病例报告

双眼晶状体脱位一例

A case of bilateral lens dislocation

:161-167
 
晶状体脱位是指由于各种病因引起的悬韧带发育异常及断裂,从而导致晶状体的位置异常。晶状体脱位的类型复杂,临床处理也各不相同。本文报道了一名老年男性,因外伤分别致右眼晶状体全脱位,左眼人工晶状体不全脱位,伴高同型半胱氨酸血症,在入院后行双眼手术,术式不一,但都获得了预期效果。
Ectopai lentis refers to the abnormal development and rupture of the suspensory ligament caused by various causes, which leads to the abnormal position of the lens. The types of lens dislocation are complex and the clinical treatment methods are different. This article reports an elderly man who suffered from complete dislocation of the right eye lens and incomplete dislocation of the left eye intraocular lens in the left eye, respectively, accompanied by hyperhomocysteinemia due to trauma. After admission, he underwent binocular surgery after admission, and the surgical methods were different, but the expected results were obtained.
新技术交流

一种改良的简便的儿童晶状体不全脱位摘除技术(视频)

A modified-simple technique of subluxated lens extraction in children

:127-131
 
目的:探讨一种改良的简便的儿童晶状体不全脱位摘除技术的手术方法及临床效果。方法:对23例(40眼)晶状体不全脱位儿童采用改良手术方法进行脱位晶状体摘除,术中先做巩膜隧道切口,3个角膜缘穿刺口,经穿刺口放置前房维持器,在维持前房灌注下,截囊针撕囊,水分离后抽吸针头吸净晶状体内容物。撤去前房维持器,用撕囊镊和线镊将囊袋从主切口拖出。若有玻璃体脱出则行前部玻璃体切除术,然后行人工晶状体巩膜缝线固定术。术后中位随访39.0个月,观察其手术效果。结果:术后患儿平均裸眼视力为(0.44±0.22)LogMAR,平均最佳矫正视力为(0.20±0.16)LogMAR,较术前均显著提高(P<0.001)。所有患儿术中眼内压稳定,术中术后没有继发视网膜脱离、脉络膜上腔出血等眼底并发症的发生。结论:改良的儿童晶状体不全脱位摘除技术具有对玻璃体扰动少、手术时间较短、简便易学、对手术设备要求低的优点,值得临床推广。
Objective: To investigate the operation method and clinical effects of a modified-simple technique in children with subluxated lens extraction. Methods: Lens extraction was performed in 40 eyes of 23 children. During operation, the scleral tunnel and 3 lateral corneal incision were made, and anterior chamber maintainer was inserted through one corneal incision. Under stable anterior chamber perfusion, anterior capsulorrhexis was made by needle capsulotome. After hydro-dissection, the content of lens was withdrawn by suction needle completely. Then anterior chamber maintainer was removed, and the capsular bag was dragged out by capsulorhexis forceps and fixation forceps. Anterior vitrectomy was performed if there was prolapse of vitreous. Then scleral intraocular lens fixation was performed. The surgical effects were observed at median 39.0 months postoperative. Results: After surgery, the average uncorrected visual acuity was (0.44±0.22) LogMAR, the average best corrected distant visual acuity was (0.20±0.16) LogMAR. The uncorrected visual acuity and best corrected distant visual acuity were improved postoperative(P<0.001). The intraocular pressure of all patients was stable during operation. During and after operation, there were no fundus complications, such as secondary retinal detachment and suprachoroidal hemorrhage. Conclusion: Modified-simple technique of subluxated lens extraction of children has little disturbance on vitreous and takes shorter time of operation. It is simple, easy to learn and requires simple surgical equipment. This modified technique deserves to be generalized.
综述

阿托品近视防控的临床与实验室研究进展

Clinical and laboratory research progress of atropine in the prevention and control of myopia

:424-434
 
随着近视人口的逐年增长,近视已经成为全球关注的热点问题。如何预防近视、控制近视进展、减少病理性近视的发生、减少近视的成本投入是临床工作及科学研究的主要目的。阿托品是目前防控近视的主要药物方法,实验室研究及临床试验均已证实其显著的近视防控效果。美国眼科学会推荐使用0.01%低浓度阿托品,目前报道其近视防控效果为50%~53%。本文汇总了近年来近视防控相关的临床与实验室研究,对阿托品近视防控效果、其相关影响因素(如浓度、个体差异、生物利用度等)以及作用机制等方面的研究进展进行归纳综述,并分析了阿托品用于临床儿童近视防控工作存在的困难与挑战。
As the population of myopia grows rapidly, myopia has become a hot issue of global concern. Preventing myopia and slowing the progression of myopia to reduce the occurrence of pathological myopia and reduce the cost of myopia is the main purpose of related clinical work and scientific researches. Currently, atropine is the main drug for the prevention and control of myopia, and both laboratory studies and clinical trials have confirmed its effect. The American Academy of Ophthalmology recommends the use of 0.01% atropine, which is reported to be 50% to 53% effective in preventing and controlling myopia. This review collects the clinical and laboratory researches in decades to summarize the study progress in atropine for preventing and controlling myopia, including the clinical application effects, the influencing factors such as concentration, individual differences, bioavailability, and the related mechanisms. We also highlight the existing difficulties and challenges in the use of atropine in clinic.
论著

兰州市中小学生屈光状态筛查

Screening on the refractive status of primary and secondary school students in Lanzhou City

:9-16
 
目的:对兰州市中小学生的屈光状态进行调查分析,了解兰州市中小学生筛查性屈光不正的流行病学特征。方法:采用横断面研究方法,用随机分层抽样法抽取2021年4至12月在甘肃省兰州市47所学校的中小学生作为调查对象。以学校为单位,采用国际标准视力表检查视力,采用非睫状肌麻痹的电脑自动验光仪进行屈光检查。裸眼视力<0.8为视力低下,具体分为:近视为等效球镜度≥–0.75 DS;远视为等效球镜度≥+2.00 DS;散光为柱镜度≥1.00 DC;屈光参差为双眼屈光度数差值(等效球镜度)≥1.00 DS。比较不同年级不同屈光状态人数所占的百分比。结果:共纳入40 302人,其中男21 328人,女18 974人;汉族37 938人,少数民族2364人。小学、初中、高中各26 122、9346和4834人。视力低下的总检出率为59.1%(23 832/40 302),小学、初中和高中年级视力低下的检出率分别为48.8%(12 748/26 122),76.9%(7 189/9 346)和87.9%(4 250/4 834)。近视的总检出率为63.3%(25 521/40 302),其中,小学、初中和高中筛查性近视的检出率分别为51.4%(13 438/26 122),84.4%(7 888/9 346)和86.8%(4 195/4 834)。筛查性视力低下、远视、近视、散光及屈光参差的检出率在低中高年级间比较差异均有统计学意义(均P<0.001)。结论:兰州市中小学生视力低下和近视人群的检出率高于国家平均水平,且随着年级的增加检出率逐渐升高。
Objective: To investigate and analyze the refractive status of primary and secondary school students in Lanzhou City, and to understand the epidemiological characteristics of screening refractive errors among primary and secondary school students in Lanzhou City. Methods: Using the cross-sectional research method, primary and secondary school students from 47 schools in Lanzhou City, Gansu Province from April to December 2021 were selected as survey subjects by random stratified sampling method. Taking school as a unit, international standard visual acuity chart was used to check the eyesight and non-cycloplegia computerized autorefractor was used for refractive examination. Visual acuity ≥5.0 is considered normal; whereas visual acuity <4.8 is considered as poor vision. Poor vision is further divided into: short-sightedness with myopic spherical equivalent ≥0.75 DS; long-sightedness with telephoto spherical equivalent ≥+2.00 DS; astigmatism with cylinder mirror equivalent ≥1.00 DC; anisometropia with the difference of diopters between the two eyes (spherical equivalent) ≥1.00 DS. The percentage of the survey subjects with different refractive status in different grades were compared. Results: total of 40 302 subjects were enrolled, including 21 328 males and 18 974 females. There were 37 938 Han and 2 364 ethnic minorities; 26 122 elementary, 9 346 middle and 4 834 high schools. The total detection rate of low visual acuity was 59.1% (23 832/40 302), and 48.8% (12 748/26 122) in primary school, junior middle school and senior high school, 76.9% (7 189/9 346) and 87.9% (4 250/4 834), respectively. The total detection rate of myopia was 63.3% (25 521/40 302), among which, the detection rate of screening myopia in primary school, middle school and high school was 51.4% (13 438/26 122), 84.4% (7 888/9 346) and 86.8% (4 195/4 834), respectively. The detection rates of screening low visual acuity, hyperopia, myopia, astigmatism and anisometropia were statistically significant in low, middle and high grades (all P<0.001). Conclusion: The detection rate of low vision and myopia among primary and secondary school students in Lanzhou is higher than the national average, and the detection rate increases gradually with the increase of grades.
综述

高度近视视神经改变与原发性开角型青光眼的相关性研究进展

Research progress on the correlation between optic neuropathy and primary open-angle glaucoma in high myopia

:45-51
 
高度近视(high myopia,HM)作为一种特殊类型的屈光型眼病,不仅会导致进行性、退行性眼底改变,其视神经损伤的患病率也很高。青光眼是全球范围内最常见的一种不可逆致盲性眼病,原发性开角型青光眼(primary open-angle glaucoma,POAG)是最常见的青光眼类型。近年来的研究发现HM与POAG的病理改变存在相似之处。由于HM眼底改变与早期POAG眼底改变容易混淆,HM患者早期发现POAG对延缓或阻止疾病进展很重要。HM患者长期随访不仅要观察黄斑病变,视神经形态与结构改变的观察也不容忽视。

As a special type of refractive eye disease, high myopia (HM) not only causes progressive and degenerative fundus changes, but also has a high prevalence of optic nerve damage. Glaucoma is the most common form of irreversible blinding eye diseases worldwide, among which, primary open-angle glaucoma (POAG) is the most common type. In recent studies, HM is found to have similarities on pathological changes as that of POAG. And HM fundus changes are easily confused with early stage POAG fundus changes; thus, the early detection of POAG on HM patients is highly important on disease deferment or prevention of disease progression. Macular degeneration as well as optic nerve morphology and structural changes are to be observed in the long-term follow-up for HM patients.

论著

并轨住院医师规范化培训的眼科专业学位硕士研究生科研能力现状与思考

Current situation and thinking of scientific researchability for postgraduates with professional degree inophthalmology under the mode of mergingresidency training

:468-476
 
 目的:了解医学专业学位硕士(专硕)研究生培养并轨住院医师规范化培训制度下的眼科专硕科研能 力现状,并提出提升科研能力的对策。方法:对哈尔滨医科大学三所附属医院眼科学76名不同年级 专硕研究生的科研能力现状、阻碍科研学习的因素、科研训练意愿等进行问卷调查。结果:在目前 的培养模式下,专硕科研和临床知识基础相对薄弱及临床学习任务繁重是科研学习的主要障碍。 结论:提出教学基地可以因需施教、提供多模式科研训练;强化临床诊疗培训为科研思维培养助 力;导师可以结合新时代发展背景优化科研选题策略、拓宽学生科研视野等措施。
Objective: To understand the current situation of scientific research ability of postgraduates with professional degrees in ophthalmology and put forward improvement measures. Methods: A questionnaire survey was conducted on the current situation of scientific research ability, scientific research obstacles and scientific research training willingness, 76 postgraduate students of different grades majoring in ophthalmology of three affiliated hospitals of Harbin Medical University were involved. Results: Under the merging residency training system, the foundation of scientific research and clinical knowledge of postgraduates is relatively weak, and the heavy clinical learning task were the main obstacles to scientific research of postgraduates. Conclusion: It is proposed that the teaching bases could provide multi-mode scientific research training to cater to students' individual needs. Not only clinical diagnosis and treatment training could be strengthened to cultivate students’ scientific research thinking, but scientific research topic selection strategy could be optimized by to meet the demand for development of times and broaden students’ scientific research vision.
综述

人工智能在白内障诊疗中的应用进展

Advances in the application of artificial intelligence in diagnosis and treatment of cataract

:85-90
 
人工智能(artificial intelligence,AI)在眼科领域的应用不断深入、拓展,目前在糖尿病性视网膜病变、白内障、青光眼以及早产儿视网膜病变在内的多种常见眼病的诊疗中逐渐成为研究热点。AI使医疗资源短缺、诊断标准缺乏、诊疗技术水平低下的现状得到改善,为白内障的诊疗开辟了一条“新赛道”。本文旨在综述AI在白内障诊疗中的应用现状、进展及局限性,为AI在白内障领域的进一步开发、应用及推广提供更多信息。
Artificial intelligence (AI) has been widely applied and promoted in ophthalmology, and has gradually become a research hotspot in the diagnosis and treatment of many common ophthalmopathies, including diabetic retinopathy, cataract, glaucoma, and retinopathy of prematurity. AI improves the shortage of medical care, the lack of diagnostic criteria and the low level of diagnosis and treatment technology, and explores a “new race track” for cataract diagnosis and treatment. The purpose of this article is to review the application status, progress and limitations of AI in the diagnosis and treatment of cataract, aiming to provide more information for further development, application and promotion of AI in the field of cataract.
综述

基于深度学习和智能手机的眼病预防与远程诊疗

Prevention and telemedicine of eye diseases based on deep learning and smart phones

:230-237
 
随着智能手机覆盖率的增加与可用性的提升,实现智能健康管理的应用程序成为新兴研究热点。新一代智能手机可通过追踪步数,监测心率、睡眠,拍摄照片等方式进行健康分析,成为新的医学辅助工具。随着深度学习技术在图像处理领域的不断进展,基于医学影像的智能诊断已在多个学科全面开花,有望彻底改变医院传统的眼科疾病诊疗模式。眼科疾病的常规诊断往往依赖于各种形式的图像,如裂隙灯生物显微镜、眼底成像、光学相干断层扫描等。因此,眼科成为医学人工智能发展最快的领域之一。将眼科人工智能诊疗系统部署在智能手机上,有望提高疾病诊断效率和筛查覆盖率,改善医疗资源紧张的现状,具有极大的发展前景。综述的重点是基于深度学习和智能手机的眼病预防与远程诊疗的进展,以糖尿病性视网膜病变、青光眼、白内障3种疾病为例,讲述深度学习和智能手机在眼病管理方面的具体研究、应用和展望。
With the increasing coverage and availability of smart phones, the application of realizing intelligent health management has become an emerging research hotspot. The new generation of smart phones can perform health analysis by tracking the step numbers, monitoring heart rate and sleep quality, taking photos and other approaches, thereby becoming a new medical aid tool. With the continuous development of deep learning technology in the field of image processing, intelligent diagnosis based on medical imaging has blossomed in many disciplines, which is expected to completely change the traditional eye diseases diagnosis and treatment mode of hospitals. The conventional diagnosis of ophthalmic diseases often relies on various forms of images, such as slit lamp biological microscope, fundus imaging, optical coherence tomography, etc. As a result, ophthalmology has become one of the fastest growing areas of medical artificial intelligence (AI). The deployment of ophthalmological AI diagnosis and treatment system on smart phones is expected to improve the diagnostic efficiency and screening coverage to relieve the strain of medical resources, which has a great development prospect. This review focuses on the prevention and telemedicine progress of eye diseases based on deep learning and smart phones, taking diabetic retinopathy, glaucoma and cataract as examples to describe the specific research, application and prospect of deep learning and smart phones in the management of eye diseases.
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

中医热疗在古代中国眼科的发展简史

Historical overview of thermotherapy in traditional Chinese ophthalmology

:666-670
 
近年来,热疗因其操作简便和显著疗效,在干眼及相关眼病治疗中受到关注。热疗通过加热睑板腺区域,软化睑脂,改善睑板腺导管通畅,广泛应用于睑板腺囊肿、睑腺炎、睑缘炎及睑板腺功能障碍等眼病。此外,热疗还有效缓解视疲劳和干眼不适,促进眼部创口愈合,减少感染风险。在中国古代,《黄帝内经》及《韩非子》早期记载了热疗技术的应用。西汉《淮南子》提到烧灼法用于眼病,东晋葛洪的《肘后备急方》描述了热敷治疗眼部不适的方法。隋唐时期的《备急千金要方》和《外台秘要》详细介绍了热疗的应用,宋代《圣济总录》和《龙树菩萨眼论》进一步精细化了热疗技术。明清时期的《普济方》和《目经大成》中记载了热疗的新进展。由此,古代热疗在眼科应用中积累了丰富的经验,尽管现代医学技术不断进步,但这些传统方法仍具有重要参考价值。
In recent years, heat therapy has gained attention for its simplicity and significant efficacy in treating dry eye and related ocular conditions. By heating the meibomian gland area, heat therapy softens meibomian secretions and improves gland duct patency, making it widely used for chalazion, hordeolum, blepharitis, and meibomian gland dysfunction. Additionally, it effectively alleviates visual fatigue and dry eye discomfort, promotes ocular healing, and reduces the risk of infection.In ancient China, the application of heat therapy was recorded early in texts such as the Huangdi Neijing and Han Feizi. The Huainanzi from the Western Han Dynasty mentions the use of cautery for eye diseases, while Zhouhou Beiji Fang by Ge Hong in the Eastern Jin Dynasty describes methods for treating eye discomfort with hot compresses. During the Sui and Tang dynasties, Beiji Qianjin Yaofang and Wai Tai Mi Yao provided detailed accounts of heat therapy applications. The Song Dynasty works *Shengji Zonglu* and Longshu Bodhisattva's Eye Treatise further refined the techniques. The Ming and Qing dynasties’ texts Pujifang and Mujing Dacheng documented new advancements in heat therapy.In summary, ancient heat therapy for ophthalmology accumulated substantial experience. Despite advances in modern medical technology, these traditional methods still hold significant reference value.
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
    浏览
  • 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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