AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family memb...AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center,Sun Yat-sen University,in Guangzhou,China.The survey gathered data on respondents’willingness,demographic and socioeconomic profiles,as well as their reasons and concerns regarding engagement in clinical trials.RESULTS:Of the 1078 residents surveyed(mean age 31.2±13.1y;65.8%females)in Guangzhou,749(69.5%)expressed a willingness to participate in future ophthalmic clinical trials.Specific characteristics associated with greater willingness included a younger age,lower annual income,higher education,prior participation experience,previous ophthalmic treatment,and a better understanding of clinical trials.With the exception of age,these characteristics were significantly linked to a higher willingness.The primary barrier to participation,expressed by 64.8%of those willing and 54.4%of those unwilling,was“Uncertain efficacy”.In terms of motivations,the willing group ranked“Better therapeutic benefits”(35.0%),“Professional monitoring”(34.3%),and“Trust in healthcare professionals”(33.1%)as their top three reasons,whereas the unwilling participants indicated“Full comprehension of the protocol”(46.2%)as the key facilitator.CONCLUSION:This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors.Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies.Importantly,the need for and trust in healthcare professionals stand out as powerful motivations,underscoring the importance of enhancing physician-patient relationships,adopting patient-centered communication approaches,and addressing individualized needs to improve accrual rates.展开更多
AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who dev...AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.展开更多
AIM:To investigate the effects of Sonic hedgehog(Shh)gene-modified bone marrow mesenchymal stem cells(MSCs)on graft-induced retinal gliosis and retinal ganglion cells(RGCs)survival in diabetic mice.METHODS:Bone marrow...AIM:To investigate the effects of Sonic hedgehog(Shh)gene-modified bone marrow mesenchymal stem cells(MSCs)on graft-induced retinal gliosis and retinal ganglion cells(RGCs)survival in diabetic mice.METHODS:Bone marrow-derived MSCs were genetically modified with the Shh gene to generate a stably transfected cell line of Shh-modified MSCs(MSC-Shh).Intravitreal injections of MSC-Shh and green fluorescent protein-modified MSCs(MSC-Gfp;control)were administered in diabetic mice.After 4wk,the effects of MSC-Shh on retinal gliosis were evaluated using fundus photography,and markers of gliosis were examined by immunofluorescence and Western blotting.The neurotrophic factors expression and RGCs survival in the host retina were evaluated using Western blotting and immunofluorescence.The mechanisms underlying the effects of MSC-Shh was investigated.RESULTS:A significant reduction of proliferative vitreoretinopathy(PVR)was observed after intravitreal injection of MSC-Shh compared to MSC-Gfp.Significant downregulation of glial fibrillary acidic protein(GFAP)was demonstrated in the host retina after MSC-Shh administration compared to MSC-Gfp.The extracellular signal-regulated kinase 1/2(ERK1/2),protein kinase B(AKT)and phosphatidylin-ositol-3-kinase(PI3K)pathways were significantly downregulated after MSC-Shh administration compared to MSC-Gfp.Brain-derived neurotrophic factor(BDNF)and ciliary neurotrophic factor(CNTF)levels were significantly increased in the host retina,and RGCs loss was significantly prevented after MSC-Shh administration.CONCLUSION:MSC-Shh administration reduces graft-induced reactive gliosis following intravitreal injection in diabetic mice.The ERK1/2,AKT and PI3K pathways are involved in this process.MSC-Shh also increases the levels of neurotrophic factors in the host retina and promoted RGCs survival in diabetic mice.展开更多
●AIM:To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes.●METHODS:Consecutive patient...●AIM:To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes.●METHODS:Consecutive patients diagnosed with congenital cataracts and undergoing surgery between January 2005 and November 2021 were recruited.Data on visual outcomes and the phenotypic characteristics of ocular biometry and the anterior and posterior segments were extracted from the patients’medical records.A hierarchical cluster analysis was performed.The main outcome measure was the identification of distinct clusters of eyes with congenital cataracts.●RESULTS:A total of 164 children(299 eyes)were divided into two clusters based on their ocular features.Cluster 1(96 eyes)had a shorter axial length(mean±SD,19.44±1.68 mm),a low prevalence of macular abnormalities(1.04%),and no retinal abnormalities or posterior cataracts.Cluster 2(203 eyes)had a greater axial length(mean±SD,20.42±2.10 mm)and a higher prevalence of macular abnormalities(8.37%),retinal abnormalities(98.52%),and posterior cataracts(4.93%).Compared with the eyes in Cluster 2(57.14%),those in Cluster 1(71.88%)had a 2.2 times higher chance of good best-corrected visual acuity[<0.7 logMAR;OR(95%CI),2.20(1.25–3.81);P=0.006].●CONCLUSION:This retrospective study categorizes congenital cataracts into two distinct clusters,each associated with a different likelihood of visual outcomes.This innovative classification may enable the personalization and prioritization of early interventions for patients who may gain the greatest benefit,thereby making strides toward precision medicine in the field of congenital cataracts.展开更多
AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophth...AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.展开更多
AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who receiv...AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.展开更多
●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features ...●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.展开更多
●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
This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthal...This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.展开更多
AIM:To explore the usage of choroidal thickness measured by swept-source optical coherence tomography(SS-OCT)to detect myopic macular degeneration(MMD)in high myopic participants.METHODS:Participants with bilateral hi...AIM:To explore the usage of choroidal thickness measured by swept-source optical coherence tomography(SS-OCT)to detect myopic macular degeneration(MMD)in high myopic participants.METHODS:Participants with bilateral high myopia(≤−6 diopters)were recruited from a subset of the Guangzhou Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort Study.SS-OCT was performed to determine the choroidal thickness,and myopic maculopathy was graded by the International Meta-Analysis for Pathologic Myopia(META-PM)Classification.Presence of MMD was defined as META-PM category 2 or above.RESULTS:A total of 568 right eyes were included for analysis.Eyes with MMD(n=106,18.7%)were found to have older age,longer axial lengths(AL),higher myopic spherical equivalents(SE),and reduced choroidal thickness in each Early Treatment Diabetic Retinopathy Study(ETDRS)grid sector(P<0.001).The area under the receiver operating characteristic(ROC)curves(AUC)for subfoveal choroidal thickness(0.907)was greater than that of the model,including age,AL,and SE at 0.6249,0.8208,and 0.8205,respectively.The choroidal thickness of the inner and outer nasal sectors was the most accurate indicator of MMD(AUC of 0.928 and 0.923,respectively).An outer nasal sector choroidal thickness of less than 74μm demonstrated the highest odds of predicting MMD(OR=33.8).CONCLUSION:Choroidal thickness detects the presence of MMD with high agreement,particularly of the inner and outer nasal sectors of the posterior pole,which appears to be a biometric parameter more precise than age,AL,or SE.展开更多
BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of di...BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.展开更多
Purpose:.To evaluate the effect of preoperative visits on patients′ psychology, physiology, and behavior during the perioperative period of eye surgery under local anesthesia, with the aim of enhancing patients′ coo...Purpose:.To evaluate the effect of preoperative visits on patients′ psychology, physiology, and behavior during the perioperative period of eye surgery under local anesthesia, with the aim of enhancing patients′ cooperation with the surgery and improving their degree of satisfaction.Methods:.A total of 240 patients scheduled to undergo eye surgery between August and October 2013 were randomly divided into an observation(n = 120) and a control(n = 120)group..Patients in the observation group attended preoperative visits with nurses and received conventional nursing care. The control group received only conventional nursing.Results:.The Zung self-rating anxiety scale(SAS) scores were significantly lower in patients from the observation group than in the control group(P<0.05). Surgeons operating on the observation group were more satisfied with their patients′ cooperation with the surgery than were surgeons operating on the controls(P<0.01). Patients in the observation group had a significantly higher degree of satisfaction in terms of work efficiency in the operating room(P<0.01).Conclusion:.Preoperative visits by patients scheduled to undergo eye surgery can effectively mitigate preoperative anxiety in those patients,.build up a positive attitude toward the upcoming surgery,.instruct the patients to coordinate with the surgery,.enhance surgical safety,.and improve the patients′degree of satisfaction regarding the nursing care in the operating room.展开更多
Purpose:Corneal topograph-guided laser subepithelial keratomileusis (LASEK) can effectively correct decentered ablation occurring post laser in situ keratomileusis (LASIK) and to enhance our understanding and diagnosi...Purpose:Corneal topograph-guided laser subepithelial keratomileusis (LASEK) can effectively correct decentered ablation occurring post laser in situ keratomileusis (LASIK) and to enhance our understanding and diagnosis of decentered ablation following LASIK. Methods:Previous studies in the relevant literature are reviewed, and a case report is provided. Results:A patient with high myopia undergoing LASIK in both eyes presented with distorted vision in the left eye, which interfered with the vision in the right eye and caused blurred vision in both eyes. The patient was unable to see objects with both eyes. After receiving corneal topography-guided LASEK,the signs of distorted vision in the left eye and bilateral blurred vision were significantly alleviated,and the patient could see objects with both eyes simultaneously. Conclusion: Clinical ophthalmologists should be aware of the occurrence of decentered ablation after LASIK. Corneal topography-guided LASEK is an efficacious tool for correcting decentered ablation.展开更多
AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observation...AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.展开更多
Dear Sir,We hereby report two cases of methanol optic neuropathy with relapsed vision disturbance.Methanol intoxication appears after accidental or suicidal oral ingestion of industrial solvents or cleaning and antifr...Dear Sir,We hereby report two cases of methanol optic neuropathy with relapsed vision disturbance.Methanol intoxication appears after accidental or suicidal oral ingestion of industrial solvents or cleaning and antifreeze liquids or occasionally is due to fraudulent adulteration of wine or other alcoholic beverages.Its ingestion can cause severe visual disturbances and the outcomes of visual disturbances vary diffusively.Some completely or partially recovered,and some展开更多
AIM:To investigate the spectrum and antibiotic susceptibility of bacteria isolated from patients with suspected corneal infections in Zhongshan Ophthalmic Center in South China over the past four years retrospectively...AIM:To investigate the spectrum and antibiotic susceptibility of bacteria isolated from patients with suspected corneal infections in Zhongshan Ophthalmic Center in South China over the past four years retrospectively.· METHODS:Totally 1943 corneal scrapes from patients with corneal infections from 2010 to 2013 were cultured and processed using standard microbiological procedures to identify bacterial isolates.Simultaneously,the bacterial isolates were tested for antibiotic susceptibility to 8 antibiotics(ceftazidime,cefuroxim,cefazolin,levofloxacin,ofloxacin,neomycin,tobramycin,chloramphenicol) using the Kirby-Bauer disc diffusion technique.· RESULTS:Of the total 1943 scrapes,397(20.43%) were culture-positive,of which 294(74.06%) were grampositive(GP) and 103(25.94%) were gram-negative(GN)bacteria.Of the GP organisms,the most prevalent genera were Staphylococcus spp.(56.17%,n=223),Kocuria spp.(5.29%,n=21) and Micrococcus spp.(1.26%,n=5).On the other hand,the most prevalent genera were Pseudomonas spp.(12.85%,n=51),Burkholderia spp.(2.02%,n=8) and Acinetobacter spp.(1.51%,n=6) for the GN organisms.Among five antibiotics that have eye drop products,the resistant to neomycin of GP(7.82%,95%CI:4.72%-10.92%) and GN isolates(9.71%,95%CI:4.01%-15.41%) was lowest,while the resistant to chloramphenicol was highest(GP:34.35%,95%CI:28.92%-39.78%;GN:60.19%,95%CI:50.74%-69.64%).· CONCLUSION:Staphylococcus spp.was the most common bacterial pathogens isolated from patients with corneal infections in this setting.High percentages of GP and GN bacteria were mostly susceptible to neomycin and highly resistant to chloramphenicol.展开更多
Background:Using a randomized controlled trial(RCT),to assess the efficacy of the folded technique of self-adherent wrap to eyes after orbital tumour extirpation and compare it with the classic technique.Methods:A sin...Background:Using a randomized controlled trial(RCT),to assess the efficacy of the folded technique of self-adherent wrap to eyes after orbital tumour extirpation and compare it with the classic technique.Methods:A single-centre,prospective,randomized,controlled study was conducted among 128 patients who underwent orbital tumour extirpation in this study.The folded and classic techniques of applying self-adherent wraps were randomly allocated to patients(1:1).The primary endpoint was the interface pressure on the affected eye.Secondary efficacy endpoints were the interface pressure above and below the ear of the affected side,above the ear of the non-affected side,and discomfort scores.Postoperative complications were observed for 24 hours.Results:The interface pressure with the folded technique on the affected eye was neither inferior nor superior to the classic technique(1.33±0.07 vs.1.41±0.09 mmHg,P=0.480).Most importantly,the pressure at three other points outside of the affected eye,including above and below the ear of the affected side,and above the ear of the non-affected side,were significantly higher when using the classic technique than when using the folded technique(P=0.041,0.019,and 0.047,respectively).Discomfort scores were higher in the classic technique group than in the folded technique group(2.93±0.30 vs.1.52±0.19,P≤0.001).Conclusions:Findings demonstrated the advantages of using folded technique to apply self-adherent wrap for wounds after orbital tumour extirpation with lower interface pressure outside of the affected eye and patient discomfort scores,without influencing pressure on the affected eye comparing with the classic technique.展开更多
Background:This study aims to investigate the current status and influencing factors of evidence-based practice(EBP)with knowledge,attitude and practice(KAP)of ophthalmic nursing staffs in south China.Methods:Using a ...Background:This study aims to investigate the current status and influencing factors of evidence-based practice(EBP)with knowledge,attitude and practice(KAP)of ophthalmic nursing staffs in south China.Methods:Using a convenient sampling method,we selected 429 ophthalmic nursing staffs from 28 ophthalmology specialist hospitals or general hospitals in south China,and investigated their general information and implemented the evidence-based practice questionnaire(EBPQ).Results:The scores of EBP and KAP of ophthalmic nursing staffs in south China from high to low were as follows:practical attitude(4.85±1.07 points),practical behavior(4.42±1.14 points),practical knowledge and skills(4.30±0.65 points).The single factor analysis results showed that the first graduation degree,technical title,scientific research achievements,whether or not participate in EBP training,the frequency of reading literature at ordinary time,and whether or not participate in EBP project were the influencing factors of EBP level;the multi-factor analysis results showed that EBP attitude,EBP knowledge and skills,whether or not participate in EBP training were independent influencing factors of EBP.Conclusions:The ophthalmic nursing staffs in south China have a positive attitude towards EBP,however,their EBP knowledge,skills and behavioral capabilities need to be focused and improved.The ophthalmic nursing administrators should fully master the factors affecting the implementation of EBP,and take effective intervention measurement to improve the EBP abilities of ophthalmic nursing staffs,and promote the development of EBP in ophthalmology specialty.展开更多
Background:We investigated the procedures used by medical institutions in Guangdong Province for reprocessing ophthalmic surgical instruments and analyzed the problems identified in order to improve the quality of cle...Background:We investigated the procedures used by medical institutions in Guangdong Province for reprocessing ophthalmic surgical instruments and analyzed the problems identified in order to improve the quality of cleaning medical instruments and its management.Methods:The reprocessing of ophthalmic surgical instruments was investigated in 72 hospitals in Guangdong Province using a questionnaire designed for this purpose.Results:Ophthalmic surgical instruments underwent centralized reprocessing in the disinfection and supply centers in 50%of the 72 hospitals.Cataract phacoemulsification surgery was the main ophthalmic surgery performed in 94%of the 72 hospitals.The main reasons for using centralized reprocessing were an insufficient supply of ophthalmic surgical instruments,short turnaround times between surgeries,and the high cost of losing these precise and fragile instruments.Manual processing was the predominant method of reprocessing ophthalmic surgical instruments;enzyme detergents were used in 63.89%of the hospitals;and 48.61%of the hospitals used N-model small pressure-steam sterilizers for the ophthalmic surgical instruments.Conclusions:In order to improve the quality and management of the cleaning of medical instruments,and guarantee high-quality medical care,the following measures are recommended.Centralized management of ophthalmic surgical instruments should be based on the instruments’characteristics.Pay more attention to reprocessing site locations and staff training.Choose detergents based on manufacturers’instructions for use with specific instruments.Increase the number of available ophthalmic instruments in accordance with their demand and select appropriate small pressure-steam sterilizers.展开更多
基金Supported by the Science and Technology Program of Guangzhou(No.201803010066)the High-level Hospital Construction Project,Zhongshan Ophthalmic Center,Sun Yat-sen University(No.303010202).
文摘AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center,Sun Yat-sen University,in Guangzhou,China.The survey gathered data on respondents’willingness,demographic and socioeconomic profiles,as well as their reasons and concerns regarding engagement in clinical trials.RESULTS:Of the 1078 residents surveyed(mean age 31.2±13.1y;65.8%females)in Guangzhou,749(69.5%)expressed a willingness to participate in future ophthalmic clinical trials.Specific characteristics associated with greater willingness included a younger age,lower annual income,higher education,prior participation experience,previous ophthalmic treatment,and a better understanding of clinical trials.With the exception of age,these characteristics were significantly linked to a higher willingness.The primary barrier to participation,expressed by 64.8%of those willing and 54.4%of those unwilling,was“Uncertain efficacy”.In terms of motivations,the willing group ranked“Better therapeutic benefits”(35.0%),“Professional monitoring”(34.3%),and“Trust in healthcare professionals”(33.1%)as their top three reasons,whereas the unwilling participants indicated“Full comprehension of the protocol”(46.2%)as the key facilitator.CONCLUSION:This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors.Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies.Importantly,the need for and trust in healthcare professionals stand out as powerful motivations,underscoring the importance of enhancing physician-patient relationships,adopting patient-centered communication approaches,and addressing individualized needs to improve accrual rates.
基金Supported by the National Key R&D Program of China(No.2020YFC2008200)the National Natural Science Foundation of China(No.81970778,No.82271066,No.81970813)+1 种基金the Natural Science Foundation of Guangdong Province(No.2023A1515011198)Guangzhou Municipal Science and Technology Project(No.SL2022A03J00553).
文摘AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.
基金Supported by the Natural Science Foundation of Guangdong Province(No.2018A0303130293,No.2023A1515012470).
文摘AIM:To investigate the effects of Sonic hedgehog(Shh)gene-modified bone marrow mesenchymal stem cells(MSCs)on graft-induced retinal gliosis and retinal ganglion cells(RGCs)survival in diabetic mice.METHODS:Bone marrow-derived MSCs were genetically modified with the Shh gene to generate a stably transfected cell line of Shh-modified MSCs(MSC-Shh).Intravitreal injections of MSC-Shh and green fluorescent protein-modified MSCs(MSC-Gfp;control)were administered in diabetic mice.After 4wk,the effects of MSC-Shh on retinal gliosis were evaluated using fundus photography,and markers of gliosis were examined by immunofluorescence and Western blotting.The neurotrophic factors expression and RGCs survival in the host retina were evaluated using Western blotting and immunofluorescence.The mechanisms underlying the effects of MSC-Shh was investigated.RESULTS:A significant reduction of proliferative vitreoretinopathy(PVR)was observed after intravitreal injection of MSC-Shh compared to MSC-Gfp.Significant downregulation of glial fibrillary acidic protein(GFAP)was demonstrated in the host retina after MSC-Shh administration compared to MSC-Gfp.The extracellular signal-regulated kinase 1/2(ERK1/2),protein kinase B(AKT)and phosphatidylin-ositol-3-kinase(PI3K)pathways were significantly downregulated after MSC-Shh administration compared to MSC-Gfp.Brain-derived neurotrophic factor(BDNF)and ciliary neurotrophic factor(CNTF)levels were significantly increased in the host retina,and RGCs loss was significantly prevented after MSC-Shh administration.CONCLUSION:MSC-Shh administration reduces graft-induced reactive gliosis following intravitreal injection in diabetic mice.The ERK1/2,AKT and PI3K pathways are involved in this process.MSC-Shh also increases the levels of neurotrophic factors in the host retina and promoted RGCs survival in diabetic mice.
基金Supported by the Municipal Government and School(Hospital)Joint Funding Programme of Guangzhou(No.2023A03J0174,No.2023A03J0188)the State Key Laboratories’Youth Program of China(No.83000-32030003).
文摘●AIM:To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes.●METHODS:Consecutive patients diagnosed with congenital cataracts and undergoing surgery between January 2005 and November 2021 were recruited.Data on visual outcomes and the phenotypic characteristics of ocular biometry and the anterior and posterior segments were extracted from the patients’medical records.A hierarchical cluster analysis was performed.The main outcome measure was the identification of distinct clusters of eyes with congenital cataracts.●RESULTS:A total of 164 children(299 eyes)were divided into two clusters based on their ocular features.Cluster 1(96 eyes)had a shorter axial length(mean±SD,19.44±1.68 mm),a low prevalence of macular abnormalities(1.04%),and no retinal abnormalities or posterior cataracts.Cluster 2(203 eyes)had a greater axial length(mean±SD,20.42±2.10 mm)and a higher prevalence of macular abnormalities(8.37%),retinal abnormalities(98.52%),and posterior cataracts(4.93%).Compared with the eyes in Cluster 2(57.14%),those in Cluster 1(71.88%)had a 2.2 times higher chance of good best-corrected visual acuity[<0.7 logMAR;OR(95%CI),2.20(1.25–3.81);P=0.006].●CONCLUSION:This retrospective study categorizes congenital cataracts into two distinct clusters,each associated with a different likelihood of visual outcomes.This innovative classification may enable the personalization and prioritization of early interventions for patients who may gain the greatest benefit,thereby making strides toward precision medicine in the field of congenital cataracts.
基金Supported by the National Natural Science Foundation of China(No.81873673)the Basic and Applied Basic Research Foundation of Guangdong Province(No.2021A1515011673).
文摘AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.
基金Supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.303060202400201203).
文摘AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.
基金Supported by the National Natural Science Foundation of China(No.82171073No.82101147).
文摘●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.
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.
文摘This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.
基金Supported by the National Natural Science Foundation of China(No.82301249,No.82371086)the Science and Technology Projects in Guangzhou(No.SL2024A04J01756)the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.83000-32030003).
文摘AIM:To explore the usage of choroidal thickness measured by swept-source optical coherence tomography(SS-OCT)to detect myopic macular degeneration(MMD)in high myopic participants.METHODS:Participants with bilateral high myopia(≤−6 diopters)were recruited from a subset of the Guangzhou Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort Study.SS-OCT was performed to determine the choroidal thickness,and myopic maculopathy was graded by the International Meta-Analysis for Pathologic Myopia(META-PM)Classification.Presence of MMD was defined as META-PM category 2 or above.RESULTS:A total of 568 right eyes were included for analysis.Eyes with MMD(n=106,18.7%)were found to have older age,longer axial lengths(AL),higher myopic spherical equivalents(SE),and reduced choroidal thickness in each Early Treatment Diabetic Retinopathy Study(ETDRS)grid sector(P<0.001).The area under the receiver operating characteristic(ROC)curves(AUC)for subfoveal choroidal thickness(0.907)was greater than that of the model,including age,AL,and SE at 0.6249,0.8208,and 0.8205,respectively.The choroidal thickness of the inner and outer nasal sectors was the most accurate indicator of MMD(AUC of 0.928 and 0.923,respectively).An outer nasal sector choroidal thickness of less than 74μm demonstrated the highest odds of predicting MMD(OR=33.8).CONCLUSION:Choroidal thickness detects the presence of MMD with high agreement,particularly of the inner and outer nasal sectors of the posterior pole,which appears to be a biometric parameter more precise than age,AL,or SE.
基金Supported by National Natural Science Foundation of China,No.32200545The GDPH Supporting Fund for Talent Program,No.KJ012020633 and KJ012019530Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine,No.YN2022GK04。
文摘BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.
文摘Purpose:.To evaluate the effect of preoperative visits on patients′ psychology, physiology, and behavior during the perioperative period of eye surgery under local anesthesia, with the aim of enhancing patients′ cooperation with the surgery and improving their degree of satisfaction.Methods:.A total of 240 patients scheduled to undergo eye surgery between August and October 2013 were randomly divided into an observation(n = 120) and a control(n = 120)group..Patients in the observation group attended preoperative visits with nurses and received conventional nursing care. The control group received only conventional nursing.Results:.The Zung self-rating anxiety scale(SAS) scores were significantly lower in patients from the observation group than in the control group(P<0.05). Surgeons operating on the observation group were more satisfied with their patients′ cooperation with the surgery than were surgeons operating on the controls(P<0.01). Patients in the observation group had a significantly higher degree of satisfaction in terms of work efficiency in the operating room(P<0.01).Conclusion:.Preoperative visits by patients scheduled to undergo eye surgery can effectively mitigate preoperative anxiety in those patients,.build up a positive attitude toward the upcoming surgery,.instruct the patients to coordinate with the surgery,.enhance surgical safety,.and improve the patients′degree of satisfaction regarding the nursing care in the operating room.
文摘Purpose:Corneal topograph-guided laser subepithelial keratomileusis (LASEK) can effectively correct decentered ablation occurring post laser in situ keratomileusis (LASIK) and to enhance our understanding and diagnosis of decentered ablation following LASIK. Methods:Previous studies in the relevant literature are reviewed, and a case report is provided. Results:A patient with high myopia undergoing LASIK in both eyes presented with distorted vision in the left eye, which interfered with the vision in the right eye and caused blurred vision in both eyes. The patient was unable to see objects with both eyes. After receiving corneal topography-guided LASEK,the signs of distorted vision in the left eye and bilateral blurred vision were significantly alleviated,and the patient could see objects with both eyes simultaneously. Conclusion: Clinical ophthalmologists should be aware of the occurrence of decentered ablation after LASIK. Corneal topography-guided LASEK is an efficacious tool for correcting decentered ablation.
文摘AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.
基金Supported by Natural Science Foundation of Guangdong ProvinceChina(S2012010008439)
文摘Dear Sir,We hereby report two cases of methanol optic neuropathy with relapsed vision disturbance.Methanol intoxication appears after accidental or suicidal oral ingestion of industrial solvents or cleaning and antifreeze liquids or occasionally is due to fraudulent adulteration of wine or other alcoholic beverages.Its ingestion can cause severe visual disturbances and the outcomes of visual disturbances vary diffusively.Some completely or partially recovered,and some
基金Supported in part by the Doctoral Program of Higher Education,Ministry of Education and the Ophthalmologic State Key Laboratory,Sun-Yat Sen University,China
文摘AIM:To investigate the spectrum and antibiotic susceptibility of bacteria isolated from patients with suspected corneal infections in Zhongshan Ophthalmic Center in South China over the past four years retrospectively.· METHODS:Totally 1943 corneal scrapes from patients with corneal infections from 2010 to 2013 were cultured and processed using standard microbiological procedures to identify bacterial isolates.Simultaneously,the bacterial isolates were tested for antibiotic susceptibility to 8 antibiotics(ceftazidime,cefuroxim,cefazolin,levofloxacin,ofloxacin,neomycin,tobramycin,chloramphenicol) using the Kirby-Bauer disc diffusion technique.· RESULTS:Of the total 1943 scrapes,397(20.43%) were culture-positive,of which 294(74.06%) were grampositive(GP) and 103(25.94%) were gram-negative(GN)bacteria.Of the GP organisms,the most prevalent genera were Staphylococcus spp.(56.17%,n=223),Kocuria spp.(5.29%,n=21) and Micrococcus spp.(1.26%,n=5).On the other hand,the most prevalent genera were Pseudomonas spp.(12.85%,n=51),Burkholderia spp.(2.02%,n=8) and Acinetobacter spp.(1.51%,n=6) for the GN organisms.Among five antibiotics that have eye drop products,the resistant to neomycin of GP(7.82%,95%CI:4.72%-10.92%) and GN isolates(9.71%,95%CI:4.01%-15.41%) was lowest,while the resistant to chloramphenicol was highest(GP:34.35%,95%CI:28.92%-39.78%;GN:60.19%,95%CI:50.74%-69.64%).· CONCLUSION:Staphylococcus spp.was the most common bacterial pathogens isolated from patients with corneal infections in this setting.High percentages of GP and GN bacteria were mostly susceptible to neomycin and highly resistant to chloramphenicol.
基金This work was supported by the National Natural Science Foundation of China(81700875,81870689,81670887)the Sun Yat-sen University Clinical Research 5010 Program,China(2014014).
文摘Background:Using a randomized controlled trial(RCT),to assess the efficacy of the folded technique of self-adherent wrap to eyes after orbital tumour extirpation and compare it with the classic technique.Methods:A single-centre,prospective,randomized,controlled study was conducted among 128 patients who underwent orbital tumour extirpation in this study.The folded and classic techniques of applying self-adherent wraps were randomly allocated to patients(1:1).The primary endpoint was the interface pressure on the affected eye.Secondary efficacy endpoints were the interface pressure above and below the ear of the affected side,above the ear of the non-affected side,and discomfort scores.Postoperative complications were observed for 24 hours.Results:The interface pressure with the folded technique on the affected eye was neither inferior nor superior to the classic technique(1.33±0.07 vs.1.41±0.09 mmHg,P=0.480).Most importantly,the pressure at three other points outside of the affected eye,including above and below the ear of the affected side,and above the ear of the non-affected side,were significantly higher when using the classic technique than when using the folded technique(P=0.041,0.019,and 0.047,respectively).Discomfort scores were higher in the classic technique group than in the folded technique group(2.93±0.30 vs.1.52±0.19,P≤0.001).Conclusions:Findings demonstrated the advantages of using folded technique to apply self-adherent wrap for wounds after orbital tumour extirpation with lower interface pressure outside of the affected eye and patient discomfort scores,without influencing pressure on the affected eye comparing with the classic technique.
基金The first author would like to thank The Teaching and Research Department of Sun Yat-sen Ophthalmology Center of Sun Yat-sen University for the funding support。
文摘Background:This study aims to investigate the current status and influencing factors of evidence-based practice(EBP)with knowledge,attitude and practice(KAP)of ophthalmic nursing staffs in south China.Methods:Using a convenient sampling method,we selected 429 ophthalmic nursing staffs from 28 ophthalmology specialist hospitals or general hospitals in south China,and investigated their general information and implemented the evidence-based practice questionnaire(EBPQ).Results:The scores of EBP and KAP of ophthalmic nursing staffs in south China from high to low were as follows:practical attitude(4.85±1.07 points),practical behavior(4.42±1.14 points),practical knowledge and skills(4.30±0.65 points).The single factor analysis results showed that the first graduation degree,technical title,scientific research achievements,whether or not participate in EBP training,the frequency of reading literature at ordinary time,and whether or not participate in EBP project were the influencing factors of EBP level;the multi-factor analysis results showed that EBP attitude,EBP knowledge and skills,whether or not participate in EBP training were independent influencing factors of EBP.Conclusions:The ophthalmic nursing staffs in south China have a positive attitude towards EBP,however,their EBP knowledge,skills and behavioral capabilities need to be focused and improved.The ophthalmic nursing administrators should fully master the factors affecting the implementation of EBP,and take effective intervention measurement to improve the EBP abilities of ophthalmic nursing staffs,and promote the development of EBP in ophthalmology specialty.
文摘Background:We investigated the procedures used by medical institutions in Guangdong Province for reprocessing ophthalmic surgical instruments and analyzed the problems identified in order to improve the quality of cleaning medical instruments and its management.Methods:The reprocessing of ophthalmic surgical instruments was investigated in 72 hospitals in Guangdong Province using a questionnaire designed for this purpose.Results:Ophthalmic surgical instruments underwent centralized reprocessing in the disinfection and supply centers in 50%of the 72 hospitals.Cataract phacoemulsification surgery was the main ophthalmic surgery performed in 94%of the 72 hospitals.The main reasons for using centralized reprocessing were an insufficient supply of ophthalmic surgical instruments,short turnaround times between surgeries,and the high cost of losing these precise and fragile instruments.Manual processing was the predominant method of reprocessing ophthalmic surgical instruments;enzyme detergents were used in 63.89%of the hospitals;and 48.61%of the hospitals used N-model small pressure-steam sterilizers for the ophthalmic surgical instruments.Conclusions:In order to improve the quality and management of the cleaning of medical instruments,and guarantee high-quality medical care,the following measures are recommended.Centralized management of ophthalmic surgical instruments should be based on the instruments’characteristics.Pay more attention to reprocessing site locations and staff training.Choose detergents based on manufacturers’instructions for use with specific instruments.Increase the number of available ophthalmic instruments in accordance with their demand and select appropriate small pressure-steam sterilizers.
