状体混浊。近年来随着分子生物学、表观遗传学、免疫学、有机化学等学科快速发展,国内外学者对白内障也进行了大量分子水平的研究,探讨了白内障发生发展相关分子机制,为未来基因治疗和靶向药物等治疗白内障提供了理论基础。对白内障分子病理改变的了解,是白内障精准诊治的基础。
Cataract is the main cause of blindness worldwide. The normal crystalline lens is a transparent biconvex disc,with highest protein content in all human tissues. The lens is composed of capsule, lens epithelial cells, lens fiber and zonular ligment. Cataract is a decrease in the transparency of the lens, which is characterized by opacity. In recent years, with the rapid development of molecular biology, epigenetics, immunology and organic chemistry,researchers have conducted a large number of studies on the molecular basis of genetic or targeted therapy of cataract. It is important to know the molecular pathology of cataract, which is the basis of precise diagnosis and treatment of cataract.
论著

白内障超声乳化手术中主控液流与重力液流系统对青光眼患者视盘血流的影响

Influence of active versus passive phacoemulsification fluidics systems on optic disc blood flow in patients with glaucoma

:642-648
 
目的:比较重力液流与主控液流2种灌注方式下行白内障超声乳化手术对青光眼患者视盘血流的影响。方法:采用随机数字表法将患者分为2组,分别为重力液流灌注组和主控液流灌注组。记录术中超声乳化累积释放能量(cumulative dissipated energy,CDE),术后1天、1周、1个月和3个月患者最佳矫正视力(best corrected visual acuity,BCVA)、眼压、视盘血流密度及视网膜神经纤维层厚度。结果:主控液流灌注组术中CDE小于重力液流灌注组(5.6±1.3 vs 6.3±1.2,P=0.034)。术后1天重力液流灌注组视盘周围血管密度(circumpapillary vascular density,cpVD)、整个图像血管密度(whole en face image vessel density,wiVD)和视盘内血管密度(inside disc vascular density,inside disc VD)均高于主控液流灌注组(P<0.05),其余时间点差异无统计学意义(P>0.05)。术后1周和1个月重力液流灌注组视网膜神经纤维层厚度大于主控液流灌注组(P<0.05),术后1天和3个月未见明显差异。结论:相较于传统的重力液流灌注,主控灌注能够在青光眼患者白内障超声乳化手术中减少超声能量的使用,术后早期可减轻由术中高眼压引起的视盘炎症性充血,可以减轻对视网膜神经纤维层的影响。
Objective: To compare the influence of active versus passive phacoemulsification fluidics systems on optic disc blood flow in patients with glaucoma. Methods: Patients were divided into 2 groups by a random number table method, namely the active fluidics system group and the passive fluidics system group. The intraoperative cumulative dissipated energy (CDE) was recorded, and the best corrected visual acuity (BCVA), intraocular pressure, optic disc blood flow density and retinal nerve fiber layer thickness were measured at the follow-up of 1 day, 1 week, 1 month and 3 months. Results: During phacoemulsification, CDE in the active fluidics system group was lower than that in the passive fluidics system group (5.6±1.3 vs. 6.3±1.2, P=0.034). One day after the surgery,the circumpapillary vessel density (cpVD), whole image vessel density (wiVD) and inside disc vascular density(inside disc VD) in the passive fluidics system group were higher than those in the active fluidics system group(P<0.05), and the differences were not statistically significant at the rest of the follow-ups (P>0.05).The retinal nerve fiber layer in passive fluidics system group was thicker than that in active fluidics system group at the follow-ups of 1 week and 1 month (P<0.05), and the difference was not statistically significant at the follow-up ofs 1 day and 3 months. Conclusion: Compared with the traditional passive fluidics system, the active fluidics system can reduce the CDE during phacoemulsification surgery. It can reduce the inflammatory congestion of the optic disc caused by intraoperative high intraocular pressure on the early postoperative stage. In addition, it can also protect retinal nerve fiber layer.
论著

四种仪器在暗室环境下测量白内障患者Kappa角的对比研究

Comparison of four kinds of instruments in measuring angle Kappa in cataract patients in a dark room

:517-524
 
目的:比较四种不同原理的仪器在暗室中对年龄相关性白内障患者Kappa角测量的一致性。方法:对年龄相关性白内障术前60例(60只眼),暗室中适应10 min后,分别应用iTrace视觉分析仪、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径和Kappa角。四种仪器间所测量的数据比较采用单因素方差分析检验和Kruskal-Wallis非参数检验,一致性比较采用Bland-Altman分析。结果:iTrace、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径分别为(4.64±0.71) mm,(2.96±0.47) mm,(4.86±0.76) mm,(4.66±0.92) mm;Kappa角大小分别为(0.227±0.121) mm,(0.161±0.09) mm,(0.2±0.124) mm,(0.203±0.104) mm;大于0.5 mm的Kappa角比例分比为3.33%、3.33%、1.67%、1.67%;Pentacam和iTrace的Kappa角测量结果有统计学意义(P=0.001),Pentacam和Lenstar900、IOLMaster700的Kappa角测量结果差异无统计学意义(P=0.044,0.036),其他三种仪器之间Kappa角测量结果差异均无统计学意义(P=0.181,0.245,0.860); 60例被检测者对iTrace、PentacamHR、Lenstar900、IOLMaster700四种仪器测量过程中光强度主观评分结果显示60例(100%)被检测者认为Pentacam HR在测量过程中有明显的不适感,40例(66.67%)被检测者认为IOLMaster700检测过程中舒适感最好,结果差异有统计学意义(χ2=191.236,P<0.001)。结论:Pentacam HR与iTrace、Lenstar900和IOLMaster700三种仪器在暗室中Kappa角的测量结果一致性稍差,临床上需谨慎替换使用。
Objective: To compare the consistency of Kappa Angle measurements in patients with age-related cataracts using four instruments of different principles in a dark room. Methods: Sixty cases (60 eyes) of age-related cataract were adapted in the darkroom for 10 minutes. The pupil size and angle Kappa were measured by iTrace, Pentacam HR, Lenstar900 and IOLMaster700. One-way ANOVA test and Kruskal-Wallis nonparametric test were used to compare the measured data among the four instruments, and Bland-Altman analysis was used for consistency comparison. Results: The measured pupil diameters of iTrace, Pentacam HR, Lenstar900 and IOLmaster700 were 4.64±0.71 mm, 2.96±0.47 mm, 4.86±0.76 mm and 4.66±0.92 mm. The Angle Kappa sizes were 0.227±0.121 mm, 0.161± 0.09 mm, 0.2±0.124 mm, 0.203±0.104 mm. The proportion of angle Kappa larger than 0.5 mm was 3.33%, 3.33%, 1.67% and 1.67%. The measurement results of angle Kappa between Pentacam and iTrace were statistically significant (P=0.001). There was no significant difference in the measurement results of angle Kappa between Pentacam and Lenstar900, Pentacam HR and IOL-Master700 (P=0.044, 0.036). There was no significant difference in the results of angle Kappa measurement among the other three instruments. The subjective score of light intensity in the process of measurement of iTrace, Pentacam HR, Lenstar900 and IOLMaster700 showed that during the process of measurement, 60 cases (100%) experienced obvious discomfort caused by the light intensity in Pentacam HR, while 40 cases (66.67%) felt comfort in IOLMaster700. The differences among the subjective score of light intensity of four instruments were statistically significant (P<0.001). Conclusion: The consistency of the measurement results of Kappa angle between Pentacam HR and iTrace, Lenstar900, IOLMaster700 in the darkroom is relatively poor, so it is necessary to be careful to replace them in clinic.
论著

PDCA循环管理模式在优化白内障日间患者诊疗流程中的应用

Application of PDCA cycle management mode in optimizing the diagnosis and treatment process of cataract patients with daytime surgery

:211-214
 
目的:探讨PDCA循环管理模式在优化白内障日间患者诊疗流程中的应用与成效。方法:选取中山大学中山眼科中心白内障病区2018年9月至2019年12月收治的白内障日间患者400例作为试验对象,选择2018年9月至2019年4月200例患者作为优化前组,选择实施PDCA循环管理模式后的2019年5月至2019年12月的200例患者作为优化后组。统计并比较两组患者实施前后的术前检查时长、住院时长、术后第1天复诊路径及患者满意度。结果:PDCA循环管理法实施了7个月后,患者术前检查时长由优化前的(2.94±2.12) h降至(2.09±0.93) h,住院时长由优化前的(22.73±1.14) h 降至(5.22±1.29) h,差异均具有统计学意义( P <0.001);患者满意度由优化前的92%上升至96%(P<0.05);术后第1天,患者复查所需行走的路径缩短,由以前的172 m降至129 m。结论:实施PDCA循环管理模式能有效地改善白内障日间患者的诊疗流程,缩短患者诊疗时间,提高患者的满意度,值得临床推广。
Objective: To explore the application and effect of Plan-Do-Check-Act (PDCA) cycle management mode in optimizing the diagnosis and treatment process of cataract patients with daytime surgery. Methods: A total of 400 cases of patients with daytime surgery admitted to Department of Cataract, Zhongshan Ophthalmic Center,Sun Yat-sen University from September 2018 to December 2019 were selected as the experimental subjects. 200 patients from September 2018 to April 2019 were selected as the pre-optimization group, and 200 patients from May 2019 to December 2019 after the implementation of the PDCA cycle management mode were selected as the post-optimization group. Time of preoperative examination, length of hospital stay, the follow-up path in the first day after surgery and patient satisfaction were statistically compared between the two groups before and after implementation. Results: Seven months after the implementation of PDCA cycle management mode, the preoperative examination time decreased from (2.94±2.12) h to (2.09±0.93) h, and the length of hospital stay decreased from (22.73±1.14) h to (5.22±1.29) h, and the differences were statistically significant (P<0.001); the patients’ satisfaction increased from 92% to 96% (P<0.05); the follow-up path in the first day after operation was changed from the 13th floor (172 m) to the 3rd floor (129 m). Conclusion: The implementation of PDCA cycle management mode can effectively improve the diagnosis and treatment process of cataract patients with daytime surgery, shorten the diagnosis and treatment time and improve the satisfaction of patients, so it is worthy of clinical promotion.
论著

微信平台在有晶体眼人工晶体植入术后并发性白内障患者延续性护理的应用

Application of WeChat platform in continuous care of patients with complicated cataract after implantable collamer lens implantation

:139-143
 
目的:探讨利用微信平台在有晶体眼人工晶体(implantable collamer lens,ICL)植入术后并发性白内障患者延续性护理的应用效果。方法:对13例(16眼)ICL植入术后并发性白内障患者利用微信平台随访和延续性护理,观察患者术前和术后1个月的护理满意度的自身对照。结果:13例患者(16眼)手术均顺利完成,术后均无出现并发症,术后视力均较术前有所提高,术后患者的护理满意度评分高于术前,差异有统计学意义(P<0.05)。结论:利用微信平台进行随访和延续性护理,可以提高患者护理满意度,是应用于ICL植入术后并发性白内障患者的有效护理方法。
Objective: To explore the application effect of WeChat platform in continuous nursing care for patients with complicated cataract after implantable collamer lens (ICL) implantation. Methods: Thirteen patients (16 eyes) with complicated cataracts after ICL implantation were followed up and continued nursing on the WeChat platform, then the self-control of the patients’ satisfaction on nursing before and one month after surgery was observed. Results: A total of 13 patients’ operation (16 eyes) went well, and they had no postoperative complications. The visual acuity of the patients was improved after operation compared with that of before operation, and the nursing satisfaction score of patients after operation was higher than that of before operation; the difference was statistically significant (P<0.05). Conclusion: Using WeChat platform for follow-up and continuous nursing can improve patients' nursing satisfaction, which was an effective nursing method for patients with complicated cataract after ICL implantation.
论著

白内障手术患者的临床分布特点

Clinical distribution characteristics of patients admitted to hospital for surgical cataract treatment

:133-138
 
目的:了解白内障手术患者的临床分布特点,为基层医院白内障防治工作提供信息参考。方法:选取2019年1月至2019年1 2月在锦州医科大学附属第三医院眼科手术医治的白内障患者892例1 008眼。查阅相关病历资料,收集姓名、性别、年龄、手术眼别、入院时间、有无糖尿病史;术前视力、角膜内皮细胞密度、眼轴、晶状体混浊类型及白内障病因;手术方式、人工晶状体(intraocular lens,IOL)、术中并发症;术后第1天眼压、视力、眼部情况,进行统计学描述及分析。结果:入 选892例1 008眼,其中男357例401眼,女535例607眼,年龄(71.17±10.28)岁,90.7%的患者病因为年龄相关性白内障。入院时间集中在3~6月和9~12月。不同年龄段白内障患者具有各自的眼部特征。白内障类型与年龄差异有统计学意义(P<0.05),相比皮质性、后囊膜下性,核性白内障患者入院年龄偏大。白内障类型与性别、有无糖尿病史差异无统计学意义(P >0.05)。白内障患者选择最多的手术方式是超声乳化吸除术联合IOL植入术,术中并发症少,术后恢复快。结论:白内障的防治工作任重道远。手术多为年龄相关性白内障患者,入院时多年龄偏大,视力偏低,错失了手术最佳时机。不同年龄段、不同类型白内障患者具有不同的特征。超声乳化吸除术因其优势成为患者首选手术方式。
Objective: To understand the clinical distribution characteristics of cataract surgery patients and provide reference for cataract prevention and treatment in primary hospitals. Methods: From January 2019 to December 2019, 892 cataract patients (1 008 eyes) were selected from the Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University. Medical records were collected, including patient’s name, gender, age, surgical eye, admission time and history of diabetes, preoperative vision, corneal endothelial cell density, eye axis, phacoscotasmus type and cataract etiology, surgery method, intraocular lens, intraoperative complications, intraocular pressure, visual acuity and eye recovery on the first day after operation. These data were statistically described and analyzed. Results: A total of 892 cataract patients (1 008 eyes) were included, including 357 males (401 eyes) and 535 females (607 eyes), with the average age of (71.17±10.28) years old. The 90.7% patients cause of disease was age-related cataract. Admission time of all patients was mainly in March–June and September– December. Cataract patients of different ages had their own ocular characteristics. There was a statistically significant difference between the type of cataract and age (P<0.05). Compared with the cortical patients and posterior subcapsular patients, nuclear cataract patients were older at admission. There was no significant difference in the type of cataract between the gender and the patients with diabetes or not (P>0.05). The most frequently selected surgical method for cataract patients was phacoemulsification and intraocular lens implantation, which has the advantages of less intraoperative complications and rapid postoperative recovery. Conclusion: We still have a long way to go in the prevention and treatment of cataract. Most of the operations were performed on age-related cataract patients, and most of them were older and had low vision when they were admitted to hospital, so the optimal timing of the operation was missed. Patients of different age groups and different types of cataract have different characteristics. Phacoemulsification is the first choice because of its own advantages.
论著

智能语音随访系统在先天性白内障患儿术后随访中的应用与分析

Application and analysis of artificial intelligence voice system in postoperative follow-up of children with congenital cataract

:23-29
 
目的:探索智能语音随访系统在医疗场景中的新型应用服务模式并分析其在新冠肺炎疫情期间的应用效果,以此评估该系统应用于互联网医院开展医疗咨询服务的实际效能。方法:本研究应用智能语音随访系统针对先天性白内障患儿术后的常见问题进行回访。首先,针对随访目的,设计出完善的结构化随访内容与步骤。其次,部署智能外呼系统自动拨打用户电话,并通过语音识别技术对用户的每次应答进行识别,根据用户的应答自动跳转到下一个随访步骤,在完成一系列问答后根据用户的回答给出恰当的建议,实现电话随访的自动化与智能化。收集2020年2月24日至2月28日期间,智能语音随访系统随访的电话内容、呼叫时间、患儿资料等数据,采用描述性统计分析。结果:2020年2月24日至2月28日期间,中山大学中山眼科中心应用智能语音随访系统电话共随访1154例,其中收到有效回访数据561例,平均有效回访率48.6%。有效回访人群中,有204位(36.4%)家属认为疫情期间复诊时间延长,对宝宝眼睛的恢复有影响,309位(55.1%)家属认为对宝宝眼睛的恢复没有影响。360位(64.2%)先天性白内障患儿眼睛恢复情况良好,没有出现不良反应,169位(30.1%)患儿出现不良反应和体征,包括瞳孔区有白点,眼睛发红和有眼屎流眼泪等。统计患儿不同行为显示,有417位(74.3%)患儿佩戴眼镜,135位(24.1%)患儿没有佩戴眼镜,另有9位(1.6%)患儿佩戴眼镜情况不清楚,经常揉眼的患儿更容易出现眼睛发红(20.4%)、眼睛有眼屎或流眼泪(17.0%)和瞳孔区有白点(6.8%)等不良反应。结论:智能语音随访系统在临床随访中显示出巨大的应用潜力,可作为一种新型的智能医疗服务模式。
Objective: This study was designed to explore its potential value for new medical service model based on the intelligent voice follow-up system and analyze its application effect during the outbreak of COVID-19. The actual effectiveness of this intelligent voice follow-up system applied in the Internet hospital to carry out medical consultation service was discussed. Methods: In this study, an intelligent voice follow up system was developed for postoperative follow-up of children with congenital cataract. First, a well-designed and structured questionnaire contents were developed for postoperative follow-up. Secondly, the intelligent voice follow-up system was deployed. The system would automatically jump to the next follow-up step according to the user’s response, and give appropriate suggestions. Finally, the data of telephone recording, call time, children’s attributes were collected and statistically analyzed. Results: From February 24 to March 15, 2020, 561 families of children with congenital cataract from Zhongshan Ophthalmic Center were recruited by using the intelligent voice follow-up system. The system completed a total of 1 154 calls, of which 561 cases received follow-up data, reaching an average effective call rate of 48.6%. Among 561 cases, 204 (36.4%) thought that the extended time of follow-up visit would affect the recovery of children, while 309 (55.1%) thought that it exerted no effect on the recovery. 360 children (64.2%) achieved good ocular recovery without complications, whereas 169 cases (30.1%) developed ocular symptoms. These include white spots in the pupil area, redness and eye secretions. Statistics of different behavior of children showed that there were 417 (74.3%) children wearing glasses, 135 (24.1%) children did not wear glasses, another 9 (1.6%) children wearing glasses were not clear, often rubbing the eyes of children were more likely to appear redness (20.4%), eye secretions (17.0%) and white spots in the pupil area (6.8%) and other adverse reactions. Conclusion: The intelligent voice follow-up system shows great application potential in clinical follow-up, which can be employed as a new service mode of intelligent medical treatment.
论著

白内障人工智能辅助诊断系统在社区筛查中的应用效果

Application of artificial intelligence-assisted diagnostic system for community-based cataract screening

:4-9
 
目的:评估白内障人工智能辅助诊断系统在社区筛查中的应用效果。方法:采用前瞻性观察性研究方法对白内障人工辅助诊断系统的应用效果进行分析,结合远程医疗的模式,由社区卫生人员对居民进行病史采集、视力检查和裂隙灯眼前节检查等,将数据上传至云平台,由白内障人工智能辅助诊断系统和人类医生依次进行白内障评估。结果:受检人群中男性所占比例为35.7%,年龄中位数为66岁,裂隙灯眼前节照片有98.7%的图像质量合格。该白内障人工智能辅助诊断系统在外部验证集中检出重度白内障的曲线下面积为0.915。在人类医生建议转诊的病例中,有80.3%也由人工智能系统给出了相同的建议。结论:该白内障人工智能辅助诊断系统在白内障社区筛查的应用中具有较好的可行性和准确性,为开展社区筛查疾病提供了参考依据。

Objective: To evaluate the effectiveness of an artificial intelligence-assisted diagnostic system for cataract screening in community. Methods: A prospective observational study was carried out based on a telemedicine platform. Patient history, medical records and anterior ocular segment images were collected and transmitted from community healthcare centers to Zhongshan Ophthalmic Center for evaluation by both ophthalmologists and artificial intelligence-assisted cataract diagnostic system. Results: Of all enumerated subjects, 35.7% were male and the median age was 66 years old. Of all enumerated slit-lamp images, 98.7% met the requirement of acceptable quality. This artificial intelligence-assisted diagnostic system achieved an AUC of 0.915 for detection of severe cataracts in the external validation dataset. For subjects who were advised to be referred to tertiary hospitals by doctors, 80.3% of them received the same suggestion from this artificial intelligence-assisted diagnostic system.Conclusion: This artificial intelligence-assisted cataract diagnostic system showed high applicability and accuracy in community-based cataract screening and could be a potential model of care in community-based disease screening.
论著

超声乳化白内障吸除术对高度近视黄斑劈裂进展影响的临床观察

Clinical observation of the effect of phacoemulsification on the progression of myopic foveoschisis in high myopia

:926-933
 
目的:评估白内障手术是否影响高度近视黄斑劈裂的进展,为高度近视黄斑劈裂合并白内障患者先行白内障手术改善视觉质量可行性提供依据。方法:选取2018年4月至2021年1月在上海市第十人民医院眼科确诊为高度近视黄斑劈裂患者共36例36眼纳入研究。根据是否行白内障手术分为实验组:男10例10眼,女8例8眼;对照组:男9例9眼,女9例9眼。比较两组初诊及1个月、3个月、6个月、12个月后黄斑中心区视网膜厚度(central subfield thickness,CST)、黄斑区视网膜容积(macular volume,MV)、视网膜平均厚度(average macular thickness,AMT)、最佳矫正视力(best corrected visual acuity,BCVA)、黄斑劈裂形态学进展率情况。结果:两组CST、MV、AMT时间和组别交互效应差异无统计学意义(F=0.825,P=0.370;F=1.266,P=0.268;F=0.612,P =0.657),两组间差异无统计学意义(F =2.519,P =0.122;F =3.318,P =0.077;F =1.378,P=0.249)。两组BCVA时间和组别交互效应差异有统计学意义(P<0.001);做简单效应分析实验组术后1、3、6及12个月BCVA较初诊差异均有统计学意义(均P<0.001);两组1、3、6、12个月BCVA较初诊BCVA的增量差异均有统计学意义(均P<0.001)。两组黄斑劈裂形态进展率差异无统计学意义(P=1.0)。结论:白内障超声乳化吸除术在短期内不影响高度近视黄斑劈裂的进展,且可以提高高度近视黄斑劈裂合并白内障患者的视力。
Objective: To assess whether cataract surgery can affect the progression of myopic foveoschisis, so as to provide evidence for the feasibility of cataract surgery to improve visual quality in patients with myopia foveoschisis accompanied by cataract. Methods: A total of 36 patients (36 eyes) diagnosed with high myopia foveoschisis at the Department of Ophthalmology, Shanghai Tenth People’s Hospital from April 2018 to January 2021 were enrolled in the study. The patients were divided into an experimental group (10 males with 10 eyes, and 8 females with 8 eyes) and an observation group (9 males with 9 eyes, and 9 females with 9 eyes) according to whether cataract surgery was performed. The central subfield thickness (CST), macular volume (MV), average macular thickness (AMT), best corrected visual acuity (BCVA), and the progression rate of foveoschis morphology were compared between the two groups at the initial diagnosis and 1 month, 3 months, 6 months, and 12 months after the surgery. Results: In terms of CST, MV, and AMT in the central macular area, no significant difference was found between the two groups (F=2.519, P=0.122; F=3.318, P=0.077; F=1.378, P=0.249), and there was no significant difference in time and group interaction effects between the two groups (F=0.825, P=0.370; F=1.266, P=0.268; F=0.612, P=0.657). In terms of BCVA, there was significant difference in time and group interaction effects between the two groups (P<0.001). The simple effect analysis showed that, compared with initial diagnosis, the BCVA in the experimental group was statistically significant at 1, 3, 6 and 12 months after the surgery (all P<0.001). In addition, there was a significant difference in the increments of BCVA between the two groups at 1, 3, 6, and 12 months after the surgery when compared with the initial diagnosis (all P<0.001). However, there was no significant difference in the morphological progression between the two groups (P=1.0). Conclusion: Phacoemulsification will not affect the progression of myopic foveoschisis in a short period, and can improve the vision of patients with myopic foveoschisis accompanied by cataract.
论著

角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响

Effect of corneal bandage lens on anxiety and quality of life in patients with one-eyed cataract

:558-562
 
目的:探讨角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响。方法:选取中山大学中山眼科中心白内障科2020年12月至2021年7月收治的120例独眼白内障患者作为试验对象,采用便利抽样法分为实验组(佩戴角膜绷带镜)与对照组(未佩戴角膜绷带镜)。运用焦虑自评量表、视功能的生存质量量表来评估比较2组患者的焦虑程度、术后生存质量。结果:入院前2组患者的焦虑评分、生存质量评分差异无统计学意义(P>0.05),术后第1天实验组患者的焦虑评分明显低于对照组、生存质量评分明显高于对照组,差异有统计学意义(P<0.05)。实验组患者的焦虑评分由入院前的55.35±7.09降低至43.77±5.56,焦虑程度比入院前减轻20%;对照组患者焦虑评分由入院前的54.27±5.93降低至47.92±7.02,焦虑程度较入院前减轻12%;实验组患者生存质量评分由入院前的55.32±25.57增至术后第1天的81.01±13.74,增长了46%;对照组患者生存质量评分由入院前的56.38±14.43降低至术后第1天的36.15±17.97,降低了35%。结论:角膜绷带镜可以减轻独眼白内障患者的焦虑情绪,提高术后生活质量。

Objective: To investigate the effect of corneal bandage lens on anxiety and quality of life in patients with monocular cataract. Methods: A total of 120 patients with monocular cataract treated in our department from December 2020 to July 2021 were selected as the subjects. They were divided into an experimental group (wearing corneal bandage lens) and a control group (without corneal bandage lens) by convenient sampling method. Self-rating Anxiety Scale and Visual Function Quality of Life Scale were used to evaluate and compare the degree of anxiety and postoperative quality of life between the 2 groups. Results: There was no significant difference in anxiety score and quality of life score between the 2 groups before admission (P>0.05). On the first day after operation, the anxiety score of the experimental group was significantly lower than that of the control group, and the quality of life score was significantly higher than that of the control group (P<0.05). The anxiety score of patients in the experimental group decreased from 55.35±7.09 to 43.77±5.56, and the degree of anxiety decreased by 20% compared with that before admission. The anxiety score of patients in the control group decreased from 54.27±5.93 to 47.92±7.02, and the degree of anxiety decreased by 12% compared with that before admission. The score of quality of life in the experimental group increased from 55.32±25.57 before admission to 81.01±13.74 on the first day after operation, an increase of 46%. The quality of life score of patients in the control group decreased from 56.38±14.43 before admission to 36.15±17.97 on the first day after operation, a decrease of 35%.Conclusion: Corneal bandage lens can reduce the anxiety of patients with monocular cataract and improve the quality of life after operation.
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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