目的:评估与原发性慢性青光眼患者生活质量最具相关性的视觉指标。方法:回顾性病例系列研究。收集2010年3月至2010年8月就诊于首都医科大学附属北京同仁医院且符合入选及排除标准的原发性慢性闭角型青光眼和原发性开角型青光眼患者131例262只眼。采用Humphrey Field AnalyzerII 750i型视野分析仪对入选患者分别进行单眼Central 24-2程序和Esterman双眼视野检查程序(Esterman Binocular Visual Field Test,EBVFT)各两次检查,以保证所得数据的可靠性。使用LogMAR视力表检查并记录受试者日常单眼生活视力和日常双眼生活视力、非接触式眼压计测量眼压、直接眼底镜检查视神经的杯盘比。记录病史及目前所使用抗青光眼药物,角膜及晶状体状态。应用视功能相关生活质量量表-25(25-Item National Eye Institute Visual Function Questionnaire,VFQ-25)对患者进行生活质量评估,并将双眼日常生活视力、较好眼生活视力、较差眼视野MD(mean defect)值、较好眼视野MD值、(Esterman Visual Field Test,EVFT)效用值和VFQ-25得分进行相关性分析。结果:共有131例受试者符合入选条件。在患者生存质量的统计中,自我评价视力、近距离活动、远距离活动、社会功能、依赖程度、色觉、视野这7项得分较好,即受试者完成该7项的能力较高。VFQ-25总分与EBVFT效用值成正相关(r=0.24998,P=0.004<0.05),与双眼日常生活视力成负相关(r=?0.37778,P<0.0001),与较差眼视野MD值成正相关(r=0.22917,P=0.0187<0.05),与较好眼生活视力、较好眼视野、较差眼生活视力无明显相关关系。结论:原发性慢性青光眼患者双眼视觉(双眼视野和双眼日常生活视力)和VFQ-25有良好的相关性,可用于评估慢性青光眼患者的生活质量。
Objective: To assess the correlation between the Esterman binocular visual field (EBVF) and the visual function quality of life (VFQ) in primary chronic glaucoma patients. Methods: It is a retrospective case series study.One hundred and thirty-one patients, that is to say, two hundreds and sixty-two eyes, with primary chronic glaucoma satisfying the methodological criteria were recruited for this study, who were chosen from Beijing Tongren Hospital, Capital Medical University from March 2010 to August 2010. The Humphrey Field Analyzer Model II 750i (Humphrey Instruments, Zeiss Company) was used to perform an Esterman binocular visual field test (EBVFT) and bilateral monocular full-threshold central visual field testing using the 24-2 SITA Standard program. Visual acuities were examined by logarithm of the minimum angle of resolution (logMAR) scale. Intraocular pressure and cup-disc ratio were also recorded. The history with glaucoma and anti-glaucoma drugs, and the state of the cornea and crystalline lens were also remarked. All interviews were administered face to face by the same experienced interviewer, by using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25). Agreement between the scores from these tests and the VFQ-25 was evaluated. Results: A total of 131 patients were recruited. In the statistics of the quality of life, seven domain scores of the VFQ-25 (self-assessment vision, color vision, near action, distant action, social function, mental health and peripheral vision) were better than the others, which meant the ability of completing the seven domain was higher. Substantial agreement was found between the composite score of the VFQ-25 and the Esterman test (r=0.24998, P=0.004<0.05), strong negative correlation was found between the composite score of the VFQ-25 and the binocular visual acuity of daily life (r=?0.37778, P<0.0001), and positive correlation was found between the composite score of the VFQ-25 and the MD of the worse eye (r=0.22917, P=0.0187<0.05).Conclusion: In this sample of clinic-based patients with primary chronic glaucoma, the efficiency score of the binocular visual field tests correlated well with the composite score of the VFQ-25. Binocular visual function can be well used in evaluating the quality of life of the glaucoma patients.
目的:应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况,探讨血流变化与青光眼的关系。方法:选取2012年1 2月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primary angle closure glaucoma,PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma,POAG)患者8例(10只眼),分别设为PACG组和POAG组;同时,选取1 0例1 0只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查,观察眼动脉(ophthalmic artery,OA)、视网膜中央动脉(central retinal artery,CRA)、睫后短动脉(short posterior ciliary artery,SPCA)的血流动力学指标,包括收缩期最大血流速度(peak systolic velocity,PSV)、舒张末期血流峰值速度(diastolic peak velocity,EDV)、血流阻力指数(resistance index,RI)、造影剂到达时间(arrival time,AT)及消退时间(departure time,DT)等指标,并对结果进行统计学分析。结果:超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035),PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010);彩色多普勒测定PACG组及POAG组的OA和SPCA,以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003);同时,PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论:彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群,为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。
Objective: This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), to investigate the association between the blood flow changes and glaucoma. Methods: Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients (20 eyes, PACG group), 8 POAG patients(10 eyes, POAG group) who were diagnosed in the Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University from Dec. 2012 to Mar. 2014. The normal eyes from 10 persons were selected as control group. The flow velocity of ophthalmic artery, central retinal artery, and posterior ciliary artery were observed, including the peak systolic velocity, diastolic peak velocity, resistance index, and the arrival time and departure time of the ultrasound microbubbles (SonoVue). Results: Compared to control group, the arrival timeof the ultrasound microbubbles (SonoVue) of ophthalmic artery of patients with POAG increased (P=0.035),and the departure time of ophthalmic artery of patients with PACG and POAG increased (P=0.010). Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased (P=0.003). Meanwhile, the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group (P<0.001). Conclusion: The flow velocity of ocular vascular was worse than that of normal group respectively. This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.
目的:测量黄斑区视网膜神经节细胞层和内界膜-视网膜色素上皮层厚度,分析其与新发缺血性脑卒中的相关性。方法:采用前瞻性研究,选择2021年12月至2022年3月在潍坊医学院附属医院体检的健康者30例(60眼)为对照组(A组);选择同期收治且年龄匹配的新发缺血性脑卒中患者30例(60眼)为卒中组(B组)。比较两组黄斑区神经节细胞层(ganglion cell layer,GCL)和内界膜-视网膜色素上皮层(inner limiting membrane-Retinal pigment epithelium,ILM-RPE)厚度及平均GCL厚度/ILM-RPE平均容积厚度(GCL/ILM-RPE厚度比)。结果:共纳入120只眼,A、B组分别60只眼。A组的平均GCL为(83.5±4.7)μm,B组的平均GCL厚度为(78.7±10.5)μm,组间比较差异有统计学意义(P<0.001)。A组的GCL最小厚度为(80.4±4.4)μm,B组的GCL最小厚度为(70.7±16.3)μm,组间比较差异有统计学意义(P<0.001)。A组的ILM-RPE中心子区厚度为(247.5±19.8)μm,B组的ILM-RPE中心子区厚度为(241.6±36.3)μm,组间比较差异无统计学意义(P=0.393)。A组的ILM-RPE平均容积厚度为278.4±9.8μm,B组的ILM-RPE平均容积厚度为(278.5±15.3)μm,组间比较差异无统计学意义(P=0.448)。A组的GCL/ILM-RPE厚度比为0.300 3±0.012 2,B组的GCL/ILM-RPE厚度比为0.286 2±0.028 6,组间比较差异有统计学意义(P<0.001)。结论:缺血性脑卒中影响GCL厚度和GCL/ILM-RPE厚度比, GCL厚度和GCL/ILM-RPE厚度比与新发缺血性脑卒中可能有关。
Objective: To measure the thickness of retinal ganglion cell layer and inner limiting membrane-retinal pigment epithelium layer in the macular region, and analyze its correlation with new-onset ischemic stroke. Methods: By using a prospective study, 30 healthy subjects (60 eyes) who underwent physical examination in Affiliated Hospital of Weifang Medical University from December 2021 to March 2022 were selected as the control group (Group A). Thirty age-matched patients with new-onset ischemic stroke admitted at the same time (60 eyes) were selected as the stroke group (Group B). The ganglioncelllayer (GCL) and innerlimitingmembrane-Retinalpigmentepithelium (ILM-RPE) were compared between the two groups. It included the thickness and mean GCL thickness/Mean Volume thickness of ILM-RPE (GCL/ILM-RPE thickness ratio). Results: A total of 120 eyes were included, with 60 eyes in group A and B. The average GCL thickness in group A was (83.5±4.7) μm, and the average GCL thickness in group B was (78.7±10.5) μm,and the difference between groups was statistically significant (P<0.001). The minimum thickness of GCL in group A was (80.4±4.4) μm, and the minimum thickness of GCL in group B was (70.7±16.3) μm, showing statistical significance(P<0.001). The thickness of the central subregion of ILM-RPE in group A was (247.5±19.8) μm, and the thickness of the central subregion of ILM-RPE in group B was (241.6±36.3) μm, and the difference was not statistically significant between two groups (P=0.393). The mean volumetric thickness of ILM-RPE in group A was (278.4±9.8) μm, and the mean volumetric thickness of ILM-RPE in group B was (278.5±15.3) μm, and the difference was not statistically significant (P=0.448). The GCL/ILM-RPE thickness ratio of group A was (0.300 3±0.012 2), and that of group B was (0.286 2±0.028 6), showing a statistical difference between groups (P<0.001). Conclusion: Ischemic stroke affects the GCL thickness and the thickness ratio of GCL/ILM-RPE, which may be related to new-onset ischemic stroke.
目的:分析肺炎克雷伯菌导致内源性眼内炎在糖尿病患者中的临床特征,总结治疗经验及评估其预后。方法:回顾性病例分析2019年1月至2022年3月期间就诊于山东中医药大学附属眼科医院的肺炎克雷伯菌导致的内源性眼内炎糖尿病患者7例(8眼)。分析其年龄、性别、感染灶来源、就诊时间、治疗前后视力、眼压、裂隙灯检查、眼底检查、眼科B超、治疗方式、感染控制及复发情况。结果:7例患者年龄(63±17.6)岁。男性5例(71.4%),女性2例(28.6%)。术后7眼(87.5%)视力NLP,1眼(12.5%)LogMAR视力0.2。视力与患者就诊时间及就诊时视力有关。6例(85.7%)就诊前发热。8眼(100%)结膜混合充血,1眼(12.5%)前房积脓。7眼(87.5%)行玻璃体切割术联合玻璃体腔注药术,1眼(12.5%)行单纯玻璃体腔注药术。8眼感染均控制,无眼球摘除。随访期间眼压正常,无感染复发。结论:肺炎克雷伯菌是内源性眼内炎的主要致病菌,易在糖尿病人群中发生。发病迅速进展快,早期临床表现不典型易被误诊,其预后和病程的长短及治疗的时机密切相关,尽早地治疗可挽回部分视力。
Objective: To analyze the clinical characteristics of endogenous endophthalmitis caused by Klebsiella pneumoniae in diabetic patients, and summarize the treatment experience and evaluate its prognosis. Methods: A retrospective case analysis was performed on 7 patients (8 eyes) with endogenous endophthalmitis caused by Klebsiella pneumoniae, who were admitted to the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to August 2022. The age, gender, origin of infection, time of treatment, visual acuity before and after treatment, intraocular pressure, slit lamp examination, fundus examination, ophthalmic B-mode ultrasound, treatment methods, infection control and recurrence were analyzed. Results: The mean age of the seven patients was (63±17.6). There were five males (71.4%) and 2 females (28.6%). Postoperative visual acuity was NLP in seven eyes (87.5%) and LogMAR visual acuity was 0.2 in one eye (12.5%). Visual acuity was related to the patient’s visit time and the visual acuity at visit. Six cases (85.7%) had fever before treatment. Fever was a risk factor for Klebsiella pneumoniae endophthalmitis infection. Eight eyes (100%) had mixed conjunctival congestion, and one eye (12.5%) had abscess in the anterior chamber. Seven eyes (87.5%) underwent vitrectomy combined with intravitreal drug injection, and one eye (12.5%) underwent intravitreal drug injection alone. Infections were controlled in all eight eyes without enucleation. Intraocular pressure was normal during the follow-up period, and there was no infection recurrence. Conclusions: Klebsiella pneumoniae is the main pathogen of endogenous endophthalmitis and is prone to occur in people with diabetes. The onset of the disease progresses rapidly. The early clinical manifestations are not typical, and the prognosis is closely related to the duration of the disease and the timing of treatment. Early treatment can restore some vision.
目的:了解原发性开角型青光眼(primary open angle glaucoma,POAG)患者视野缺损的进展情况,探讨其发生进展的相关危险因素。方法:回顾性分析2014年1月至2018年7月就诊于北京大学第三医院眼科并有至少4次视野检查的POAG患者。按照患者首次视野检查的平均偏差或平均缺损进行分期。将历次随访视野检查的平均偏差或平均缺损与时间进行线性回归分析,取其斜率(dB/年)。根据平均偏差或平均缺损的斜率将患者分为进展组与无进展组。分析患者视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度损害位置、平均随诊间隔时间、基线视野分期等因素与青光眼视野缺损进展的关系。结果:共纳入128例患者(252只眼),其中129眼使用Octopus视野计检查随访,基线视野缺损值为(10.91±5.76) dB;123眼使用Humphrey视野计,基线视野偏差值为(–10.62±6.89) dB。视野缺损早、中、晚期的比例分别为26.19%、36.51%和37.30%。进展组31只眼(12.30%),无进展组221只眼(87.70%)。上下方RNFL都存在重度损害的患者,其视野缺损更易进展(P<0.001)。平均随诊间隔时间≤4个月的患眼,发生进展的比例高于平均随诊间隔时间>4个月的患眼(P=0.058)。基线视野分期、年龄、性别、总随访时间与视野缺损进展未见显著相关性。结论:青光眼患者的视功能损害出现恶化是普遍存在的。上下方RNFL均存在重度损害、随诊间隔时间短与视野缺损进展相关。视神经结构的改变与功能损害具有相关性,结构改变的方位对功能损害进展有提示功能。规律随诊对病情监测有重要意义,对于可能快速进展的患者,应缩短随诊间隔时间。
Objective: To investigate the progression of visual field defect in primary open angle glaucoma (POAG), and to explore the related risk factors for its progression. Methods: A retrospective analysis was performed on patients with POAG who had at least 4 visual field examinations in the Department of Ophthalmology, Peking University Third Hospital from January 2014 to July 2018. The visual field was staged according to the mean deviation or mean defect of the first visual field examination. Linear regression analyses of mean deviation or mean defect were performed against time, and corresponding regression slopes (in decibels per year) were calculated. Patients were divided into progressive and non-progressive groups according to the mean deviation slope or mean defect slope. The relationship between retinal nerve fiber layer (RNFL) thickness lesion location, mean follow-up interval, baseline visual field staging, and the progression of visual field defect in glaucoma were analyzed. Results: A total of 128 patients (252 eyes) were included. Among them, 129 eyes were followed up with an Octopus perimeter, and the average mean defect value of the baseline visual field was 10.91±5.76 dB; while the other 123 eyes were followed up with a Humphrey perimeter, and the average mean deviation value of the baseline visual field was –10.62±6.89 dB. The proportion of early, middle and late visual field defects was 26.19%, 36.51% and 37.30%. There were 31 eyes (12.30%) in the progressive group and 221 eyes (87.70%) in the non-progressive group. Patients with severe damage to both the upper and lower RNFLs had more visual field defects (P<0.001). Patients with an average follow-up interval ≤4 months had a higher rate of progression than those with an average follow-up interval >4 months (P=0.058).There were no significant differences in baseline visual field stage, age, gender, and total follow-up time between the progression and progression-free groups. Conclusion: Deterioration of visual function impairment is common in glaucoma patients. The progression of visual field defects is associated with severe impairments which are present both in the upper and lower RNFLs, and short follow-up intervals. Optic nerve structure changes are related to functional impairment, and the location of structural changes is suggestive of functional impairment progression.Regular follow-up visits are of great significance for disease monitoring. For patients who may progress rapidly, the follow-up interval should be shortened.
目的:探讨品管圈在提高玻璃体切除术后患者俯卧位执行率中的应用效果。方法:成立品管圈活动小组,选定提高玻璃体切除术后患者俯卧位执行率作为活动主题,运用品管圈工具和方法,对现状进行分析,找出影响因素,制定相应的措施并组织实施,比较品管圈活动前后玻璃体切除术后患者俯卧位执行率情况。结果:玻璃体切除术后患者俯卧位执行率由活动前的64.70%提高到95.83%。结论:运用品管圈能显著提高玻璃体切除术后患者俯卧位执行率,值得临床推广。
Objective: To explore the effect of quality control circle on improving the prone position execution rate of patients after vitrectomy. Methods: Establish quality control circle activity group, select improving the prone position execution rate of patients after vitrectomy as the activity theme, use quality control circle tools and methods to analyze the status quo, find out the influencing factors, formulate corresponding measures and implement them, and compare the prone position execution rate of patients before and after quality control circle activity. Results: The prone position execution rate of patients after vitrectomy increased from 64.70% to 95.83%.Conclusion: The application of quality control circle can significantly improve the prone position implementation rate of patients after vitrectomy, which is worthy of clinical promotion.
目的:探讨PDCA循环管理模式在优化白内障日间患者诊疗流程中的应用与成效。方法:选取中山大学中山眼科中心白内障病区2018年9月至2019年12月收治的白内障日间患者400例作为试验对象,选择2018年9月至2019年4月200例患者作为优化前组,选择实施PDCA循环管理模式后的2019年5月至2019年12月的200例患者作为优化后组。统计并比较两组患者实施前后的术前检查时长、住院时长、术后第1天复诊路径及患者满意度。结果:PDCA循环管理法实施了7个月后,患者术前检查时长由优化前的(2.94±2.12) h降至(2.09±0.93) h,住院时长由优化前的(22.73±1.14) h 降至(5.22±1.29) h,差异均具有统计学意义( P <0.001);患者满意度由优化前的92%上升至96%(P<0.05);术后第1天,患者复查所需行走的路径缩短,由以前的172 m降至129 m。结论:实施PDCA循环管理模式能有效地改善白内障日间患者的诊疗流程,缩短患者诊疗时间,提高患者的满意度,值得临床推广。
Objective: To explore the application and effect of Plan-Do-Check-Act (PDCA) cycle management mode in optimizing the diagnosis and treatment process of cataract patients with daytime surgery. Methods: A total of 400 cases of patients with daytime surgery admitted to Department of Cataract, Zhongshan Ophthalmic Center,Sun Yat-sen University from September 2018 to December 2019 were selected as the experimental subjects. 200 patients from September 2018 to April 2019 were selected as the pre-optimization group, and 200 patients from May 2019 to December 2019 after the implementation of the PDCA cycle management mode were selected as the post-optimization group. Time of preoperative examination, length of hospital stay, the follow-up path in the first day after surgery and patient satisfaction were statistically compared between the two groups before and after implementation. Results: Seven months after the implementation of PDCA cycle management mode, the preoperative examination time decreased from (2.94±2.12) h to (2.09±0.93) h, and the length of hospital stay decreased from (22.73±1.14) h to (5.22±1.29) h, and the differences were statistically significant (P<0.001); the patients’ satisfaction increased from 92% to 96% (P<0.05); the follow-up path in the first day after operation was changed from the 13th floor (172 m) to the 3rd floor (129 m). Conclusion: The implementation of PDCA cycle management mode can effectively improve the diagnosis and treatment process of cataract patients with daytime surgery, shorten the diagnosis and treatment time and improve the satisfaction of patients, so it is worthy of clinical promotion.
目的:了解行全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)患者围手术期的体验感受。方法:采用定性调查的方法,选取广东省某医院的15名行SMILE的患者,进行半结构式访谈,将患者围手术期体验归纳为顾虑、紧张、疼痛、担心、放松5个主题概念,用现象学分析法整理、分析资料。结果:把5种体验汇总制成韦恩图,通过韦恩图提炼发现有1人有围手术期5种感受,3位有紧张、疼痛、担心、放松4种心理感受,2位只有紧张的感受,而无其余感受。结论:行SMILE患者的围手术期具有多种体验感受,分析不同感受状态和因素,为眼科医护人员对于寻求SMILE手术的患者做好围手术期的服务提供依据。
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.
目的:探讨利用微信平台在有晶体眼人工晶体(implantable collamer lens,ICL)植入术后并发性白内障患者延续性护理的应用效果。方法:对13例(16眼)ICL植入术后并发性白内障患者利用微信平台随访和延续性护理,观察患者术前和术后1个月的护理满意度的自身对照。结果:13例患者(16眼)手术均顺利完成,术后均无出现并发症,术后视力均较术前有所提高,术后患者的护理满意度评分高于术前,差异有统计学意义(P<0.05)。结论:利用微信平台进行随访和延续性护理,可以提高患者护理满意度,是应用于ICL植入术后并发性白内障患者的有效护理方法。
Objective: To explore the application effect of WeChat platform in continuous nursing care for patients with complicated cataract after implantable collamer lens (ICL) implantation. Methods: Thirteen patients (16 eyes) with complicated cataracts after ICL implantation were followed up and continued nursing on the WeChat platform, then the self-control of the patients’ satisfaction on nursing before and one month after surgery was observed. Results: A total of 13 patients’ operation (16 eyes) went well, and they had no postoperative complications. The visual acuity of the patients was improved after operation compared with that of before operation, and the nursing satisfaction score of patients after operation was higher than that of before operation; the difference was statistically significant (P<0.05). Conclusion: Using WeChat platform for follow-up and continuous nursing can improve patients' nursing satisfaction, which was an effective nursing method for patients with complicated cataract after ICL implantation.
目的:了解白内障手术患者的临床分布特点,为基层医院白内障防治工作提供信息参考。方法:选取2019年1月至2019年1 2月在锦州医科大学附属第三医院眼科手术医治的白内障患者892例1 008眼。查阅相关病历资料,收集姓名、性别、年龄、手术眼别、入院时间、有无糖尿病史;术前视力、角膜内皮细胞密度、眼轴、晶状体混浊类型及白内障病因;手术方式、人工晶状体(intraocular lens,IOL)、术中并发症;术后第1天眼压、视力、眼部情况,进行统计学描述及分析。结果:入 选892例1 008眼,其中男357例401眼,女535例607眼,年龄(71.17±10.28)岁,90.7%的患者病因为年龄相关性白内障。入院时间集中在3~6月和9~12月。不同年龄段白内障患者具有各自的眼部特征。白内障类型与年龄差异有统计学意义(P<0.05),相比皮质性、后囊膜下性,核性白内障患者入院年龄偏大。白内障类型与性别、有无糖尿病史差异无统计学意义(P >0.05)。白内障患者选择最多的手术方式是超声乳化吸除术联合IOL植入术,术中并发症少,术后恢复快。结论:白内障的防治工作任重道远。手术多为年龄相关性白内障患者,入院时多年龄偏大,视力偏低,错失了手术最佳时机。不同年龄段、不同类型白内障患者具有不同的特征。超声乳化吸除术因其优势成为患者首选手术方式。
Objective: To understand the clinical distribution characteristics of cataract surgery patients and provide reference for cataract prevention and treatment in primary hospitals. Methods: From January 2019 to December 2019, 892 cataract patients (1 008 eyes) were selected from the Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University. Medical records were collected, including patient’s name, gender, age, surgical eye, admission time and history of diabetes, preoperative vision, corneal endothelial cell density, eye axis, phacoscotasmus type and cataract etiology, surgery method, intraocular lens, intraoperative complications, intraocular pressure, visual acuity and eye recovery on the first day after operation. These data were statistically described and analyzed. Results: A total of 892 cataract patients (1 008 eyes) were included, including 357 males (401 eyes) and 535 females (607 eyes), with the average age of (71.17±10.28) years old. The 90.7% patients cause of disease was age-related cataract. Admission time of all patients was mainly in March–June and September– December. Cataract patients of different ages had their own ocular characteristics. There was a statistically significant difference between the type of cataract and age (P<0.05). Compared with the cortical patients and posterior subcapsular patients, nuclear cataract patients were older at admission. There was no significant difference in the type of cataract between the gender and the patients with diabetes or not (P>0.05). The most frequently selected surgical method for cataract patients was phacoemulsification and intraocular lens implantation, which has the advantages of less intraoperative complications and rapid postoperative recovery. Conclusion: We still have a long way to go in the prevention and treatment of cataract. Most of the operations were performed on age-related cataract patients, and most of them were older and had low vision when they were admitted to hospital, so the optimal timing of the operation was missed. Patients of different age groups and different types of cataract have different characteristics. Phacoemulsification is the first choice because of its own advantages.