Abstract: To report a palliative and alternative surgical procedure, allogeneic sclera graft combined with autologous conjunctival flap (ASGACF), employing to repair the large emergent corneal perforation. The detail protocol of the surgical procedure was characterized and four representative cases were reviewed. An allogeneic sclera graft and recipient bed were prepared as the traditional penetrating keratoplasty (PK). And then sutured the sclera graft to the bed with 10-0 nylon suture and covered with a pedicled autologous conjunctival flap in half size. In the follow-up, the ASGACF repaired all of the corneal perforations and restored the integral walls of eyeballs, in spite of one who underwent a second surgery. This surgical procedure provided a palliative method to repair the large emergent corneal perforation while there is the lack of a corneal graft.
Background: To assess the safety and efficacy of supracapsular implantation with optic capture of the posterior chamber intraocular lens in Chinese children with aphakic after traumatic cataract.
Methods: It was a retrospective case series study. Fifteen cases (15 eyes) Chinese children received supracapsular implantation with optic capture of the posterior chamber intraocular lens. Pre- and post-operative visual acuities were recorded. Intra- and post-operative complications were observed. The follow-up period ranged from 7 to 43 (28.7±7.2) months.
Results: Implantation of optic capture of the posterior chamber intraocular lens was successfully performed in 15 eyes. The best corrected visual acuity (BCVA) ranged from 0.3 to 1.0 (0.61±0.19). No optic axis opaque was found in 15 eyes with optic capture. The major complications of optic capture were iris posterior synechia and intraocular lens (IOL) precipitates. Intraocular dislocation was found in one case three weeks after the operation.
Conclusions: Supracapsular implantation with optic capture of the posterior chamber intraocular lens is safe and effective for the treatment of traumatic cataract in Chinese children.
Abstract: Diabetic retinopathy (DR) remains a leading cause of irreversible vision loss in adult populations around the globe. Despite growing evidence of the effectiveness of routine assessments and early intervention, DR screening strategies are not widely implemented largely due to an inadequate availability of resources to cope with the growing burden of diabetes. Advances in technology in the field of DR screening are clearly warranted and the recent emergence of deep learning-based artificial intelligence (AI) grading of retinal pathology offers significant potential benefits including an increased efficiency, accessibility and affordability of screening programmes.
Abstract: The highly competitive offer of medical training programs and schools, globalization and constant mobility of physicians and medical students (MS), and the commitment to society to deliver competent physicians, demands the definition of performance standards. This would allow to make their performances comparable no matter where they studied or which textbook did they used as reference, to have evaluation mechanisms that guarantee mastery of the integral evaluation of the performance. Assessment has been the key in the teaching-learning process as this obtains a formative and summative element, at different moments, from the extent to which the students have acquired knowledge, skills and attitudes. The progress of the learner must be enhanced with effective feedback on their performance and self-direction of the results obtained in each of the mechanisms established. If, traditionally, this has been considered as the accreditation of compliance with a standard, the evaluation also functions in an integral way as a formative process that identifies advances and deficiencies in the training of residents that allows the definition of actions and strategies for improving the operation of the programs. Different assessment mechanisms are associated with the areas of competence domain, some of the most common tools are: theoretical exams, checklists and rubrics, portfolio, projects and challenges. However, the importance of defining standards which are perceived as fair and designed according to the learning objectives remains a priority to guarantee the credibility of the evaluation agencies and institutions. Some strategies to assure credibility include the involvement of expert and trained evaluators, allowing the process to be carried out with transparency and diligence, and the principles employed should be supported by educational research.
Abstract: Program accreditation is usually a voluntary process based on published standards and performed by a governmental or non-governmental agency of peers. The accreditation process has several components: self-assessment guide completion, site visit and review of program data by the accrediting body. Program accreditation’s primary function is to facilitate self-assessment, provide standards of education and lead to program improvement. It also serves to protect the student’s education and ultimately improve patient care. The International Council of Ophthalmology has developed International Guidelines for accreditation of ophthalmology residency programs and is launching a pilot program to accredit programs on demand.
Abstract: The goal of ophthalmology residency training is to produce competent ophthalmologists. Appropriate assessments must be employed to ensure this goal is met. Valid and reliable workplace-based assessments are designed to assess competence in the many domains required of a good ophthalmologist. These assessments increase standardization and objectivity as compared to simple observational feedback. When used appropriately, workplace based assessments not only provide measures of competence but also facilitate effective formative feedback and enhance learning.
Abstract: Cataract surgery is arguably the most commonly performed operation in ophthalmology. Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure. Therefore, wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons, which establishes tissue awareness, dexterity and muscle memory required to perform each step of the procedure, safely. Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs. In the operating room, topical anesthesia is a safe alternative for teaching cataract surgery. There are three well-described approaches to teaching individual steps of cataract surgery: forward, “backwards”, and deconstructed step-by-step instruction. Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room. The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery (OASIS), Global Rating Assessment of Skills in Intraocular Surgery (GRASIS), and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR). We review the literature on trends in surgical teaching in ophthalmology, with the focus on cataract surgery instruction to the novice surgeon.
Background: The “flipped classroom” is a learner-centered approach that centers on delivering videos, podcasts or slide-based material to learners prior to a lecture or class session. The class session is then dedicated to discussion, analysis, and problem-solving activities. The aim of this study was to investigate whether the flipped classroom could be adapted to medical (ophthalmology) students learning about ocular trauma and to assess the impact of the flipped classroom on those students’ performance and attitudes.
Methods: Questionnaires (using a 4-point scale) were distributed to 93 fifth-year medical students at Sun Yat-sen University, and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.
Results: The results of pre- and post-test scores were 14.35±3.404 and 20.37±4.356, which showed a significant improvement in students’ performance after the flipped classroom was introduced (P<0.05).
Conclusions: Student response to the flipped classroom strategy was largely positive, indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
