论著

Effect evaluation of general education curriculum of medical artificial intelligence

:165-170
 
Objective: To analyze the effectiveness of medical education curriculum named “Development and Application of Ophthalmic Artificial Intelligence”, and provide reference for the development of other related curriculums. Methods: Longitudinal observational study method was adopted. During the fall semester of 2020, we conducted an education curriculum named “Development and Application of Ophthalmic Artificial Intelligence” and analyzed the results of mid-term and final examinations, and curriculum evaluation of students. Results: There were 118 undergraduate students taking the course and most of them were junior students majoring in clinical medicine. The score of the mid-term examination was in the range of 77.2±10.07, and 56 students (47.46%) got more than 80 points. The score of the final examination was in the range of 82.24±6.77, and 91 students (77.12%) got more than 80 points. The score of course evaluation of students was in the range of 98.76±3.55, and more than 90% of the students thought that teachers have made full preparations before class, together with clear teaching logic and accurate expressions in class. Conclusion: The smooth progress of our course proved the feasibility of medical artificial intelligence teaching. The teaching setting interspersed with theory and practice could help students to master knowledge and technology better, so as to achieve the teaching objectives.
论著

Application of continuous locking suture combined with corneal bandage contact lens in pterygium operation

:137-142
 
Objective: To investigate the effect of continuous locking suture combined with corneal bandage lens in the operation of pterygium. Methods: A prospective randomized controlled clinical trial was conducted. From January 2018 to June 2021, 132 patients (180 eyes) who underwent pterygium excision combined with autologous limbal conjunctival flap transplantation were randomly divided into group A and group B according to the fixation of conjunctival fla. The patients in group A (64 cases, 90 eyes) were treated with intermittent suture and fixation, and the patients in group B (68 cases, 90 eyes) were treated with continuous locking suture. Both groups were given corneal bandage lenses at the end of the operation. The postoperative ocular pain score, postoperative effect and complications were compared between the two groups. Results: The pain score in group B was significantly lower than that in group A at 1 and 3 d after operation (P<0.01), and there was no significant difference in corneal staining score between the two groups at 1, 3 and 7 d after operation (P>0.05). There was no significant difference in breakup time of tear film (BUT) between the two groups before and 3 months after operation (P>0.05), but the BUT at 3 months after operation in the group was significantly better than that before operation (P<0.05). There was no significant difference in visual acuity between the two groups before and 2 weeks after operation (P>0.05). The visual acuity of the two groups was significantly improved 2 weeks after operation (P<0.05). During the follow-up of 3 months, the main postoperative complications of the two groups included delayed healing of superficial matrix injury after pterygium avulsion, conjunctival hyperplasia, conjunctival graft loosening and so on. Conclusion: Continuous locking suture combined with corneal bandage lens in the treatment of pterygium can promote the repair of corneal wound, reduce the postoperative irritation symptoms and improve the postoperative comfort of patients. It is necessary to increase the suture span during continuous locking suture, which can reduce the loosening of conjunctival graft after operation.
论著

Optical coherence tomography angiography manifestation of strabismic amblyopia patients with eccentric fixation

:131-136
 
Objective: To explore the application value of optical coherence tomography angiography (OCTA) in patients with strabismic amblyopia accompanied by eccentric fixation. Methods: Seventeen strabismus amblyopia patients with eccentric fixation admitted to our hospital from January 2018 to May 2020 were enrolled as the study group. OCTA software was used to measure the distance between fixation point and macular fovea in micron units. Seventeen non-strabismus and non-amblyopia patients with centric fixation were enrolled as the control group. Vessel length density (VLD), perfusion density (PD), and foveal avascular zone (FOZ) were measured for the superficial retinal vascular cluster. Perimeter of FAZ and circularity of FAZ were analyzed. Results: The eccentric fixation distance was (632.18 ±310.6) μm, the macular fovea retinal thickness was (207.82±17.79) μm, the VLD of the superficial retinal vascular plexus was (5.31±3.44) mm?1, the PD was 0.16±0.08, the FAZ area was 0.28±0.17 mm2, the FAZ perimeter was 2.05±0.56 mm, and the FAZ circularity was 0.67±0.06. These results showed statistically significant differences in the VLD compared with the fellow eyes (P=0.043) and the control group (P=0.049), but there were no statistically significant differences in the PD, or FAZ area. In the strabismus group, the eccentricity of amblyopia was significantly correlated with the eccentric distance (r=0.834, P<0.001). Conclusion: OCTA can quantify the eccentric distance. The blood flow length density of macular fovea in strabismic amblyopia with eccentric fixation is lower than that in contralateral and healthy eyes.
论著

Consistency evaluation of eyeball biological measurements using StarEyes 900 and IOLMaster 500

:125-130
 
Objective: To evaluate the difference, correlation and agreement of eye parameters measured by StarEyes 900 visual function analyzer (Wan Ling Bang Qiao, China) and IOLMaster 500 (Carl Zeiss, Germany) swept-source optical coherence tomography biometer. Methods: A prospective study was designed involving 62 healthy subjects (124 eyes) undergoing ophthalmic examinations in Zhongshan Ophthalmic Center from June 2021 to July 2021. Data from their both eyes were selected for analysis in all patients. Axial length (AL), keratometry for the steepest meridian (Ks), keratometry for the flattest meridian (Kf), mean keratometry (Km) and corneal diameter (WTW) were measured by the StarEyes 900 visual function analyzer and IOLMaster 500 swept-source optical coherence tomography biometer. A paired t-test was used to analyze the differences in measurement results. The Pearson correlation coefficient was used to analyze the correlation. Bland-Airman method was used to assess the agreement of the instruments. Results: The AL, Kf, Ks, Km and WTW obtained by StarEyes 900 and IOLMaster 500 were (24.18±1.08) mm and (24.16±1.08) mm, (42.84±1.65) D and (43.04±1.57) D, (44.34±1.90) D and (44.17±1.80) D, (43.59±1.73) D and (43.61±1.64) D, and (11.64±0.29) mm and (11.64±0.30) mm, respectively. The Km and WTW of the two devices showed no significant difference (P>0.05), while the AL, Ks and Kf showed significant differences (all P<0.01). The AL and Ks obtained by StarEyes 900 were higher than by IOLMaster 500, while the Kf, Km and WTW were lower. The measurements of five aforementioned biometric parameters by both devices showed good correlation by Pearson correlation coefficient and good agreement by Bland-Airman. Conclusion: The Km and WTW measured by the two devices showed no significant difference, and provided references to one another. The difference in AL, Kf and Ks between the two devices showed significant differences. All of the measurements showed good correlation by Pearson correlation coefficient and good agreement by Bland-Airman.
论著

Measurement of corneal thickness in myopia with Corvis ST corneal biomechanical analyzer

:117-124
 
Objective: To compare the differences of corneal thickness measured by corneal biomechanical analyzer (Corvis ST), A-mode ultrasonic thickness meter (A-ultrasound) and Lenstar LS 900 (Lenstar) in myopia, so as to provide reference for preoperative screening of refractive surgery. Methods: A total of 244 patients (244 right eyes) with myopia before refractive surgery in Foshan Second People’s Hospital from March to December 2020 were included in the study, and the patients were divided into three groups according to the central corneal thickness (CCT): the thin cornea group (CCT≤520 μm), the normal cornea group (520 μm570 μm). The central corneal thickness (CCT) of the three groups was measured by Corvis ST, A-type ultrasonic thickness gauge and Lenstar LS 900, respectively, and included in the comparison index. Results: The measured values of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were statistically significant (all P<0.05). Corvis ST was positively correlated with A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group (r=0.841, P<0.001 vs r=0.832, P<0.001; r=0.866, P<0.001 vs r=0.918, P<0.001; r=0.497, P<0.001 vs r=0.801, P<0.001). In terms of consistency, the consistency coefficients ICC of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were 0.602 (0.091, 0.857), 0.758 (0.221, 0.901); 0.741 (0.207, 0.890), 0.845 (0.396, 0.938); 0.417 (0.005, 0.679), 0.667 (0.172, 0.851), and the range of 95% consistency interval were -2.2–24.2 μm, -6.7–19.5 μm; -8.4–24.6 μm, -6.8–19.4 μm; -8.7–23.8 μm, -7.0–18.3 μm. Conclusion: Through the statistical analysis of the data from the three groups, it is concluded that the measured values of Corvis ST are statistically significant compared with those of A-ultrasound and Lenstar, and the measured values of Corvis ST are higher than those of the latter two instruments. Corvis ST has a high correlation with the latter two, and the correlation is the highest in the measurement of normal corneal thickness. In terms of consistency, from the ICC point estimation and 95% confidence interval numerical analysis, the consistency was poor. From the perspective of Bland Altman, the maximum absolute value difference between Corvis ST and Lenstar was more than 10 μm, indicating poor consistency, but the maximum absolute value difference between Corvis ST and Lenstar was within 20 μm. Therefore, in refractive surgery screening with high measurement accuracy, Corvis ST, A-ultrasound and Lenstar cannot replace each other. However, in large-scale clinical screening, the measured value of corneal thickness has a certain clinical reference significance on the impact of intraocular pressure.
论著

Clinical presentation and outcomes of rhegmatogenous retinal detachment in phakic eyes after posterior chamber phakic intraocular lens implantation for high-myopia

:111-116
 
Objective: To analyze the clinical presentation, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD) in patients with high-myopia corrected by posterior chamber phakic (PCP) intraocular lens (IOL) implantation. Methods: Nine eyes of 9 patients in whom RRD developed after PCPIOL implantation from April 2012 to June 2021 in Zhongshan Ophthalmic Center were retrospectively studied. Mean follow-up after retinal detachment surgery was (4.96±4.78)months. Results: Mean patient age was (30.44±20.11) years old. RRD occurred (32.10±17.80) months after PCPIOL implantation. Four (44.4%) breaks were horseshoe tear, 1 (11.1%) was atrophic hole and 4 participants (44.4%) had a giant retinal tear. Nine cases had causative breaks located anterior to the equator while peripheral retina lattice degeneration was found in 6 eyes. RRD extended from 1 to 4 quadrants (3.0±1.12 quadrants) and 8 cases were macula-off retinal detachments. Four eyes’ proliferative vitreoretinopathy were more severe than level C. Initial reattachment rate was 77.80%. Final retinal reattachment was 100%. Final follow-up BCVA was significantly better than baseline (P<0.05). Furthermore, concurrent cataract occurred in 2 eyes in which silicone oil was used as tamponade. Ocular hypertension was detected in 4 eyes after surgery. Conclusion: The existed lattice degeneration and postoperative vitreous traction may be risk factors for RRD after PCPIOL implantation.
发明与创新

Development of an eyewash cart

:162.html-
 
We have developed an eyewash cart which is fully functional and meets the needs of eye cleaning for patients on different treatment chairs by adjusting the position of the eyewash cart in the same treatment room. At the same time, this eyewash cart can avoid frequent turning and walk of medical staffs during operation, so as to save their time and energy.
病例报告

Early capsular block syndrome after cataract surgery: A case report

:157-161
 
Capsular block syndrome (CBS), a fairly rare complication of phacoemulsification, can develop into one of the three following possible clinical scenarios: intraoperative, early postoperative, and late postoperative, depending primarily on the timing of its occurrence following surgery. This paper reported a patient who developed early capsular block syndrome. A 23-year-old patient complained of poor distant vision after undergoing phacoemulsification combined with intraocular lens (IOL) implantation because of steroid-induced cataract. Anterior segment examination confirmed the diagnosis of capsular block syndrome. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy resulted in complete resolution of her symptoms. No complication happened during follow-up.
“筑梦·铸人”专题

Emerging insights into lipid metabolism in diabetic retinopathy

:93-99
 
Abstract Abnormal lipid metabolism is a possible risk factor for diabetic retinopathy. Diabetic retinopathy is considered to be the main cause of blindness. In recent years, studies have shown that serum lipids, such as total cholesterol, triglycerides, are related to the progress of diabetic retinopathy and diabetic macular edema, and lipid-lowering drugs can delay the progress of diabetic retinopathy. With the development of lipidomics analysis methods such as chromatographic separation and mass spectrometry, lipid components other than conventional serum lipid markers have also been found to be related to the progression of diabetic retinopathy. The review summarizes the role of lipids and their derivatives in the pathogenesis of diabetic retinopathy, and highlights the potential targets and prospects of lipid metabolism treatment for diabetic retinopathy.
“筑梦·铸人”专题

Risk factors for myopia progression in school-age children in Wenzhou, China

:85-92
 
Objective: To investigate myopia progression and analyze the risk factors associated with myopia progression in a cohort of primary schoolchildren. Methods: The study was conducted in two primary schools in Wenzhou. Schoolchildren from grades 2 and 3 were examined in 2014 and were followed up annually until primary school graduation at grade 6. Children who were myopic at baseline were included in this study. The examination included non-cycloplegic subjective refraction, questionnaire survey, and binocular visual function parameters such as phoria, accommodative convergence/accommodation, positive relative accommodation, negative relative accommodation, and fusional convergence range. Multinomial logistic regression analysis was conducted to investigate the risk factors associated with various myopia progression speeds. Results: A total of 152 myopic schoolchildren [baseline age range 7–9 years; 95 male (62.5%)] were included in this study. The average refractive error (spherical equivalent refraction, SER) at baseline was -1.30±0.95 D, and the average annual myopia progression was -0.68±0.35 D. Multinomial logistic regression analysis showed that compared to the slow myopia progression group (annual myopia progression >-0.50 D), the moderate myopia progression group (-1.00 D < annual myopia progression ≤-0.50 D) and the fast myopia progression group (annual myopia progression ≤-1.00 D) were associated with having SER values ≤-1.00 D at baseline (moderate: OR=3.51, P=0.003; fast: OR=3.29, P=0.044); the fast myopia progression group was also associated with female sex (OR=4.52, P=0.012); baseline binocular visual function parameters were not related to various myopia progression speeds (P>0.05 for all). Conclusion: Sex and baseline refractive error were associated with various myopia progression among primary schoolchildren. No correlation between baseline binocular visual functions and myopia progression was found in this study. Myopia progressed faster in girls and children who had greater myopia (SER values ≤?1.00 D at age 7–9 years) at baseline.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办: 中山大学
    承办: 中山大学中山眼科中心
    主编: 林浩添
    主管:中华人民共和国教育部
    主办: 中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办: 中山大学
    承办: 中山大学中山眼科中心
    主编: 林浩添
    主管:中华人民共和国教育部
    主办: 中山大学
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