飞秒激光辅助角膜移植术的护理

Nursing care of patients undergoing femtosecond laser assisted corneal transplantation

:40-43
 
      总结32例飞秒激光辅助角膜移植术患者的护理,认为做好心理护理、术前完善眼部检查和做好充分的准备,术后严密观察敷料、眼压和角膜植片的情况,做好特殊体位和角膜接触镜的护理,并做好出院指导是提高手术的成功率及预防并发症的关键。
This paper summarized the nursing care of 32 patients received femtosecond laser assisted corneal transplantation. The key points to increase the success rate of surgery and prevent complications were psychological nursing, preoperative examinations and fully prepared, postoperative observation of dressing, intraocular pressure and corneal glass, care of special position and corneal contact lens, and discharge guidance.

Prevalence of intermittent exotropia among primary and secondary school students in Shantou, China

Prevalence of intermittent exotropia among primary and secondary school students in Shantou, China

:7-12
 
Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.
Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.
Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.
Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.
Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.
Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.
Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.
Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.

Long term changes of posterior corneal elevation after myopic laser in situ keratomileusis

Long term changes of posterior corneal elevation after myopic laser in situ keratomileusis

:13-19
 
Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.
Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.
Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.
Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK. 
Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.
Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.
Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.
Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK. 

翼状胬肉不同术式后巩膜溶解的观察分析

Observation and analysis of posterior scleral dissolution in different operation of pterygium

:20-22
 
目的:比较翼状胬肉两种不同手术方式后巩膜溶解的发生概率,探讨产生巩膜溶解的原因,选择合理手术方式。方法:对本院两年来263例翼状胬肉采用两种不同的手术方式,观察术后发生巩膜溶解的情况,并通过局部药物进行治疗。结果:263例翼状胬肉患者,130例采用胬肉切除+结膜瓣转位术,裸露角膜缘3 mm巩膜,术后局部滴0.02%丝裂霉素C(mitomycin C, MMC),胬肉复发26 例,发生巩膜溶解6例;133例采用胬肉切除+角膜缘干细胞移植术,术后滴0.02% MMC,胬肉复发5例,无1例发生巩膜溶解。结论:翼状胬肉术后发生巩膜溶解,是一种严重的手术并发症,可能与术中过度烧灼巩膜面,巩膜板层暴露于MMC有关。采用胬肉切除+角膜缘干细胞移植术,植片覆盖裸露巩膜,促进巩膜表层愈合,术后避免MMC直接浸润巩膜板层故未见此并发症发生。与传统手术方式相比,复发率低,并发症少,是一种安全、有效的翼状胬肉手术方式。
Objective: To compare the occurrence probability of posterior scleral dissolution in two different surgical methods, and to explore the reasons for the dissolution of the scleral. Methods: Using two different surgical methods on 263 cases of pterygium submitted in our hospital in 2 years, observed the occurrence of scleral at postoperative, and treated with topical drugs. Results: Two hundred and sixty three cases of patients with pterygium, 130 cases of pterygium resection and conjunctival flap transposition, bare 3 mm limbus sclera, postoperative topical mitomycin C (MMC). The recurrence of pterygium in 26 cases, scleral melting in 6 cases; 133 cases of pterygium excision and limbal stem cell transplantation, MMC (0.02% MMC drip after operation, 5 cases of recurrent pterygium, no scleral melting occurred in 1 case. Conclusion: The scleral dissolution occurred after pterygium surgery is a serious complication, which may be related to the excessive burning of the scleral surface, and the lamellar exposure to MMC. Excision of pterygium and corneal limbal stem cell transplantation  were used to cover the exposed scleral, promote the surface healing of the wound, and avoid the MMC direct infiltration of the lamina. Compared with the traditional operation mode, the recurrence rate is low, and the complication is little. It is a safe and effective surgical method. 

口服25%葡萄糖减轻早产儿眼底检查疼痛的研究

A clinical study of oral 25% glucose solution to reduce the pain of premature fundus examination

:23-25
 
目的:探讨口服25%葡萄糖减轻早产极低出生体重儿在第一次早产儿视网膜病眼底检查时的疼痛 的效果。方法:选取2014年9月至2015年8月在广东省妇幼保健院NICU住院的早产极低出生体重儿,随机分为观察组和对照组,观察组在进行第一次早产儿视网膜病眼底检查前2 min,给予25% 葡萄糖溶液1mL口服;对照组未用任何安慰剂。两组患儿眼底检查后分别进行新生儿疼痛量表的 评估。结果:观察组患儿眼底检查后疼痛评分低于对照组(P<0.001)。结论:眼底检查前2 min口服25%葡萄糖溶液1 mL是缓解早产儿视网膜病检查引起的疼痛的有效措施。
Objective: To explore the analgesic effect of oral glucose 25% on preterm and very low birth weight infants for the first time of fundus examination for retinopathy screening. Methods: Cases of preterm and very low birth weight infants in Guangdong Women and Children’s Hospital NICU from February 2014 to January 2015 were randomly divided into observation group and control group. The observation group was given 1 mL of 25% glucose solution by oral 2 min before the first time of retinopathy screening. The control group was given nothing. Pain was evaluated using the Neonatal Infant Pain Scale immediately after the fundus examination in both groups. Results: The NIPS of the observation group was lower than that of the control group (P<0.001). Conclusion: 1 mL of 25% glucose solution given 2 min before fundus examination for retinopathy of prematurity by oral was an effective measure for pain relief.

青光眼视神经保护的相关分析及研究进展

The correlation analysis and research progress of the protection of optic nerve in glaucoma

:26-34
 
      青光眼(glaucoma)是一组具有特征性视神经损害和视野缺损的眼病,在临床上常常表现为视力减退、眼部胀痛伴头痛等症状,是一种致盲率居第二位的不可逆性眼病。青光眼视神经损伤有一定 的遗传倾向,造成视神经凹陷性萎缩及视野不同程度缺损这两种结局的危险因素有多种,其中致盲的主要原因包括进行性视神经节损害、病理性眼压升高等。所以在青光眼的治疗中一方面要考虑降低眼压,另一方面还要保护好视神经。本文将从视神经损害的机制、影响因素、分级方法、视神经相关检测指标及其在临床上相关仪器应用、治疗等方面进行综述。
Glaucoma is an irreversible eye disease with the characteristic of optic nerve damage and visual ?eld defect, the clinical manifestation is behaved for vision loss, eye pain with symptoms such as headache, which rate of blindness ranks second place. The optic nerve injury of glaucoma has a certain genetic predisposition. There are many risk factors result in optic nerve atrophy and visual ?eld defect, one of the major causes of blindness including optic ganglion damage, pathological elevation of intraocular pressure. So on the one hand in the treatment of glaucoma should be considered to reduce intraocular pressure, on the other hand, to protect the optic nerve. This article will reviews the mechanism, influencing factors, classification methods, optic nerve related detection indexes and clinical application and treatment of optic nerve injury. 
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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