2022年2月 第37卷 第2期

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:葛坚 刘奕志
“筑梦·铸人”专题

中国温州学龄儿童近视进展的危险因素

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

:85-92
 
目的:观察学龄儿童的近视进展情况,分析近视进展的危险因素。方法:于2014年纳入温州2所小学二、三年级近视儿童,每年随访1次,直至小学毕业。检查内容包括非睫状肌麻痹主觉验光、双眼视功能检查(隐斜、调节性集合/调节、正负相对调节、正负融像性聚散)和问卷调查。采用无序多分类logistic回归分析近视进展速度的危险因素。结果:共纳入152名近视儿童[年龄7~9岁,95名(62.5%)男性],初始屈光度为-1.30±0.95屈光度(diopter,D),年近视进展量为-0.68±0.35 D。回归分析表明:与慢速组相比(年近视进展量>-0.50 D),中速组(-1.00 D<年近视进展量≤-0.50 D)与快速组(年近视进展量≤-1.00 D)中初始屈光度≤-1.00 D的儿童占比更大(中速组:OR=3.51,P=0.003;快速组:OR=3.29,P=0.044),快速组中女性占比更大(OR=4.52,P=0.012),基线双眼视功能参数在不同组间差异均无统计学意义(均P>0.05)。结论:学龄儿童近视进展速度与性别、初始屈光度相关,与基线双眼视功能无关。女孩、初始近视程度大(7~9岁时,屈光度≤-1.00 D)的儿童近视进展快。
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.

糖尿病性视网膜病变脂质代谢的研究进展

Emerging insights into lipid metabolism in diabetic retinopathy

:93-99
 
脂质代谢异常是糖尿病性视网膜病变可能的危险因素。糖尿病性视网膜病变被认为是致盲的主要原因。近年来研究认为总胆固醇、三酰甘油等血脂与糖尿病性视网膜病变及糖尿病黄斑水肿的进展有关,降脂药物的应用能够延缓糖尿病性视网膜病变进展。随着色谱分离和质谱分析等脂质组学分析方法的发展,除了常规的血清脂质标志物以外的各种脂质成分也被发现可能与糖尿病性视网膜病变进展有关。现总结脂质及其衍生物在糖尿病性视网膜病变发病机制中的作用,阐述糖尿病性视网膜病变脂质代谢治疗的潜在靶点和前景。
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.
“眼科再生医学”专题

培养皿中的眼睛:眼组织类器官技术发展与应用

An eye in a culture dish: ocular organoids and their application

:100-110
 
眼睛是人体最重要的感觉器官之一,主要由角膜和晶状体构成的屈光系统和视网膜构成的视觉神经系统2个部分构成。眼睛各组织的发育和功能异常都可影响视功能,甚至致盲。现有的致盲眼病的治疗方式均存在各自瓶颈问题,新的诊治方法亟待开发。近年来,得益于干细胞和组织工程学的发展,结合现有眼各组织的发育理论知识,研究者们利用多种来源的干细胞在体外成功诱导出具有组织特异结构和功能的眼类器官。眼类器官研究为利用干细胞研究眼组织发育和眼病发病机制、药物筛选以及替代治疗创造了新机遇,将干细胞治疗眼病的转化研究推向了一个更高平台。本文将对现有眼类器官的技术发展及应用进行综述。
Being one of the most important sensory organs, the eye is composed of the cornea, the lens, which are responsible for refraction, and the retina, which is the neural sensory part of the eye. Various kinds of developmental abnormalities and functional defects could lead to visual dysfunctions, and even blindness. Current treatments for blindness-causing eye diseases all have their own limitations, awaiting new efficient diagnostic and treating methods. Thanks to the development in stem cell biology and bioengineering, taking advantage of the rich knowledge accumulated on the mechanisms governing eye development, researchers have successfully generated various ocular organoids using multiple sources of stem cells in vitro, which resemble their counterparts in vivo on both the structural level and functional level. Ocular organoids provide valuable material and models for studying eye development, pathology, drug screening, and cell replacement therapy, pushing translational studies of ocular stem cell to a new era. Here, the paper reviews the development and application of ocular organoid technologies.
论著

高度近视有晶状体眼后房型人工晶状体术后孔源性视网膜脱离的临床特征及预后分析

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

:111-116
 
目的:分析高度近视有晶状体眼后房型人工晶状体植入术后孔源性视网膜脱离的临床特征及预后。方法:回顾分析2012年4月至2021年6月中山眼科中心收治的9例(9只眼)行后房型人工晶状体植入术后孔源性视网膜脱离患者的临床特征、手术方式及疗效,随访(4.96±4.78)个月。结果:患者年龄(30.44±20.11)岁,屈光手术至发病时间(32.10±17.80)个月。4例(44.4%)马蹄形裂孔,1例(11.1%)萎缩性裂孔,4例(44.4%)巨大裂孔;9眼裂孔均位于赤道部前,除2眼(22.2%)为单个巨大裂孔,1眼(11.1%)单个马蹄孔,余6眼(66.7%)均有视网膜周边变性区存在;视网膜脱离范围(3.0±1.12)个象限,8例累及黄斑;增殖性玻璃体视网膜病变C级以上4眼。视网膜初始复位率为77.8%,最终视网膜复位率100%。末次随访最佳矫正视力优于术前(P<0.05)。随访期间,2例硅油填充眼发生并发性白内障,4眼发生术后早期高眼压。结论:有晶状体眼后房型人工晶状体植入术前存在的视网膜变性或术后玻璃体牵引的存在可能是孔源性视网膜脱离发生的危险因素。
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.

Corvis ST角膜生物力学分析仪测量近视眼角膜厚度

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

:117-124
 
目的:比较角膜生物力学分析仪(Corvis ST)、A型超声测厚仪(A超)、Lenstar LS 900(Lenstar)在测量近视眼角膜厚度的差异,为屈光术前筛查提供参考。方法:纳入2020年3至12月佛山市第二人民医院收治的屈光术前近视患者244例(244只右眼),并按中央角膜厚度(central corneal thickness,CCT)将患者分为3组:薄角膜组(CCT≤520 μm)、正常角膜组(520 μm570 μm),分别采用Corvis ST、A超、Lenstar三种仪器测量3组患者的中央角膜厚度,并纳入对比指标。结果:Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组的测量值对比差异均有统计学意义(均P<0.05);在相关性方面,Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组呈正相关(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);在一致性方面,Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组上一致性系数ICC及95%置信区间分别为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),95%一致性区间范围分别是(-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)。结论:通过对3组数据统计分析得出,Corvis ST与A超、Lenstar的测量值相比,差异均有统计学意义,且Corvis ST的测量值均高于后两种仪器;Corvis ST与后两者均有着较高的相关性,且在正常角膜厚度测量上相关性最高;在一致性方面,从ICC点估计及95%置信区间数值分析,一致性较差;从Bland-Altman角度分析,Corvis ST与后两者的绝对值最大差值超过10 μm,一致性较差,但在与Lenstar的绝对值最大差值均在20 μm内。因此,在测量精度要求较高的屈光手术筛查方面,Corvis ST与A超、Lenstar之间不能相互替代,而对于大规模临床筛查,其角膜厚度测量值对眼压的影响有一定的临床参考意义。
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.

光学眼科生物测量仪StarEyes 900与IOLMaster 500对眼球生物学测量的一致性评价

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

:125-130
 
目的:评价StarEyes 900(万灵帮桥,中国)与IOLMaster 500(蔡司,德国)2种眼科光学生物测量仪测量健康受试者眼部参数的差异性、相关性及一致性。方法:前瞻性观察2021年6月至7月于中山大学中山眼科中心进行眼部检查的62例健康受试者共124只眼,分别通过StarEyes 900与IOLMaster 500完成眼轴长度(axial length,AL)、最小角膜屈光力径线上角膜曲率(keratometry for the flattest meridian,Kf)、最大角膜屈光力径线上角膜曲率(keratometry for the steepest meridian,Ks)、平均角膜曲率(mean keratometry,Km)、角膜白到白直径(white-to-white corneal diameter,WTW)等参数的测量,采用配对t检验、Pearson相关分析和Bland-Altman法对其测量结果的差异进行评价。结果:StarEyes 900与IOLMaster 500测量的AL分别为(24.18±1.08) mm和(24.16±1.08) mm;Kf分别为(42.84±1.65) D和(43.04±1.57) D;Ks分别为(44.34±1.90) D和(44.17±1.80) D;Km分别为(43.59±1.73) D和(43.61±1.64) D;WTW分别为(11.64±0.29) mm和(11.64±0.30) mm。StarEyes 900与IOLMaster 500在测量Km、WTW时,其差异无统计学意义(P>0.05),而在AL、Kf、Ks的测量上差异有统计学意义(P<0.01)。其中StarEyes 900所测的AL和Ks值大于IOLMaster 500,而Kf、Km和WTW值则小于IOLMaster 500。经Pearson相关分析,2种仪器的测量结果均表现出较高的相关性;经Bland-Altman法评价,2种仪器的测量结果均表现出较高的一致性。结论:StarEyes 900与IOLMaster 500测量的Km、WTW均表现出较高的一致性,2种方法可互为参考;测量的AL、Kf、Ks存在的差异具有统计学意义;各项参数的测量均具有较好的相关性和一致性。
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.

斜视性弱视伴偏中心注视患者的光学相干断层扫描血管成像技术表现

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

:131-136
 
目的:探讨光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)在斜视性弱视伴偏中心注视患者中应用的价值。方法:收集2018年1月到2020年5月斜视性弱视伴偏中心注视的患者17人为研究组,采用OCTA系统软件工具,以μm为单位测量视网膜固视点和黄斑中心凹之间的距离,同时收集非斜视、弱视且中心注视健康者17人为对照组,并分析受试者的浅层视网膜血管丛的黄斑中心凹血流长度密度(vessel length density,VLD)、灌注密度(perfusion density,PD)、黄斑中心凹无血流信号区(foveal avascular zone,FAZ)、面积、FAZ周长及FAZ圆形度。结果:斜视组弱视眼偏心距离为(632.18±310.62) μm,黄斑中心凹浅层血管丛VLD为(5.31±3.44) mm?1,PD为0.16±0.08,黄斑中心凹无血流信号区FAZ面积(0.28±0.17) mm2,FAZ周长(2.05±0.56) mm、FAZ圆形度0.67±0.06;与研究组対侧眼和对照组相比,VLD差异有统计学意义(P<0.05),PD、FAZ面积等差异无统计学意义(P>0.05)。斜视组弱视眼偏心度与偏中心距离显著相关(r=0.834,P<0.001)。结论:OCTA可以量化偏中心距离,斜视性弱视伴偏中心注视眼的黄斑中心凹血流长度密度较対侧眼及健康眼低。
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.

连续锁边缝合联合角膜绷带镜在翼状胬肉手术中的应用

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

:137-142
 
目的:探讨连续锁边缝合联合角膜绷带镜在翼状胬肉手术中应用的效果。方法:采用前瞻性随机对照临床研究。选取2018年1月到2021年6月期间在我院行翼状胬肉切除联合自体角膜缘结膜瓣移植术的患者132例180眼,按结膜瓣固定方式随机分为A、B两组,其中A组患者(64例90眼)行间断缝合固定法,B组患者(68例90眼)行连续锁边缝合法,术毕两组患者均给与配戴角膜绷带镜。比较两组患者的术后眼部疼痛程度评分、术后效果及并发症。结果:术后1、3 d,B组疼痛评分明显低于A组,差异有统计学意义(P<0.01);术后1、3、7 d两组间角膜染色评分差异无统计学意义(P>0.05);术前、术后3个月两组间泪膜破裂时间(breakup time of tear film,BUT)差异无统计学意义(P>0.05),但术后3个月组内的BUT较手术前有明显改善(P<0.05)。术前、术后2周两组间视力差异均无统计学意义(P>0.05),术后2周两组组内视力较手术前均有明显改善(P<0.05)。随访3个月,两组患者主要术后并发症包括胬肉撕除后浅层基质损伤延迟愈合、线结处结膜增生、结膜植片松脱等,并发症发生率两组相当。结论:采用连续锁边缝合联合配戴角膜绷带镜治疗翼状胬肉可以促进角膜创面的修复,减轻患者的术后刺激症状,提高患者术后舒适度;连续锁边缝合时需要适当增加缝线跨度,可减少术后结膜植片的松脱。
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.
综述

玻璃体切除术后白内障患者屈光预测误差来源的研究进展

Research progress on the sources of refractive prediction error in cataract patients after vitrectomy

:143-149
 
随着微创玻璃体切除术(pars plana vitrectomy,PPV)的广泛开展和手术技术的提高,患者对手术后视觉质量的要求越来越高。白内障是PPV术后最常见并发症,而具有玻璃体切除史的白内障患者屈光变异大,预测难度高。本文综述了生物测量误差、人工晶状体屈光力计算公式选择以及有效晶状体位置预测等影响有玻璃体切除手术史的白内障患者术后屈光误差的主要因素,旨在为降低这一类特殊人群白内障术后屈光误差提供参考。
With the widespread application of minimally invasive vitrectomy and the improvement of surgical techniques, the demands of patients for better postoperative visual quality are increasing. Cataract is the most common complication after vitrectomy, whereas the refractive outcomes of cataract patients with prior vitrectomy are viable and difficult to predict. In this paper, the main factors affecting postoperative refractive error of cataract patients with a history of vitrectomy, such as biometric error, selection of intraocular lens calculation formulas and prediction of effective lens position, were reviewed in order to provide reference for reducing postoperative refractive error of this special group of cataract patients.

光学相干断层成像技术在帕金森病中的发现及探索

Discovery and exploration of optical coherence tomography in Parkinson’s disease

:150-156
 
帕金森病(Parkinson’s disease,PD)是老年人常见的神经系统退行性疾病,眼部及视觉功能障碍是PD常见的非运动症状之一,进一步影响其生活质量。已有研究表明PD患者视网膜内存在多巴胺浓度的减少以及α突触核蛋白的沉积。目前,PD仍缺乏有效的早期诊断及病情评估工具,光学相干断层扫描及光学相干断层扫描血管成像技术可以显示视网膜各层微细结构及微血管的异常,应用该技术研究者发现PD患者视乳头旁视网膜神经纤维层及黄斑区视网膜的厚度均存在不同程度的变薄,视网膜浅层及深层毛细血管丛的毛细血管密度和复杂性下降。进一步研究者应用该技术在PD临床应用中进行了探索,并发现其可用于检测早期PD中发生的病理变化,反映疾病的病程及严重程度,并且在鉴别诊断中起到一定的作用。总而言之,视网膜相关检测可能成为评估PD患者脑病理严重程度的指标,并且帮助疾病诊断和监测疾病的进展,不过这仍需要大样本、多中心的重复研究以提供更多理论依据。
Parkinson’s disease is a common neurodegenerative disease in the elderly, and ocular and visual dysfunction is one of the common non-motor symptoms of PD, further affecting PD patients’quality of life. Reduced dopamine concentrations and deposition of α-synuclein in the retina of PD patients have been shown in studies. At present, there is still a lack of effective tools for early diagnosis and assessment of PD. Optical coherence tomography and optical coherence tomography angiography can reveal abnormalities in the microstructure and microvasculature of the retinal layers, and researchers applying these techniques have found that the thickness of the parapapillary retinal nerve fiber layer and the retina in the macula in PD patients have had varying degrees of thinning, and the density and complexity of capillaries in the superficial and deep capillary plexus of the retina have been reduced. Further, investigators have explored the clinical application of these techniques in PD and have found that they can be used to detect pathological changes occurring in early PD, reflect the course and severity of the disease, and play a role in differential diagnosis. In conclusion, retinal-correlated testing may be an indicator to assess the severity of brain pathology in PD patients and to aid in disease diagnosis and monitoring the progression of PD, although large sample, multicenter replication studies are still needed to provide more reliable results.
病例报告

白内障术后早期囊袋阻滞综合征1例

Early capsular block syndrome after cataract surgery: A case report

:157-161
 
囊袋阻滞综合征(capsular block syndrome,CBS)是白内障手术较为罕见的并发症,可发生在白内障术中、术后早期及晚期。本文报道1例23岁的女性患者,为发生在白内障术后早期的CBS,因左眼激素性白内障而实施左眼白内障超声乳化联合后房型人工晶状体(intraocular lens,IOL)植入术,术后患者因屈光不正、后囊膜及IOL之间较宽间隙而诊断为CBS,行Nd:YAG激光后囊膜切开治疗后,患者视力恢复至正常,后囊膜及IOL贴合紧密,随访期间未出现黄斑水肿及视网膜脱离等并发症。
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.
发明与创新

一种洗眼车的研制

Development of an eyewash cart

:162.html-
 
本洗眼车功能齐全,也可通过调整位置,满足对同一治疗室内不同治疗椅上的患者进行眼部清洗;同时,避免医护人员操作过程中的频繁转身和走动,节省时间和体力。
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.
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  • 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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