●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:T...●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.展开更多
AIM: To evaluate the effectiveness of autologous conjunctival flap surgery for repairing the late-onset filtering bleb leakage after trabeculectomy.METHODS: This study retrospectively reviewed 106 eyes from 106 patien...AIM: To evaluate the effectiveness of autologous conjunctival flap surgery for repairing the late-onset filtering bleb leakage after trabeculectomy.METHODS: This study retrospectively reviewed 106 eyes from 106 patients with late-onset filtering bleb leakage after trabeculectomy who received autologous conjunctival flap surgery at the Zhongshan Ophthalmic Centre from 2005 to 2015. The basic information was recorded, and the interval time between trabeculectomy and autologous conjunctival flap surgery as well as related risk factors, intraocular pressure(IOP), anterior chamber depth(ACD) and best corrected visual acuity(BCVA) were analysed. Moreover, 41 patients who completed the 1-year follow up were analysed to determine the IOP and BCVA changes and long-term success rates.RESULTS: The 50 male and 56 female subjects(average age 39.13±17.96 y) included 47(44.34%) and 33(31.13%) cases of primary open angle and primary angle-closure glaucoma. The mean interval between trabeculectomy and repair surgery was 60.60±56.92(3-264)mo. The mean mitomycin(MMC) concentration during trabeculectomy was 0.27±0.04(0.12-0.4) mg/m L in the fornix-based conjunctival flap group(68 patients) and 0.28±0.04(0.20-0.33) mg/m L in the limbal-based conjunctival flap group(11 patients). After bleb leakage, the patients' vision remained stable while the IOP decreased from 10.25±4.76(3-20.86) to 9.44±4.33(2-21) mm Hg(P<0.01). In the 41 analysed patients, the IOP was controlled at 15.68±5.11(7-40) mm Hg in the 1^(st) year after autologous conjunctival flap surgery and recurrence was not observed, for a long-term success rate of 100%. CONCLUSION: Autologous conjunctival flap repairing surgery is an effective technique for sealing filtering bleb leakages and controlling IOP postoperatively.展开更多
Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated ...Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.展开更多
文摘●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.
基金Supported by the Guangdong Province Science and Technology Projects(No.2014A020212712)Guangzhou City Science and Technology Projects(No.2014Y2-00172)
文摘AIM: To evaluate the effectiveness of autologous conjunctival flap surgery for repairing the late-onset filtering bleb leakage after trabeculectomy.METHODS: This study retrospectively reviewed 106 eyes from 106 patients with late-onset filtering bleb leakage after trabeculectomy who received autologous conjunctival flap surgery at the Zhongshan Ophthalmic Centre from 2005 to 2015. The basic information was recorded, and the interval time between trabeculectomy and autologous conjunctival flap surgery as well as related risk factors, intraocular pressure(IOP), anterior chamber depth(ACD) and best corrected visual acuity(BCVA) were analysed. Moreover, 41 patients who completed the 1-year follow up were analysed to determine the IOP and BCVA changes and long-term success rates.RESULTS: The 50 male and 56 female subjects(average age 39.13±17.96 y) included 47(44.34%) and 33(31.13%) cases of primary open angle and primary angle-closure glaucoma. The mean interval between trabeculectomy and repair surgery was 60.60±56.92(3-264)mo. The mean mitomycin(MMC) concentration during trabeculectomy was 0.27±0.04(0.12-0.4) mg/m L in the fornix-based conjunctival flap group(68 patients) and 0.28±0.04(0.20-0.33) mg/m L in the limbal-based conjunctival flap group(11 patients). After bleb leakage, the patients' vision remained stable while the IOP decreased from 10.25±4.76(3-20.86) to 9.44±4.33(2-21) mm Hg(P<0.01). In the 41 analysed patients, the IOP was controlled at 15.68±5.11(7-40) mm Hg in the 1^(st) year after autologous conjunctival flap surgery and recurrence was not observed, for a long-term success rate of 100%. CONCLUSION: Autologous conjunctival flap repairing surgery is an effective technique for sealing filtering bleb leakages and controlling IOP postoperatively.
基金All the procedures in this study were approved by the Institutional Review Board of Zhongshan Ophthalmic Center of Sun Yat-sen University(Ethic ID:2016MEKY062).Informed consent was obtained from each student.
文摘Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
