Objective: To evaluate and summarize the evidences of nursing management of ophthalmic postoperative adult patients intra-day ward, and improve the quality of clinical nursing. Methods: The related databases were searched from the establishment to June 2022. The searching contents include systematic review, clinical decision-making, evidence summary, guidelines and expert consensus on nursing management in postoperative patients intra-day wards at home and aboard. Based on the theme, the evidences were extracted and summarized after independent literature quality evaluation was conducted by 2 researchers. Results: Base on the inclusion criteria, a total of 13 pieces of literature were selected, including 5 expert consensus, 3 evidence summaries, 1 evidence-based practice, 2 systematic reviews and 1 guideline. Through literature review, evidence extraction and classification, a total of 17 pieces of evidence on 8 aspects were summarized, including admission qualifications for daytime surgical nurses, development of clinical nursing path, pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative management, discharge assessment, rehabilitation and follow-up guidance. Conclusion: This article summarized the best evidence of nursing management for ophthalmic adult day surgery patients in intra-day ward,to provide scientific evidences for nursing managers to develop ophthalmic intra-day ward guidelines and practical standards.
Objective: To compare the consistency of Pentacamand iTrace in detecting anglekappa. Methods: A retrospective study was carried out on a total of 172 eyes of 86 volunteers to measure the anglekappa by iTrace visual analyzer and Pentacamanterior section analyzer in Zhengzhou Aier Eye Hospital. The measured data were collected and analyzed by SPSS software. Results: In the measurement results between Pentacam and iTrace , there was a statistically significant difference in the X value, Y value, and azimuth angle values of the horizontal axis (P<0.05); There was no statistically significant difference in chord distance values (P>0.05). Conclusions: 3-D anterior section analyzer the significant difference is found in the concordance of the anglekappa measurement results between the Pentacam and iTrace. It should be caution to replace two kinds of equipment in clinical practice.
The purpose of this review is to provide a comprehensive and updated overview of the clinical features, imaging modalities, differential diagnosis, diagnostic criteria, and treatment options for Vogt-Koyanagi-Harada (VKH) syndrome, a rare progressive inflammatory condition characterized by bilateral granulomatous panuveitis and systemic manifestations. While the clinical features and disease course of VKH syndrome are well-characterized in the literature, its diagnosis is challenging due to a broad differential that include infectious and noninfectious causes of uveitis and rare inflammatory conditions, as well as a lack of a single diagnostic finding on exam, laboratory testing, or imaging. The evolution of the diagnostic criteria for VKH syndrome reflects the growing understanding of the disease by the ophthalmic community and advancement of imaging technology. Findings on enhanced depth imaging (EDI) optical coherence tomography (OCT) and indocyanine green angiography (ICGA) help detect subtle inflammation of the choroid and were incorporated into new diagnostic criteria developed in the last few years. There is limited research on the treatment for acute VKH, but results of studies to date support the early initiation of immunomodulatory therapy (IMT) due to a high recurrence rate and progression to chronic disease in patients treated with monotherapy with high-dose systemic corticosteroids. This review will provide an in-depth summary of recent literature on advanced imaging modality and IMT to guide clinicians in their management of patients with VKH syndrome.
Diabetic retinopathy is one of the microvascular diseases caused by diabetes, it is an irreversible blindness eye disease. According to its course, it can be divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy, including diabetic macular edema. Te general practitioner needs to measure the uncorrected visual acuity, corrected visual acuity intraocular pressure, use the slit lamp microscope to exam the anterior segment and fundus to evaluate the overall condition of the eye. Controlling blood glucose, blood pressure and blood lipid is very important to improve the prognosis. Attach importance to pre- and postprandial blood glucose, glycosylated hemoglobin and metabolic memory should be carried out. The first-line antihypertensive drugs are angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Statins are the first choice for lipid-lowering drugs, fenofibrate has additional protective efect of retinal. Intervention in lifestyle, education and early detection are is important. Te general practitioner needs to perform fundus screening and scoring, timely refer to ophthalmology department for treatment. Ophthalmic treatment includes panretinal laser photocoagulation, pars plana vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor drugs.
As a modifed trabeculotomy, Gonioscopy-Assisted Transluminal Trabeculotomy (GAT) is a new type of minimally invasive glaucoma surgery developed at home and abroad in recent years. GAT inserts a microcatheter (iTrack) into the Schlemm's canal and advance the catheter through the canal circumferentially 360°, then circumferentially fracture the trabecular meshwork and inner wall of Schlemm’s canal. Tis method can reduce intraocular pressure by increasing the outfow of aqueous humor. Te physiological outfow pathway of aqueous humor is reconstructed, which can avoid the resistance of trabecular meshwork and realizing the direct entry of the aqueous humor directly into the collector channel from the anterior chamber. With a wide range of indications, GAT is mainly used in open-angle glaucoma, including primary open-angle glaucoma and secondary open-angle glaucoma, and is also used in primary closed- angle glaucoma. Additionally, GATT can be the preferred surgical modality for open-angle glaucoma, as it has the following advantages: minimally invasive, independent of fltration bleb, can signifcantly reduce the use of medications, stable medium- and long-term efcacy, high safety, and has fewer sight-threatening complications. In order to provide a reference for clinical application, this article reviews the indications, mechanism of action, surgical procedures, efectiveness, complication and factors afecting therapeutic efect.
A case of neuromyelitis optica spectrum disorders(NMOSD) complicated with human immunodeficiency virus(HIV) infection/acquired immunodeficiency syndrome(AIDS) was reported, and the pathogenesis, clinical characteristics, treatment and prognosis were summarized through the literature review. The retrieved literatures included seven English literatures (eight cases) and one Chinese literature, in which a total of nine cases of NMOSD co-infected with HIV infection/AIDS were reported. Combined with the case reported in this paper, the total number of cases was ten, among which five cases were female and five cases were male, three cases of HIV infection/AIDS were newly developed, and the other cases had earlier onset of HIV infection/AIDS than NMOSD. In terms of clinical manifestations, seven cases all had simultaneous or sequential optic nerve and myelitis, two patients presented with a uniphasic course or recurrent myelitis, and one case presented only with bilateral optic neuritis occurring sequentially in both eyes. All ten patients had typical abnormal signals of the optic nerve or spinal cord with or without enhancement on cranial or spinal MRI. Two patients did not undergo AQP4 antibody IgG testing , and of the remaining seven cases, five were positive for AQP4 antibodies and three were negative. For AIDS treatment, eight of the ten patients received highly active antiretroviral therapy(HAART). For NMOSD treatment, among the ten patients, eight patients received intravenous methylprednisolone,three patients received plasmapheresis, and two patients received intravenous immunoglobulin in the acute phase. Six patients received immunosuppressive therapy during the sequential treatment period, and one of them was discontinued due to hyperbilirubinemia. Of the seven cases with optic neuritis, two patients remained blind after treatment and five had partial recovery of vision. Of the eight cases with myelitis, five patients were left with paraplegia or mild paralysis, and three had partial recovery of muscle strength. One case died due to serious complications.NMOSD combined with HIV infection/AIDS is rare in clinic and has a poor prognosis. Patients are often left with severe visual impairment and paralysis. Clinical treatment is quite difficult, hormones and immunosuppressive agents are not considered as contraindications. Treatment decisions need to be made with fully considered about the balance of risks and benefits.
Myopia prevention and control has risen to the national strategic level in China. Optic neuropathy caused by high myopia can damage visual function, but it is often ignored in clinical practice Optical coherence tomography (OCT) characterized by non-invasiveness, high resolution, rapid, and repeatable quantifying the thickness of each layer in the retina has emerged as a powerful tool for evaluating high myopia related optic neuropathy. Due to the changes in and near the optic disc in high myopia, errors often occur in the quantification of the thickness of the optic nerve fiber layer. In recent years, researchers have gradually focused on the study of the thickness of ganglion cell complex (GCC), but the regularity of its changes in high myopia is not yet unified. This article reviews the measurement specifications, diagnostic values, and change rules of GCC in the macular region of high myopia in recent years, in order to improve the attention and research level of ophthalmologists on high myopia optic neuropathy.
Marfan syndrome (MFS) is a common systemic disease associated with lens heterotopia, and about 50%~80% of Marfan patients have lens heterotopia. This article reports a case of a 21-year-old male patient who suffered from bilateral lens subluxation and concurrent cataract due to MFS, who underwent cataract extraction and IOL implantation with CTR suspension fixation was performed to preserve low-grade myopia after surger y. No complications such as increased intraocular pressure, intraocular lens severely displacement and capsular bag shrinkage were found during follow-up.
Crystalline lens dislocation is a commonly encountered clinical condition that remains challenging in the realm of lens surgery. Inspired by prior studies, the authors originally proposed a technique involving implantable polypropylene capsular hooks after demonstrating their feasibility and safety. After six years of clinical application and follow-up, the technique has shown capable of helping preserve the complete lens capsule to a maximally viable extent and achieve intracapsular implantation of an intraocular lens with high efficacy. At the same time, the authors have also improved the technique’s design and operational method. This paper comprehensively disseminates lessons learned on the principle, design, feasibility, indications, and procedural details of the implantable polypropylene capsular hook technique.
Objective: To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens (IOL) implantation in the treatment of microspherophakia (MSP). Methods: by retrospective analysis, 37 MSP patients (37 eyes) who were treated in our hospital from January 2019 to June 2020 were randomly divided into two groups, including 20 MSP patients (20 eyes) who treated by SCSF-IOL and 17 MSP patients (17 eyes) who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL). The best corrected vision and complications were observed. Results: the best corrected vision was significantly improved in both groups (P < 0.001), but there was no remarkable difference between the two groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd: YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment, and one eye (5.00%) had a decentered capsule opening. Posterior capsular opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up. Conclusions: SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL. Nd: YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.