目的系统评价首次硅油取出术后视网膜再脱离的影响因素。方法检索中国数据库(知网、中国生物医学文献数据库、维普、万方)、英文数据库(PubMed、Cochrane、Embase、Web of science),查找自建库至2023年8月20日关于首次行玻璃体切割(PPV...目的系统评价首次硅油取出术后视网膜再脱离的影响因素。方法检索中国数据库(知网、中国生物医学文献数据库、维普、万方)、英文数据库(PubMed、Cochrane、Embase、Web of science),查找自建库至2023年8月20日关于首次行玻璃体切割(PPV)联合硅油填充的患眼硅油取出术后视网膜再脱离的影响因素研究文献。根据纽卡斯尔-渥太华量表(NOS)文献质量评价标准进行质量评价。提取文献中首次硅油取出术后视网膜再脱离发生相关的影响因素,剔除提及文献<3篇的影响因素。运用RevMan5.3软件对收集的数据进行综合定量分析。结果共纳入14篇文献,包括3393术眼,其中复发组498眼,未复发组2895眼。meta分析结果显示,高度近视[比值比(OR)=1.40,95%置信区间(CI)∶1.08~1.81]、巨大视网膜裂孔(OR=2.36,95%CI:1.63~3.41)、玻璃体残留(OR=130.02,95%CI:66.03~256.02)、PPV术前人工晶状体状态(OR=1.86,95%CI:1.26~2.75)是硅油取出后视网膜再脱离的危险因素,而孔源性视网膜脱离(OR=0.68,95%CI:0.50~0.92)、PPV联合巩膜外加压(OR=0.63,95%CI:0.45~0.88)、取硅油前2~4周眼底激光光凝(OR=0.25,95%CI:0.13~0.49)是硅油取出后视网膜再脱离的保护性因素。敏感性分析结果显示,改变分析模型后分析结果无明显改变。所纳入研究的文献间均无发表偏倚。结论高度近视、巨大视网膜脱离、玻璃体残留、PPV术前人工晶状体状态增加了首次硅油取出后视网膜再脱离发生的风险。孔源性视网膜脱离、PPV联合巩膜外加压、取硅油前2~4周眼底激光光凝可能是其保护因素。展开更多
随着屈光手术技术的发展,患者对术后视觉质量的关注已逐渐超越单纯的裸眼视力提升。波前像差引导的LASIK技术通过个性化切削设计和精确的波前测量,显著减少术后高阶像差(HOAs)的发生,优化了术后视觉效果,成为近年来屈光手术领域的研究...随着屈光手术技术的发展,患者对术后视觉质量的关注已逐渐超越单纯的裸眼视力提升。波前像差引导的LASIK技术通过个性化切削设计和精确的波前测量,显著减少术后高阶像差(HOAs)的发生,优化了术后视觉效果,成为近年来屈光手术领域的研究热点。然而,术后视觉质量仍可能受到高阶像差的负面影响,表现为眩光、光晕、夜间视力下降以及对比敏感度降低等问题,这些仍是影响患者满意度和术后效果的核心难题。本文系统综述了波前像差引导的LASIK手术在减少术后高阶像差和优化视觉质量方面的优势,详细探讨了术后高阶像差的变化规律及其对视觉质量的多维影响,分析了相关影响因素及技术局限性。结合现有研究成果,本文展望了波前像差技术未来在设备改进、个性化设计及术后管理等方面的发展方向,以期为进一步提升手术设计和患者满意度提供科学依据。With the advancement of refractive surgical techniques, patients’ focus on postoperative visual quality has gradually shifted from mere improvement in unaided visual acuity to a more comprehensive assessment. Wavefront-guided LASIK technology, through personalized ablation designs and precise wavefront measurements, significantly reduces the occurrence of postoperative higher-order aberrations (HOAs), thereby optimizing postoperative visual outcomes. This approach has become a research hotspot in the field of refractive surgery in recent years. However, postoperative visual quality may still be negatively affected by higher-order aberrations, manifested as glare, halos, reduced night vision, and decreased contrast sensitivity. These issues remain core challenges affecting patient satisfaction and surgical outcomes. This review systematically summarizes the advantages of wavefront-guided LASIK surgery in reducing postoperative higher-order aberrations and optimizing visual quality. It also discusses in detail the patterns of changes in higher-order aberrations and their multidimensional impact on visual quality, analyzing relevant influencing factors and technical limitations. In light of existing research, the article also anticipates future developments of wavefront aberration technology in areas such as equipment improvements, personalized design, and postoperative management, aiming to provide scientific evidence for further enhancing surgical design and patient satisfaction.展开更多
伴随社会老龄化进一步加重,年龄相关性白内障已经成为全球关注的公共卫生问题,通过手术方式实现人工晶状体置换是解决白内障的重要手段。随着科技的进步,白内障手术已从复明性手术转变为屈光性手术,追求尽可能地改善患者术后的视觉质量...伴随社会老龄化进一步加重,年龄相关性白内障已经成为全球关注的公共卫生问题,通过手术方式实现人工晶状体置换是解决白内障的重要手段。随着科技的进步,白内障手术已从复明性手术转变为屈光性手术,追求尽可能地改善患者术后的视觉质量及视觉效果,准确计算人工晶状体屈光度是手术的关键,根据患者期望的近视力水平选择合适人工晶状体更能提高术后满意度。本文通过查阅国内外相关文献,对于影响多焦点人工晶状体选择的因素作一综述。With the further aging of society, age-related cataract has become a public health problem of global concern, and the surgical realization of IOL replacement is an important means to solve cataracts. With the advancement of science and technology, cataract surgery has been transformed from restorative surgery to refractive surgery, aiming to improve patients’ postoperative visual quality and visual outcome as much as possible. Accurate calculation of IOL refraction is the key to surgery, and selecting the appropriate IOL according to the patient’s desired level of near visual acuity is more likely to improve postoperative satisfaction. In this article, we review the factors that influence the selection of multifocal IOLs by reviewing the relevant national and international literature.展开更多
文摘目的系统评价首次硅油取出术后视网膜再脱离的影响因素。方法检索中国数据库(知网、中国生物医学文献数据库、维普、万方)、英文数据库(PubMed、Cochrane、Embase、Web of science),查找自建库至2023年8月20日关于首次行玻璃体切割(PPV)联合硅油填充的患眼硅油取出术后视网膜再脱离的影响因素研究文献。根据纽卡斯尔-渥太华量表(NOS)文献质量评价标准进行质量评价。提取文献中首次硅油取出术后视网膜再脱离发生相关的影响因素,剔除提及文献<3篇的影响因素。运用RevMan5.3软件对收集的数据进行综合定量分析。结果共纳入14篇文献,包括3393术眼,其中复发组498眼,未复发组2895眼。meta分析结果显示,高度近视[比值比(OR)=1.40,95%置信区间(CI)∶1.08~1.81]、巨大视网膜裂孔(OR=2.36,95%CI:1.63~3.41)、玻璃体残留(OR=130.02,95%CI:66.03~256.02)、PPV术前人工晶状体状态(OR=1.86,95%CI:1.26~2.75)是硅油取出后视网膜再脱离的危险因素,而孔源性视网膜脱离(OR=0.68,95%CI:0.50~0.92)、PPV联合巩膜外加压(OR=0.63,95%CI:0.45~0.88)、取硅油前2~4周眼底激光光凝(OR=0.25,95%CI:0.13~0.49)是硅油取出后视网膜再脱离的保护性因素。敏感性分析结果显示,改变分析模型后分析结果无明显改变。所纳入研究的文献间均无发表偏倚。结论高度近视、巨大视网膜脱离、玻璃体残留、PPV术前人工晶状体状态增加了首次硅油取出后视网膜再脱离发生的风险。孔源性视网膜脱离、PPV联合巩膜外加压、取硅油前2~4周眼底激光光凝可能是其保护因素。
文摘随着屈光手术技术的发展,患者对术后视觉质量的关注已逐渐超越单纯的裸眼视力提升。波前像差引导的LASIK技术通过个性化切削设计和精确的波前测量,显著减少术后高阶像差(HOAs)的发生,优化了术后视觉效果,成为近年来屈光手术领域的研究热点。然而,术后视觉质量仍可能受到高阶像差的负面影响,表现为眩光、光晕、夜间视力下降以及对比敏感度降低等问题,这些仍是影响患者满意度和术后效果的核心难题。本文系统综述了波前像差引导的LASIK手术在减少术后高阶像差和优化视觉质量方面的优势,详细探讨了术后高阶像差的变化规律及其对视觉质量的多维影响,分析了相关影响因素及技术局限性。结合现有研究成果,本文展望了波前像差技术未来在设备改进、个性化设计及术后管理等方面的发展方向,以期为进一步提升手术设计和患者满意度提供科学依据。With the advancement of refractive surgical techniques, patients’ focus on postoperative visual quality has gradually shifted from mere improvement in unaided visual acuity to a more comprehensive assessment. Wavefront-guided LASIK technology, through personalized ablation designs and precise wavefront measurements, significantly reduces the occurrence of postoperative higher-order aberrations (HOAs), thereby optimizing postoperative visual outcomes. This approach has become a research hotspot in the field of refractive surgery in recent years. However, postoperative visual quality may still be negatively affected by higher-order aberrations, manifested as glare, halos, reduced night vision, and decreased contrast sensitivity. These issues remain core challenges affecting patient satisfaction and surgical outcomes. This review systematically summarizes the advantages of wavefront-guided LASIK surgery in reducing postoperative higher-order aberrations and optimizing visual quality. It also discusses in detail the patterns of changes in higher-order aberrations and their multidimensional impact on visual quality, analyzing relevant influencing factors and technical limitations. In light of existing research, the article also anticipates future developments of wavefront aberration technology in areas such as equipment improvements, personalized design, and postoperative management, aiming to provide scientific evidence for further enhancing surgical design and patient satisfaction.
文摘伴随社会老龄化进一步加重,年龄相关性白内障已经成为全球关注的公共卫生问题,通过手术方式实现人工晶状体置换是解决白内障的重要手段。随着科技的进步,白内障手术已从复明性手术转变为屈光性手术,追求尽可能地改善患者术后的视觉质量及视觉效果,准确计算人工晶状体屈光度是手术的关键,根据患者期望的近视力水平选择合适人工晶状体更能提高术后满意度。本文通过查阅国内外相关文献,对于影响多焦点人工晶状体选择的因素作一综述。With the further aging of society, age-related cataract has become a public health problem of global concern, and the surgical realization of IOL replacement is an important means to solve cataracts. With the advancement of science and technology, cataract surgery has been transformed from restorative surgery to refractive surgery, aiming to improve patients’ postoperative visual quality and visual outcome as much as possible. Accurate calculation of IOL refraction is the key to surgery, and selecting the appropriate IOL according to the patient’s desired level of near visual acuity is more likely to improve postoperative satisfaction. In this article, we review the factors that influence the selection of multifocal IOLs by reviewing the relevant national and international literature.
