目的：探讨老年性糖尿病性白内障患者治疗及延续护理的措施。

方法：对2014年1月～2014年12月142例老年性糖尿病性白内障患者随机平均分为A组和B组，A组接受常规的出院指导；B组接受常规的出院指导及加强延续护理，根据老年性糖尿病性白内障患者 的具体情况制定护理措施 (眼部的护理、用药指导、饮食护理、心理护理、自我监测指导、定期随访及复查等内容)，并进行跟踪处理。

结果：实施延续护理一年后的患者，体重、空腹血糖、餐后2 h血糖与未实施延续护理的患者相比，差异有显著意义 (P＜0.05)。

结论：护士对老年性糖尿病性白内障患者及家属进行用眼和糖尿病相关的知识宣教、针对性的心理护理、药物治疗护理及日常生活指导等，老年性糖尿病性白内障患者的遵医率提高，减少了因疾病而对生活工作的影响，生活质量有不同程度的提高。

Purpose: To explore the treatment and continuing nursing of patients diagnosed with senile and diabetic cataract．

Methods: In total, 142 patients diagnosed with senile and diabetic cataract admitted to Zhongshan Ophthalmic Center from January to December 2014 were randomly assigned into groups A and B. In group A, patients received conventional instruction after discharge, and those in group B additionally received continuing nursing care after discharge including ocular nursing, use of anti-diabetic drugs, psychological nursing,  diet nursing, self-monitoring guidance,  re-examination and regular follow-up according to the patients’ conditions．

Results: After one year of continuing nursing care, visual acuity of patients in group B was increased without complications. Body mass index, the fasting and 2h postprandial plasma glucose,  and the systolic and diastolic blood pressure were decreased significantly compared with those in group A (all P＜0．05)．

Conclusion: Continuing nursing care, including knowledge education related to ocular use and diabetes mellitus, targeted psychological nursing,  medication nursing and daily life guidance,  play a pivotal role in enhancing the compliance rate of the patients,  reducing the influence upon work and life and enhancing the quality of life to varying extent．

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.

Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.

Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).

Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.

Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.

Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.

Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).

Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.

目的：探讨3种不同的滴眼液在麻醉小鼠晶状体浑浊中的保护作用。方法：将20只6周龄C57BL/6j小鼠分为4组，A组为自然暴露组(对照组)，B组为滴用透明质酸钠组，C组为滴用甲基纤维素滴眼液组，D组为滴用生理盐水组。分别于麻醉后10，20，30，45和60 min观察小鼠晶状体浑浊情况。结果：与A组相比，3种滴眼液均不同程度地延长小鼠晶状体浑浊的时间；30 min时，4组小鼠浑浊 发生率分别为90%，50%，50%和10%，并延缓晶状体浑浊的进展；60 min时，4组小鼠3级浑浊的发生率为30%，10%，10%和0，其中生理盐水的作用效果最优，可以明显延迟晶状体变浑浊的时间。结论：麻醉小鼠的晶状体浑浊程度可以被相关滴眼液延缓，适用于短时间的眼科检查和处理，又因其经济易得，可广泛应用于小鼠活体的眼科检查中。

Objective: To study the effect of saline, carboxymethylcellulose sodium eye drops and sodium hyaluronate gel to stop the development of cataract in anesthetized mice. Methods: Twenty C57BL/6j mice, aged 6 weeks, were divided into four groups, group A was naturally exposed to air, group B was treated with sodium hyaluronate gel, group C was treated with carboxymethylcellulose sodium eye drops and group D was treated with saline. The lens opacity was observed at 10, 20, 30, 45 and 60 min after the start of the experiment. Results: Compared with group A, the eye drops delayed the development of lens opacity in varying degrees. At 30 min, the incidence rate of cataract in group A, B, C and D was 90%, 50%, 50% and 10%, respectively. At 60 min, the incidence rate of grade 3 cataract in group A, B, C and D was 30%, 10%, 10% and 0 respectively, saline did the best, which can significantly slow the process. Conclusion: Cataract development can be slowed by the protective eye drops. This finding is relevant for those experimental settings in which clear ocular media are required. 

目的：探讨下乡行大批量白内障扶贫手术的手术器械管理方法。方法：对大批量白内障扶贫手术专用的眼科器械实施规范化管理流程，运输过程严格保护，并培训当地护理人员、定人定岗，实行责任制管理，对清洗流程的质量检测及术中严格的无菌操作把控，确保手术安全进行。结果：眼科手术器械得到规范处理和保养，基层护理人员的规范培训提升其对眼科手术器械处理的能力。结论：建立下乡扶贫规范化的手术器械管理流程和培训制度，是大批量白内障扶贫手术顺利完成的基础保障。

Objective: To investigate the methods of management of surgical equipment in large quantities of cataract poverty alleviation surgery for the countryside patients. Methods: The standardized management of cataract poverty alleviation surgery was implented, the ophthalmic equipment on the transport was strictly protected, and nursing training, fixed posts, responsibility system management, cleaning process quality testing and aseptic control were performed to ensure the safety of operation. Results: The processing and maintenance of the surgical equipment were standardized. Nursing training enhanced their ability to manage ophthalmic surgical equipment. Conclusion: A standardized system of surgical equipment management guarantees the successful completion of large quantities of cataract poverty alleviation surgery.

目的：总结大批量白内障扶贫手术的护理安全管理经验。方法：回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况，分析其安全隐患，并在护理过程中采取相应的安全措施。术前充分评估和准备，对患者进行健康指导；术中对手术环境规范管理；指导加强术后患者的自我管理。结果：8批次共1 064例白内障摘除联合人工晶体植入术顺利完成，无1例发生术后感染。结论：建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节，做好术前的评估和准备工作，落实患者的健康教育及术后患者自我管理指导，才能确保手术顺利进行。

Objective: To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: TTis is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. TTe following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1 064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed.Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety. 

目的：探讨白内障小切口非超声乳化术向超声乳化术转型中的技术转变。

方法：对 2009 年 4 月 - 2009 年 12 月“光明工程”中白内障超声乳化手术转型期 193 例 193 眼的情况进行回顾性分析，同期行小切口非超声乳化吸除术患者 43 例 48 眼作对照。

结果：对照组术后第 1 日裸眼视力大于或等于 0.5 的比例高于治疗组（P < 0.05），术后第 1 周、 第 1 个月裸眼视力大于或等于 0.5 及术后第 1 个月最佳矫正视力大于或等于 0.5 的比例，两组比较差异无统计学意义（均 P > 0.05）。对照组术后主要并发症比率均低于治疗组（均 P < 0.05）。

结论：小切口非超声乳化术向超声乳化术转型中，由于技术差异较大，发生后囊破裂和角膜内皮水肿的几率较高，转型此手术要有熟练的显微手术基础、处理并发症的能力和一定的设备条件。

Purpose: To investigate the clinical outcome during the conversion from small incision sutureless cataract surgery (SICS) to phacoemulsification cataract surgery (phaco).

Methods: During the conversion period from SICS to phaco, 241 cataract cases were assigned to SICS and phaco surgery procedures. The intraoperative complications and early postoperative outcomes were assessed.

Results: The 1st day visual acuity outcome (VA 0.5 or better) was lower in the phaco group (P < 0.05); however, the visual acuity outcomes were no longer statistically different at 1 week and 1 month visits (P > 0.05 for each visit). Among 193 cases operated in the phaco group, 51 cases (26.4%) developed corneal edema at the 1 day visit, 13 cases (6.7%) had posterior capsular rupture, 5 cases (2.6%) had zonular rupture, and 5 cases (2.6%) failed to implant IOL. These rates were higher than those found in the SICS group.

Conclusion: The outcome of phaco cataract surgery is comparable with SICS during this conversion period. Techniques that the surgeons may pay attention to are also discussed.

目的：该课题通过对纳入患者进行术前艾森克人格问卷调查及性别、年龄、文化程度、收入水平等 资料收集，与白内障术后1天、1月、3月的视觉满意度进行Logistic有序回归分析术后视觉满意度与人格特质等因素的关联性，以期以期探究患者植入非球面型人工晶体后视觉满意度与人格特质的关联，同时也可根据艾森克人格问卷评分对患者的预后视觉满意度进行必要术前告知沟通，降低术后预期值，提高视觉满意度，减少纠纷。方法：按照纳入标准筛选出年龄在40~84岁的112名患者，其中男性65例，女性47例。术前记录性别、年龄、收入水平及文化程度及森克人格问卷简式量表中国版(Eysenck Personality Questionnaire Revise Short Scale，EPQ-RSC)调查结果。由经验丰富的同一术者进行手术，随访并记录术后1天、1月、3月的视觉满意度。对视觉满意度进行描述性统计分析，并以不同人格特质(E、P、N、L量表所得T分)、年龄、性别、文化程度、收入水平作自变量，以视觉满意度(术后1天、1月、3月)作因变量用SPSS19做logistic有序回归分析。并将有统计学关联的因子不同组别 的视觉满意度行Kruskal Wallis分析(H检验)看组间是否存在统计学差异，若存在，再进行两两秩和检验予以比较。结果：术后1天、1月、3月总视觉满意度分别为90.18%、82.41%、90.18%。Logistic回归分析得出：术后1天，男性患者，属中间型E类人格的患者视觉满意度较高。术后1月，年龄在40~49岁， 属中间型E类人格，患者视觉满意度较高。术后3月，年龄在40~49岁，属中间型E类人格，患者视觉满意度较高。相关因素行H检验后只有E量表的P<0.05，存在统计学意义，对E组内的不同分组行两两 秩和检验后得出多组间存在统计学差异，典型外向型E类人格视觉满意度最高，中间型视觉满意度次之，倾向内、外向型E类人格视觉满意度均偏低，且倾向内向型视觉满意度最低。结论：白内障患者超声乳化术后1天、1月、3月的总体视觉满意度间存显著差异，术后1天视觉满意度较高，术后1月略有下降，而术后3月视觉满意度提高。术后3月不同E量表表型的视觉满意度间存在统计学差异。

目的：该课题通过对纳入患者进行术前艾森克人格问卷调查及性别、年龄、文化程度、收入水平等 资料收集，与白内障术后1天、1月、3月的视觉满意度进行Logistic有序回归分析术后视觉满意度与人格特质等因素的关联性，以期以期探究患者植入非球面型人工晶体后视觉满意度与人格特质的关联，同时也可根据艾森克人格问卷评分对患者的预后视觉满意度进行必要术前告知沟通，降低术后预期值，提高视觉满意度，减少纠纷。方法：按照纳入标准筛选出年龄在40~84岁的112名患者，其中男性65例，女性47例。术前记录性别、年龄、收入水平及文化程度及森克人格问卷简式量表中国版(Eysenck Personality Questionnaire Revise Short Scale，EPQ-RSC)调查结果。由经验丰富的同一术者进行手术，随访并记录术后1天、1月、3月的视觉满意度。对视觉满意度进行描述性统计分析，并以不同人格特质(E、P、N、L量表所得T分)、年龄、性别、文化程度、收入水平作自变量，以视觉满意度(术后1天、1月、3月)作因变量用SPSS19做logistic有序回归分析。并将有统计学关联的因子不同组别 的视觉满意度行Kruskal Wallis分析(H检验)看组间是否存在统计学差异，若存在，再进行两两秩和检验予以比较。结果：术后1天、1月、3月总视觉满意度分别为90.18%、82.41%、90.18%。Logistic回归分析得出：术后1天，男性患者，属中间型E类人格的患者视觉满意度较高。术后1月，年龄在40~49岁， 属中间型E类人格，患者视觉满意度较高。术后3月，年龄在40~49岁，属中间型E类人格，患者视觉满意度较高。相关因素行H检验后只有E量表的P<0.05，存在统计学意义，对E组内的不同分组行两两 秩和检验后得出多组间存在统计学差异，典型外向型E类人格视觉满意度最高，中间型视觉满意度次之，倾向内、外向型E类人格视觉满意度均偏低，且倾向内向型视觉满意度最低。结论：白内障患者超声乳化术后1天、1月、3月的总体视觉满意度间存显著差异，术后1天视觉满意度较高，术后1月略有下降，而术后3月视觉满意度提高。术后3月不同E量表表型的视觉满意度间存在统计学差异。

A 74-year-old man presented with a three-year history of foreign body sensation in the right eye after cataract surgery. He underwent uneventful trabeculectomy with mitomycin C (MMC) in the right eye seven years ago. Slit-lamp examination revealed a large avascular filltration bleb overhanging on the cornea with a thin base connected to the conjunctiva. Preoperative ultrasound biomicroscopy (UBM) impressions were confirmed by leakage of aqueous from the incision intraoperatively. Surgical dissection and revision of the bleb was performed with satisfactory outcome. Histopathologic evaluation showed proliferation of fibrous tissue under the conjunctival epithelia with irregular cystoids change. The current case may be the first report of a post-trabeculectomy overhanging filtration bleb related to cataract surgery. The possible mechanism may be related to microleakage of the surgical wound after phacoemulsiff cation which initiated the healing and scarring process.

A 74-year-old man presented with a three-year history of foreign body sensation in the right eye after cataract surgery. He underwent uneventful trabeculectomy with mitomycin C (MMC) in the right eye seven years ago. Slit-lamp examination revealed a large avascular filltration bleb overhanging on the cornea with a thin base connected to the conjunctiva. Preoperative ultrasound biomicroscopy (UBM) impressions were confirmed by leakage of aqueous from the incision intraoperatively. Surgical dissection and revision of the bleb was performed with satisfactory outcome. Histopathologic evaluation showed proliferation of fibrous tissue under the conjunctival epithelia with irregular cystoids change. The current case may be the first report of a post-trabeculectomy overhanging filtration bleb related to cataract surgery. The possible mechanism may be related to microleakage of the surgical wound after phacoemulsiff cation which initiated the healing and scarring process.