论著

Laryngeal mask and endotracheal intubation in pediatric ophthalmic general anesthesia: A comparative study

:700-706
 
Objective: To select the appropriate airway management mode for children under general anesthesia by comparing the application of laryngeal mask and endotracheal intubation in pediatric ophthalmology. Methods: A total of 86 children who underwent ophthalmic general anesthesia surgery in our hospital in June 2019 and April 2021 were selected as the study subjects, and the tracheal catheter or laryngeal mask was placed after induction of general nesthesia, and the group of 43 cases were divided into intubation group and laryngeal mask group. Volumecontrolled ventilation is performed after induction of anesthesia after insertion of a tracheal catheter or laryngeal mask. Heart rate and mean arterial pressure were detected by retrospectively collecting anesthesia records alone before anesthesia induction (T0), after anesthesia induction (T1), when a tracheal catheter or laryngeal mask was inserted (T2), at the beginning of surgery (T3), at the end of surgery (T4), and when the laryngeal mask or tracheal catheter was removed (T5). As well as the average airway pressure and end-expiratory CO2 partial pressure at 5, 10, and 20 min after intubation. The number of endotracheal intubations or laryngeal hoods, the occurrence of cough during awakening, and agitation in each patient was queried according to the anesthesia record. The timing of anesthesia, the first success rate of catheterization/laryngeal mask, the time of extubation/uncommissioning, the time of spontaneous breathing recovery, and the time of anesthesia resuscitation were compared between the 2 groups. The occurrence of complications (choking cough, agitation) in both groups of patients was observed. Results: At T2, T3 and T5, the heart rate in the intubation group was significantly higher than that in the laryngeal mask group (P<0.05), and at T2, T3, T4 and T5, the mean arterial pressure in the intubation group was significantly higher than that in the laryngeal mask group(P<0.05). At 5, 10, and 20 min after intubation, the mean airway pressure in the intubation group was higher than that in the laryngeal mask group, and the difference was statistically significant (P<0.05). There was no statistical difference in the partial pressure of CO2 at the end of expiratory breath at different time points between the 2 groups (P<0.05). The incidence of choking cough and agitation during anesthesia resuscitation in the laryngeal mask group was significantly lower than that in the intubation group, and the difference was statistically significant (P<0.05). Conclusion: The laryngeal mask has the advantages of simple operation and less stimulation of the airway, and when used for pediatric ophthalmic general anesthesia, it has less hemodynamic effect, low airway responsiveness and fewer complications, and is worth promoting in clinical practice
封面故事

Exfoliation glaucoma: report of two cases

:-
 
Exfoliation glaucoma is a category of glaucoma secondary to exfoliation syndrome, which is rarely encountered in clinical practice. We reported 2 cases with deposits of white material on the pupillary border of the iris. Opacity band could be observed surrounding the anterior lens capsule after pupil dilation, and the Sampaolesi line was seen under gonioscope. Understanding the clinical characteristics contribute to improving the diagnosis and treatment of exfoliation glaucoma.
论著

Application of inhaled sevoflurane via laryngeal mask airway in children undergoing outpatient fundus fluorescein angiography with general anesthesia

:695-699
 
Objective: To observe the eye position, the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography (FFA) with inhaled sevoflurane via laryngeal mask airway. Methods: Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed. Eye position at the beginning of examination, incidence of eye movement during examination, the efficiency of propofol on correcting eccentric eyeball position during procedure, the time to resume normal activities, and adverse events were recorded. Results: Fifty-four children aged 1–9 years were included in this study. The rates of eye position from grade one to grade three at the beginning of examination were 42.6% (23/54), 51.9% (28/54), and 5.6% (3/54), respectively. The incidence of eye movement during examination was 61.1% (33/54). 13% (7/54) of children with unsatisfactory eye-position needed intervention with propofol. The efficacy of propofol (1 mg/kg) in correcting eye position was 100%. The mean time to return normal activities was 24.4 min. There were no any adverse events during the peri-anesthetic period. Conclusion: Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children. Children can resume daily activities soon after anesthesia. Propofol can return the incorrect eye position during examination
专家述评

Attach importance to assessment before anesthesia of pediatric ophthalmic surgery

:691-694
 
The challenge of pediatric ophthalmic anesthesia is how to balance the safety and efficiency of ophthalmic surgery. Careful pre-operative evaluation and preparation can effectively reduce potential complications during pediatric ophthalmic anesthesia. During the preoperative assessment, it’s necessary to gather information, perform a full physical examination, take required laboratory tests or consultations with specialties, and deliver appropriate information and consent to increase the safety of pediatric ophthalmic anesthesia
综述

Progress in diagnosis and treatment of lens-induced glaucoma

:827-834
 
Lens-induced glaucoma (LIG) is a kind of secondary glaucoma caused by lens proteins or anatomic abnormality of the lens. Based on the pathogenesis, LIG is classified as phacolytic glaucoma, lens-particle induced glaucoma, phacoanaphylactic glaucoma, phacomorphic glaucoma, pupillary block glaucoma. The angle may be open or closed. High-molecular-weight lens protein, release of lens particles, and pupillary block, increase in the volume of the cataractous lens are the mechanisms of glaucoma. Its pathogensis includes intumescent cataracts, mature senile cataract, hyper-mature senile cataracts, surgery and trauma in eyes, and dislocation of lens. The epidemiology varies across developed and developing countries. The common symptom includes diminution of vision, redness of the eye, and unilateral eye pain. It can cause glaucomatous irreversible visual impairment. Ocular ultrasonography is helpful for its diagnosis. Differential diagnosis includes acute angle-closure glaucoma, ciliary block glaucoma, supra-choroidal hemorrhage, post-traumatic or postoperative endophthalmitis. The management is the removal of inciting lenticular matter to control intraocular pressure
综述

Current research in animal model of neuromyelitis optica spectrum disorders

:821-826
 
Neuromyelitis optica spectrum disorders (NMOSD) is an inflammatory demyelinating disease of the central nervous system. It is mainly characterized by the involvement of the optic nerve, spinal cord and brain. The disease is prone to relapse and has a high rate of blindness and disability, which seriously threatens human vision and health. At present, the etiology of NMSOD is not clear, and the existing treatment schemes can’t completely cure NMOSD. Animal models are important tools to explore its pathogenesis and pathophysiological characteristics. NMOSD animals were mainly established on the basis of anti-aquaporin 4 immunoglobulin G (AQP4-IgG), including destroying or bypassing the blood-brain barrier and passively transferring AQP4-IgG or AQP4 specific T cells. At present, no animal model can completely simulate the clinical and pathological characteristics of human NMOSD. Therefore, it is important to select appropriate animal models for the study. This article reviews various animal models of NMOSD in recent years, and discusses the advantages and disadvantages of various models, in order to provide references for the study of the progress and treatment of NMOSD.
论著

:814-820
 
Objective: Based on the construction and practice of Internet nurse-led clinic in our hospital, the model and effect of Internet specialized nursing service were analyzed to provide reference for Internet-based nursing service in ophthalmology. Methods: Relying on the hospital’s high-quality resources, the Internet nurse-led clinic in ophthalmology was established. According to the actual needs of ophthalmology patients, the Internet nursing consultation outpatient service system and workflow were formulated, experts’ qualification were reviewed, and training and assessment for the experts were conducted. The data on the number of outpatient visits, patients’ satisfaction, advisory questions and nurses’ perceived professional benefits were collected and analyzed. Results: From 26th June to 31st December 2021, the number of clinical reception was 1 266. The visit time is mainly between 08:00 to 22:00, the most frequently asked questions were eye health knowledge, the overall patients’ satisfaction was 99.52%, and the total score and the score of all dimensions of nurses’ perceived professional benefits were improved, with statistical significance (all P<0.05). Conclusion: Ophthalmic internet nurse-led consultation clinic can effectively meet the health care needs of all kinds of people, with high patient satisfaction, and can also improve nurses’ perceived professional benefits, which is worthy of further promotion.
论著

Effect evaluation of ideological and political education in the eight-year clinical medicine ophthalmology integrated curriculum

:806-813
 
Objective: To investigate the student satisfaction and educational effect of integrating ideological and political elements into the eight-year clinical medicine ophthalmology integrated curriculum. Methods: An anonymous paper questionnaire survey was administered to fifth-grade clinical medicine students ofthe eight-year clinical medicine program of Sun Yat-sen University to assess students’ satisfaction with ideological and political education as well as the educational effectiveness. Descriptive statistical analysis was performed on thequestionnaire results, and the qualitative data were represented by frequency and percentage. Results: Ninety valid surveys were collected. 91% of the students agreed with the incorporation of ideological and political elements into the curriculum, 93% of the students thought the incorporation of ideological and political elements into the curriculum was good or very good, and 82% of the students believed that the ideological and political curricula helped arouse their interest in ophthalmology. The overall correct rate for ideological and political questions reached 92.9%, with the following correct rates from most accurate to least accurate: doctor-patient communication (100%), history of ophthalmology (98.9%), policy (83.3%), and research frontier (82.2%). Conclusion: Eight-year clinical medicine students are highly satisfied with the integration of intellectual and political components into the ophthalmology integration curriculum. Ideological and political education has yielded favorable results, with students demonstrating a thorough grasp of ideological and political facts. Future curricula should expand students’ awareness of research frontiers and policy issues while maintaining their interest in doctor-patient communication and the history of ophthalmology.
小儿眼病专题

Advances in application of artificial intelligence in infantile eye diseases

:799-805
 
In recent years, the application of artificial intelligence (AI) in medicine, especially in ophthalmology, has developed rapidly with remarkable results. This has greatly improved the diagnostic efficiency of relevant imaging data and promoted further research in this field. However, most applications of AI are focused on adult eye diseases, and few studies have addressed infantile eye diseases. This may be because of the non-cooperative nature of infants, the limited availability of imaging equipment in infants, and the lack of pediatric ophthalmologists. Infancy is the most important stage of vision development. Disturbance during this period have a profound and lasting influence on vision development. Hence, early screening, diagnosis, and treatment of birth defects is important. AI-related products, which improves the efficacy of infant eye disease screening, are urgently needed. This paper reviews the current status, progress, and existing problems of recent research related to application of AI in infantile eye diseases.
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
    浏览
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