Abstract Objective: To analyze the application of general anesthesia in the ambulatory glaucoma surgery. Methods：This retrospective study collected 71 patients who underwent ambulatory glaucoma surgery with general anesthesia at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2023 to June 2023, and 154 patients who underwent similar glaucoma surgery with local anesthesia during the same period. Age differences between the two groups were balanced by propensity score-matched analysis. The main outcome measures were the patient's post-operative discharge time, and the secondary end points included the duration of surgery, the patients' preoperative and postoperative intraocular pressure (IOP), visual acuity status, central anterior chamber depth, peripheral anterior chamber depth, mannitol use, the difference in IOP reduction after surgery compared to preoperative. Results: After propensity score-matched analysis, as compared with group L, general anesthesia did not prolong the patient's post-operative discharge time(P>0.05).Patients in the group G displayed significant higher IOP (P<0.001), shallower central anterior chamber depth (P=0.018), and shallower peripheral anterior depth (P<0.001).The dramatic reductions in IOP after surgery were exhibited in group G as compared with group L(P=0.009).There were no statistically significant differences in postoperative central anterior chamber depth, incidences in postoperative mannitol use, as well as incidences in visual acuity improvement on the first day after surgery. Conclusion: Glaucoma patients with poor preoperative ocular conditions were able to complete the complex glaucoma surgery under general anesthesia without prolonging their post-operative discharge time.
Objective: To compare the applications of general anesthesia versus local anesthesia in the ambulatory glaucoma surgery. Methods：This retrospective study collected 225 patients who underwent ambulatory glaucoma surgery at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2023 to June 2023, and the patients were divided into general anesthesia group (Group G, 71 patients) and local anesthesia group (Group L, 154 patients).The patients' preoperative and postoperative intraocular pressure (IOP), visual acuity status, central anterior chamber depth, peripheral anterior chamber depth, mannitol use, as well as the duration of surgery, the difference in IOP reduction after surgery compared to preoperative, and time to discharge home after surgery were analyzed. Age differences between the two groups were balanced by propensity score-matched analysis. Results: After propensity score-matched analysis, as compared with group L before surgery, patients in the group G displayed significant higher IOP (P<0.001), shallower central anterior chamber depth (P=0.018), and shallower peripheral anterior depth (P<0.001).The dramatic reductions in IOP after surgery were exhibited in group G as compared with group L(P=0.009).There were no statistically significant differences in postoperative central anterior chamber depth, incidences in postoperative mannitol use, incidences in visual acuity improvement on the first day after surgery, as well as time to discharge home between the two groups(P>0.05). Conclusion: General anesthesia may have more potential benefits for ambulatory patients with poor condition undergoing complex glaucoma surgery than local anesthesia has.
Corneal ulcer is a serious eye disease, and its incidence is increasing year by year, bringing great pain and visual damage to patients. The causes of corneal ulcer are complex, including bacterial infection, viral infection, fungal infection and other factors. Severe keratitis due to adenovirus (ADV) infection can cause visual loss. The cornea infected with ADV leads to the occurrence and development of corneal ulcers through the direct destruction of corneal epithelial cells and the initiation of immune response. However, corneal ulcers caused by adenovirus in infants are relatively rare, infants do not cooperate, medication is difficult, treatment is difficult, easy to leave sequelae. A pair of term twins, 5 months, ocular photophobia, repeated redness with increased secretion for 10 days. Hand-held slit lamp examination showed highly congested conjunctiva, thick pseudo membrane on the surface of the upper and lower eyelid conjunctiva, corneal shield ulcer, and clear edges. The conjunctival sac secretions were culture-negative and there were no signs such as preauricular lymph node enlargement. Diagnosis of a corneal ulcer in both eyes. Rapid detection of 13 respiratory viruses using nasopharyngeal swabs quickly confirmed adenovirus infection and received regular treatment with acyclovir eye drops. Two weeks later, the corneal ulcer was healed and repaired without sequelae.
Ophthalmic surgery time is short, the use of equipment turnover is fast, and the purchase cost of ophthalmic equipment is high, the number of instruments carried to the countryside will be relatively insufficient, how to improve the use rate of instruments carried to the countryside and reduce the loss in the disinfection and cleaning process is of great significance. Objective To explore two different cleaning and disinfection management modes of ophthalmic surgical instruments in rural areas and evaluate their effects. Methods Twenty sets (240 pieces) of ophthalmic surgical instruments sent to rural areas from January 2023 to June 2023 were selected as the sample group, and the cleaning and disinfection mode was traditional classification method. Twenty sets (240 pieces in total) of ophthalmic surgical instruments sent to rural areas from July 2023 to December 2023 were selected as the experimental group, and the cleaning and disinfection mode was centralized management. The control group used the traditional method to clean and disinfect the equipment sent to the countryside, the observation group used the centralized management method to clean and disinfect the management, and observed the qualified rate and loss rate of the two groups. Results: The qualified rate of cleaning and disinfecting instruments was 96.25% in the control group and 99.17% in the experimental group. The qualified rate of ophthalmic instrument cleaning in control group was significantly higher than that in experimental group, and the difference was statistically significant (P < 0.05). Conclusion The cleaning and disinfection management mode of centralized management can effectively improve the cleaning and disinfection quality of ophthalmic surgical instruments in rural areas and reduce the loss of instruments.
Diabetic retinopathy (DRD), which includes diabetic retinopathy (DR), diabetic macular edema (DME), and diabetic optic neuropathy (DON), is the leading cause of vision loss in the working-age population. Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that uses red blood cell movement and computer algorithms to detect retinal and choroidal circulation, widely applied in fundus vascular diseases. OCTA can identify various pathological features of DRD, such as microaneurysms, retinal neovascularization (RNV), and intraretinal microvascular abnormalities, often detecting microvascular changes earlier than microaneurysms. It is as effective as fundus fluorescein angiography in identifying retinal neovascularization and intraretinal microvascular abnormalities and surpasses fundus color photography. OCTA also quantifies the foveal avascular zone and vascular density, crucial for screening, monitoring, and predicting visual outcomes in DRD. Wide-field OCTA is particularly useful for long-term follow-up, providing detailed images of peripheral non-perfused areas and RNV. Improving the consistency of vascular assessments across different OCTA devices, enhancing data quality, and standardizing interpretation will further solidify the role of OCTA in managing DRD patients.
This case reports the first report of a new diagnostic technique that uses nasopharyngeal swabs to detect 13 respiratory viruses to help diagnose adenovirus corneal ulcers in children. Corneal ulcer caused by adenovirus infection. Twins, 5 months, binocular photophobia, repeated redness with increased secretions, the diagnosis of corneal ulcer. Using nasopharyngeal swabs for 13 respiratory viruses, adenovirus infection was quickly confirmed and antiviral treatment was given. The corneal ulcer was healed and repaired without sequelae. Furthermore, we report new diagnostic techniques used to promote the identification of pathogenic factors of corneal ulcers in infants and young children for timely treatment.
