Objective: To investigate the perioperative experience after small incision lenticule extraction (SMILE). Methods: A semi-structured interview was conducted in 15 patients who underwent SMILE surgery in Zhuhai People’s Hospital.The data were collected and analyzed by phenomenological analysis. Results: The perioperative feelings of patients were summarized into five categories: concern, tension, pain, worry and relaxation. These feelings were compiled and extracted by Venn diagram. One patient had all five categories of feelings during the perioperative period. Three patients experienced four psychological feelings of tension, pain, worry and relaxation, and 2 patients had only nervous feelings during the full femtosecond operation period. Conclusion: Patients undergoing SMILE have avariety of experience feelings during perioperative period. Analysis of different feeling states and factors will provide evidence for ophthalmic medical staff to provide perioperative services for patients seeking SMILE surgery.
Objective: To conduct a preliminary study of the Lea Symbols and HOTV charts to explore the visual development of children aged 2.5 to 5.0 years, and evaluate the application values of the two charts. Methods: A total of 461 children (922 eyes) in 2 early education centers and 3 kindergartens in Guangzhou were examined by using the Lea Symbols visual acuity chart and HOTV visual acuity chart in random order. All the children underwent low-pupil photometry, anterior section slit-lamp examination, retinal condition, eye movement, and eye position examination 1 day in advance. Children with no organic eye disease and normal diopter were selected as subjects. Visual acuity was recorded with 5 points. Results: 1) Measurable rate (visual acuity chart use degree of cooperation). 407 children completed visual examination of Lea Symbols, with an overall detectable rate of 92.08%; 402 children completed HOTV vision examination, with an overall detectable rate of 90.95%. The detectable rate of the former was higher than that of the latter, but the difference was not statistically significant (χ2 =0.417, P=0.580). Further study found that the detectable rate of both visual acuities increased with age, and children were able to complete both visual acuity tests after the age of 3. 2) Results and comparison of two visual acuity (5-point recording method). The visual acuity of Lea was 4.89±0.05 in the right eye and 4.90±0.05 in the left eye. HOTV visual acuity was 4.84±0.05 in the right eye and 4.85±0.04 in the left eye. The visual acuity of the former was better than that of the latter, the difference was statistically significant (right eye: t=3.171, P=0.003; left eye: t=3.230, P=0.003). 3) Correlation between visual development and age. There was a significant positive correlation between the two types of visual development and age (P<0.001), that is, visual acuity gradually improves with age. 4) The relationship between visual development and eye and sex. There was no difference in visual development between the left and right eyes, but male children had better visual development than female, and the difference was statistically significant (P<0.05). Conclusion: Lea Symbols and HOTV visual acuity charts are recommended for visual acuity examination of children over 3 years old, and children are more likely to receive examination of Lea Symbols visual acuity chart. With the growth of age, the visual development of children shows a trend of improvement. Lea vision is superior to HOTV vision. Vision development has nothing to do with the eye, male children’s vision development is faster than female children.
The prevention and control of myopia has become a national strategy, and the axial length is an important parameter in the documentation of myopia prevention and control. This review summarized the measurement technology and factors associated with axial length. Axial length can be measured in various ways and can be influenced by age, gender, choroidal thickness, and other factors. A standardized definition of axial length is warranted to be established for clinical and scientific purposes.
Purpose: Analysis of the efficacy of?fortified cefazolin eye drops in severe bacterial keratitis. Methods: One hundred and thirty-five patients (135 eyes) diagnosed with severe bacterial keratitis between January 2020 and October 2021 at the Department of Keratology were analyzed. The patients were divided into two groups according to the drugs used: those using gatifloxacin eye drops were classified as the control group (n = 67), and those using cefazolin-gatifloxacin eye drops were classified as the observation group (n = 68), both of which were administered for 5 d. The scores of clinical symptoms before and after treatment were recorded and compared. Results: After treatment, the ocular clinical symptoms were significantly reduced in both groups (P < 0.05). After treatment, the scores of all indexes in the observation group were significantly better than those in the control group, except for the secretion index (P < 0.05). The rate of adverse reactions in the control group was 2.99%, the same as the rate of adverse reactions in the observation group was 4.41%, which was not significantly different (x2= 0.193, P＞0.05). Conclusion: Combined use of fortified cefazolin eye drops can reduce the damage of severe bacterial keratitis, and has important guiding significance for the empirical administration of severe bacterial keratitis before bacterial culture results.
Objective To investigate the attitude and demand of glaucoma patients to set up glaucoma continuing care clinic. Methods A convenient sampling method was used to select 434 patients from the glaucoma outpatient department of a first-class ophthalmology hospital in Guangzhou as the research objects. Through field questionnaire survey, the attitudes and demands of patients on the establishment of glaucoma extended care outpatient department were investigated. Results Among 434 patients, 78.8% thought it was necessary to set up glaucoma continuing care clinic, and 76.0% were willing to choose glaucoma extended care clinic. The highest proportion of demands were measuring intraocular pressure (95.2%), self-monitoring method (93.8%), reminding of regular review of archives (92.9%) and health consultation (92.6%). In addition, there were statistically significant differences between the types of antihypertensive drugs used and the willingness to open extended care outpatient clinic (p< 0.05). Conclusion There is a high demand for glaucoma patients to set up glaucoma extended care outpatient clinic, but it must be given the significance of The Times, adapt to the diversified needs of patients, make it become an effective bridge for the management of glaucoma patients in and out of hospital.
Abstract：Objective：To investigate the efficacy and safety of ranibizumab using different repeat injection criteria in the treatment of macular edema secondary to retinal branch vein occlusion. Methods：A prospective randomized controlled study was conducted from July 2020 to July 2022 in our department, including 60 eyes from 60 patients diagnosed with macular edema secondary to retinal branch vein occlusion and treated with intravitreal injection of ranibizumab. The patients were divided into an experimental group and a control group. The repeat injection criteria for the experimental group were defined as central macular thickness (CMT) >250 μm, or the presence of macular edema in or around the fovea. The repeat injection criteria for the control group were defined as CMT >300 μm, significant thickening compared to the last follow-up, and a decrease in vision of more than 1 line. Both groups were followed up for 6 months with monthly visits. The difference in the mean number of injections between the two groups during the follow-up period was observed, as well as the changes in best-corrected visual acuity and central macular thickness before and after treatment. Results：The average number of injections in the experimental group was significantly higher than that in the control group (P<0.05). After treatment, the BCVA of both groups was significantly improved compared to before treatment (P<0.05), and the BCVA of the experimental group was significantly higher than that of the control group (P<0.05). The central foveal thickness of both groups was significantly reduced compared to before treatment (P<0.05), and the central foveal thickness of the experimental group was significantly lower than that of the control group after treatment (P<0.05). Conclusions：Looser criteria for repeated drug injections can significantly reduce the number of injections during follow-up, which may be more time- and cost-effective for patients. In terms of treatment efficacy, strict criteria for repeated drug injections are superior to looser ones. However, in actual clinical practice, the selection should be based on the specific condition of the patient to achieve the best treatment efficacy and patient satisfaction.
Objective To evaluate and summarize the evidence of ward nursing management in adult patients undergoing ophthalmic day surgery, and to improve the quality of clinical nursing. Methods We systematically searched for the evidence on perioperative nursing management in patients undergoing day surgery in JBI, NGC, NICE, GIN, SIGN, EMbase, RNAO, The Cochrane Library, CINAHL, BMJ, Up To Date, PubMed, AAO, CNKI, CBM, VIP，Wanfang Database，IAAS and CASA to collect the literature，including clinical guidelines，evidence summaries，evidence-based practice，recommended practice and systematic reviews. The retrieval period was from the inception of databases to June 2022. 2 researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence. Results A total of 12 articles were included, including 5 expert consensus, 3 evidence summary, 1 evidence-based practice, 2 systematic evaluation and 1 guideline. A total of 18 pieces of best evidence including 8 dimensions were summarized，namely access qualification, clinical nursing path formulation, pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative management, discharge assessment, rehabilitation and follow-up guidance. Conclusion Standardized ward nursing management is helpful to improve patients' satisfaction. Medical staff should combine clinical situation, fully consider patients ' opinions, and improve personalized guidance for patients to further improve the quality of life of patients.
From the point of view of anatomy and pharmacokinetics, the delivery of drugs to the posterior segment of the eye is a challenge, and several topical dosing regimens, such as intravitreal injection and subretinal injection in the clinic, today have their advantages and disadvantages. Suprachoroidal space drug administration is the injection of drugs in the space between the choroid and the sclera, this minimally invasive injection surgery targets the posterior segment of the eye to minimize interference with the anterior part of the eye. This technology is being explored to treat retinal diseases. the suprachoroidal injection has been used in human clinical trials. This article reviews the surgical methods,pharmacokinetics and pharmacodynamics of suprachoroidal space, human clinical trials and their application in gene and cell therapy.
[Objective] To develop computer vision models based on deep convolutional neural networks for diabetic retinopathy (DR) referral. [Methods] Retinal images of diabetic patients from Lixiang Eye Hospital of Soochow University (train set, n = 350 and validation set, n = 100) and Suzhou Municipal Hospital (test set, n = 200) were collected. The patients were divided into the referrable DR group and the non-referrable DR group by retinal images. The performance of modes was evaluated based on Test set and compared with two ophthalmologists. [Results] Four convolutional neural networks, pretrained on ImageNet, were chosen as backbones for transfer learning. MobileNet showed accuracy 0.815, sensitivity 0.724, specificity 0.852 and area under ROC curves (AUC) 0.838. Xception indicated accuracy 0.855, sensitivity 0.793, specificity 0.880 and AUC 0.851. ResNet sowed accuracy 0.850, sensitivity 0.776, specificity 0.880 and AUC 0.858. EfficientNet indicated accuracy 0.910, sensitivity 0.845, specificity 0.937 and AUC 0.914. [Conclusions] Computer vision models based on deep convolutional neural networks show practicable performance in diabetic retinopathy referral, better than junior ophthalmologist. The models could assist doctors and improve clinical diagnosis.
Objective: To explore the application effect of quality control circle in shortening the length of outpatient visit in fundus surgery. Methods: A quality control circle group was established to set up the activity theme of shortening the duration of treatment for outpatient patients of fundus surgery, and 484 patients who visited outpatient clinics outside fundus in September 2020 were selected as the pre-activity research objects. In December 2020, 976 patients who visited fundus surgery outpatient department were the subjects of the post-activity study. We analyzed the duration of treatment and the reasons for poor medical experience of patients before the intervention, formulated countermeasures for the reasons and organized and implemented them. Results: After the quality control circle activity was carried out, the mean duration of outpatient visits in fundus surgery was significantly shortened (P<0.05). With the help of the information system, the medical treatment process was optimized to improve the satisfaction of patients, and the team cohesion, enthusiasm, communication and coordination ability of the circle members were significantly improved. Conclusion: Quality control circle activities can shorten the duration of treatment for fundus surgery patients, improve patients' medical experience, enhance the comprehensive ability of the nursing team, and the improvement effect can be maintained sustainably.
