目的：探讨标准操作程序在玻璃体腔内注药术护理中的应用效果。方法：选择2018年9至12月中山大学中山眼科中心眼底专科门诊504例玻璃体腔内注药术患者作为研究对象，对护理人力资源的整合、患者等待手术时间、患者和家属的满意度、医护人员满意度进行评价。结果：标准操作程序后明确护士岗位职责，护士操作水平和综合能力有效提升，患者手术等待时间由原来的预约2周缩短为2 d。患者和家属的满意度分别由92.0%和91.0%提高到98.5%和97.0%。医护人员满意度的评价由95%提到至98.4%。结论：玻璃体腔内注药术标准操作程序不仅提升了工作效率，更提升了患者和家属、医务人员的满意度，规范化的标准操作程序是玻璃体腔内注药的安全保障。
Objective: To investigate the effect of standard operation procedure in the intravitreal injection. Methods: A total of 504 patients visiting the fundus clinics of our hospital from September to December 2018 were selected in this study. The integration of nursing human resources, patient waiting time, patient and family satisfaction,and medical staff satisfaction were evaluated. Results: The nurses’ job responsibilities were clarified, and the nurses’ operation level and comprehensive ability were improved. The patients’ waiting time for surgery was shortened from 2 weeks to 2 days. Patient and family satisfaction increased from 92.0% and 91.0% to 98.5% and 97.0%, respectively. The evaluation of the satisfaction of medical staff was elevated from 95% to 98.4%.Conclusion: The standard operation procedure of intravitreal injection not only improves the work efficiency, but also significantly increases the satisfaction of patients and their families and medical staffs. Therefore, the standard operation procedure can guarantee the safety of intravitreal injection.
目的：开发眼科供应室质量管理追溯系统的实时回收、科室签收功能模块，实现消毒供应中心无纸化办公，提高工作效率。方法：通过构建眼科消毒供应中心质量管理追溯系统的实时回收、科室签收功能模块，消毒供应中心工作人员使用个人数字助理(personal digital assistant，PDA)与临床科室人员进行面对面的器械回收清点和下送物品的清点签收，通过实施该模块等数据信息进行前后比较以评价其应用效果。结果：通过使用PDA对眼科器械进行实时回收、物品签收，回收器械物品清点记录的差错率由原来的3.32%下降到0.51%，实施前后因物品数目、名称等不符发生纠纷例数由原来的14.39%下降到1.56%。结论：该模块实现了无纸化办公，提高了回收、下送物品的精准性，提高了工作效率；减少了与临床科室的纠纷，提高了临床科室对消毒供应中心的满意度。
Objective: To develop the function module of real-time recovery counting and department receipt signing of the quality management traceability system of the ophthalmic supply room, realize the paperless office of the disinfection supply center, and improve the work efficiency. Methods: Eye disinfection supply center is built with quality management traceability system of real-time collection, department to sign for function module,counting supply room staff use personal digital assistants (PDAs) and clinical departments personnel under the face-to-face equipment recycling counted and send goods receipt, counting of implementation process control,reducing disputes. Results: By using PDA to collect and count the ophthalmic instruments in real time and sign for the receipt of the articles, the accuracy of the recovery and delivery of the articles was improved, the disputes between the supply room and the clinical department caused by the difference in the quantity of the recovered and delivery of the articles were solved, and the paperless management was realized. Conclusion: The module realizes paperless office and improves work efficiency. It reduces the disputes with the clinical departments and improves the satisfaction of the clinical departments with the supply department.
球后阻滞是将局部麻醉药注入眼球后方的肌锥内，通过阻断鼻睫神经、动眼神经和睫状神经节，达到镇痛，限制眼球运动和降低眼内压的作用。现代球后阻滞技术是内眼手术眼球制动与麻醉的“金标准”，也是最常用的眼部区域阻滞方式。虽然与该技术相关的并发症少见，但可危害视力甚至危及生命。本专家共识介绍了球后阻滞的应用范围，系统描述了支配眼球运动与感觉的神经解剖、球后阻滞的安全性、操作方法、常用药物、禁忌证和并发症的处理等，为此技术的临床应用提供指导。
Retrobulbar block refers to the injection of local anesthetics into the muscle cone behind the eyeball, blocking the ciliary, oculomotor, and ciliary ganglion nerves, to provide pain relief, restrict eye movement, and reduce intraocular pressure. Modern retrobulbar block is the "gold standard" for eyeball immobilization and anesthesia in intraocular surgeries, and it is the one of the most commonly used methods for ocular regional block. Although the complications related to this method are rare, the complications will threaten the vision and even life. Th is expert consensus introduces the application scope of retrobulbar block, and systematically describes functional neuroanatomy of eye sensation and movements, safety and procedures of retrobulbar block, local anesthetics, contraindications and complications of the block, which can provide the reference for clinical application of this method.
青光眼是全球首位不可逆性致盲眼病，该疾病与进行性视网膜神经节细胞凋亡相关，大多数患者在视功能改变之前视盘结构已经发生改变，检测视盘R结构改变对于早期青光眼的诊断至关重要。近几年新视盘参数Bruch膜开口-最小盘沿宽度(Bruch's membrane opening minimum rim width,BMO-MRW)在临床上应用越来越广泛，成为目前临床研究的一个热点参数。众所周知视网膜神经纤维层(retinal nerve fiber layer,RNFL)具有很好的青光眼诊断能力，很多研究表明BMO-MRW与RNFL具有相似的诊断性能，并在近视性、异常视盘等一些视盘结构不清晰的青光眼中，BMO-MRW的诊断能力优于RNFL，该参数在监测青光眼病情变化方面也起到一定作用。也有研究表明该参数对青光眼术后随访的应用可能受到一定限制。该文对BMO-MRW在开角型青光眼的诊断及随访中的临床应用加以综述，供临床同道参考。
Glaucoma is the leading cause for irreversible blindness in the world, which is associated with progressive retinal ganglion cell apoptosis. The changes in optic disc structure have been found before visual function variation in many patients. Detecting changes in the structure of the optic disc R is crucial for the diagnosis of early glaucoma. Recently, a new optic disc parameter, Bruce's membrane opening minimum rim width (BMO-MRW) , has been increasingly widely used in clinical practice and become a popular parameter in current clinical research. Retinal nerve fiber layer (RNFL)is an important diagnostic indicator for glaucoma. Many studies indicated that BMO-MRW and RNFL have similar diagnostic performance. In some glaucoma cases with unclear optic disc structure, such as myopia and abnormal optic disc, BMO-MRW provides better diagnostic parameter than RNFL does. It also plays a role in monitoring the changes of glaucoma. Some studies also stated the limitation of the application of this parameter in glaucoma postoperative follow-up. This artice reviews the clinical application of BMO-MRW in diagnosis and follow-up of open-angle glaucoma,providing reference for clinical practicers.
大麻二酚(Cannabidiol,CBD)为大麻提取物中的一种非成瘾性活性成分，是目前研究最热门的植物源性大麻素之一。内源性大麻素系统(endocannabinoid system,ECS)在眼表和视网膜中的研究也已经取得显著进展。CBD可以广泛存在于整个眼球，且其分布和功能具有组织特异性。近年来研究发现CBD具有良好的抗炎、抗损伤、降低眼压及神经保护作用。该文详细介绍了CBD在眼部疾病中的研究进展，以及其对各种眼部疾病的治疗潜力。此外，还讨论了CBD在临床眼科治疗中的应用面临的挑战和未来的发展方向。
Cannabidiol(CBD), a non-addictive active ingredient in cannabis extract, is one of the most popular plant-derived cannabinoids. The study on the endoenuous cannabionoid system (ESC) has made significant progress in the ocular surface and retina. CBD exists extensively in the eyeball, and its distrution and functions of anti-inflammatory,antiinjury, reducing intraocular pressure, and neuroprotective effects have been found. This article introduces the research progress in CBD in eye diseases and the therapeutic potential of cannabidiol for various eye diseases in detailed.Furthermore, the challenges and prospect for the application of CBD in clinical ophthalmology were discussed.
甲氨蝶呤(Methotrexate,MTX)是一种叶酸类似物，具有抗增殖、抗炎和免疫调节作用。在临床上广泛用于治疗多种疾病，包括恶性肿瘤和自身免疫性疾病。MTX通过眼局部注射或者全身给药用于眼科疾病的治疗，其安全性和有效性均已被证实。其中玻璃体腔注射可以减少糖皮质激素及免疫抑制剂的全身使用，在眼科的应用越来越广泛。MTX在备孕期男性及女性、妊娠期妇女、哺乳期妇女、儿童、青少年及老年人等特殊患者人群中的应用有其特殊性，用药情况因患者而异。低剂量MTX常见不良反应包括胃肠道症状、肝功能异常等，比较少出现严重的不良反应，但仍应做好药学监护。该篇综述总结MTX的临床使用方法及其不良反应，为其在眼科的临床应用提供参考。
Methotrexate (MTX) is a folate analog with anti-proliferative, anti-inflammatory and immunomodulatory effects.It is widely used in clinical practice to treat various diseases, including malignant tumors and autoimmune diseases.MTX is used for treating eye diseases by local injection or whole-body administration. Its safety and efficacy have been confirmed. The intravitreal injection can reduce the whole-body use of glucocorticoids and immunosuppressive agents, so it is applied in ophthalmology increasingly. The specificity of MTX has been found in its application in special patients, such as men and women in pregnancy preparation period, pregnant women, lactating women, children, adolescents and the elderly. The dosage varies from patient to patient. Common adverse reactions to low-dose MTX include gastrointestinal symptoms, liver dysfunction, etc. Serious adverse reactions are relatively rare, but pharmaceutical monitoring is still necessarily needed. This review summaries the usage and adverse reactions of MTX in clinical practice, to provide reference for its application in clinical practice in ophthalmology.
目的：评价欧堡Daytona 200度超广角激光扫描检眼镜检查近视患者眼底周边部视网膜病变的应用价值。方法：本研究为前瞻性病例研究，收集爱尔眼科医院要求行屈光手术的近视患者1 000例(2 000只眼)，分别进行小瞳下欧堡Daytona 200度超广角激光扫描检眼镜眼底检查和散瞳后三面镜检查，记录检查结果并进行比较分析。结果：通过欧堡Daytona 200度超广角激光扫描检眼镜检查发现有周边视网膜病变共230例(310只眼)，检出阳性率为15.50%；三面镜检查发现周边部视网膜病变共242例(322只眼)，检出阳性率为16.10%。两种检查方法对近视患者周边部视网膜病变检出阳性率具有很好的一致性(Kappa值0.8~1.0)。结论：欧堡Daytona 200度超广角成像系统为检查周边部视网膜病变提供了更省时高效的方法，在屈光手术前筛查视网膜周边部病变，具有广阔的临床应用前景。
Objectives: To evaluate the clinical value of peripheral retinal diseases in myopic patients examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona). Methods: This was a prospective case-control study. We collected 1 000 myopic patients (2 000 eyes) who were scheduled to undergo refractive surgery in Aier Eye Hospital. They were examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona) with non-mydriasis and three-mirror contact lens with mydriasis. The examination results were recorded and statistically analyzed. Results: A total of 230 cases (310 eyes) with peripheral retinopathy were found by 200-degree ultra-wide field laser ophthalmoscope (Daytona). The positive rate was 15.50%; 242 cases (322 eyes) with peripheral retinopathy were found by three- mirror contact lens, and the positive rate was 16.10%. The two methods were consistent in the detection of peripheral Retinopathy in myopic patients (the Kappa value is between 0.8 and 1.0). Conclusion: 200-degree ultra-wide field laser ophthalmoscope (Daytona) is an effective and rapid method for detecting peripheral retinopathy. It provides a broad clinical application prospects for peripheral retinopathy screening before refractive surgery.
目的：探讨标准化沟通模式(SBAR)在眼球穿通伤患者护理交班中的应用效果。方法：60例患者作为对照组，使用传统口头方式交班；60例患者作为观察组，使用SBAR沟通模式进行交接。比较两组交班耗时、两组护士对患者病情掌握程度以及患者对护理服务满意度的差异。结果：观察组与对照组比较，上述指标差异具有统计学意义(P<0.05)。结论：采取SBAR沟通模式交班有助于降低在眼球穿通伤护理中的不良事件发生率，保障了护理质量，提高了交接班效率和患者满意度，适宜推广应用。
Objective: To evaluate the SBAR communication model in the nursing care handover of patients with penetration injuries of eyeball. Methods: Transfer time, receivers’ information retention, and patient’s satisfaction were compared between two groups of patients with penetration injuries of eyeball. A total of 60 patients were handled with the traditional oral communication handover as comparison group and other 60 patients were handled with the SBAR handover as intervention group. Results: When comparing intervention group with comparison group, statistically significant improvements (P<0.05) were observed in all three factors tested. Conclusion:Implementing the communication tool SBAR in the nursing care of patients with penetration injuries of eyeball reduces rate of adverse events, improves patient care quality, enhances transfer efficiency, and boosts patient’s satisfaction.
目的：探讨应用数字化广域成像系统RetCam3行婴幼儿口服荧光素钠眼底血管荧光造影(fluorescein fundus angiography，FFA)的护理。方法：选择2018年8月至2019年12月在广州中山大学中山眼科中心小儿眼病综合科就诊的眼底疾病婴幼儿78例，应用RetCam3进行口服法FFA检查及护理，将护理要点进行总结。结果：所有患儿安全、顺利完成检查，检查过程中均未发生异常病情变化或与检查、药物相关的并发症。经FFA确诊家族性渗出性玻璃体视网膜病变(familial exudative vitreoretinopathy ，FEVR)26例，早产儿视网膜病变(retinopathy of prematurity ，ROP)23例，色素失禁症患者6例；玻璃体积血患者3例；视网膜母细胞瘤患者3例；牵牛花综合征患者1例；视网膜色素变性患者3例；弓蛔虫眼病患者1例；原始永存玻璃体患者2例；不明原因眼底病变患者5例，单眼视网膜皱襞患者1例，先天性小眼球患者1例，巨细胞病毒感染患者1例，先天性黄斑发育不良患者1例；Coats病患者1例。结论：应用RetCam3行婴幼儿口服法FFA是一种安全、有效的检查方法。规范、恰当的护理配合能够保证检查准确、顺利地完成。
Objective: To share the nursing experience of RetCam3 ultra-widefield oral fluorescein fundus angiography (FFA) in infants with fundus diseases. Methods: Seventy-eight infants with fundus diseases admitted to General Department of Pediatric Ophthalmology in Zhongshan Ophthalmic Center, Sun Yat-sen University from August 2018 to December 2019 were recruited. Oral FFA was carried out using the 130-degree lens of RetCam3, and the key points of nursing were summarized. Results: No complications related to the examination and drugs occurred after oral FFA with an appropriate nursing manner. FFA confirmed 26 cases of familial exudative vitreoretinopathy,23 cases of retinopathy of prematurity and 6 cases of pigment incontinence. Vitreous hematoma was observed in 3 patients, retinoblastoma in 3 patients, Morning Glory syndrome in 1 patient, retinitis pigmentosa in 3 patients,Ascaris lumbricoides eye disease in 1 case, original permanent vitreous body in 2 patients, unexplained fundus lesions in 5 patients, monocular retinal fold in 1 patient, congenital micro-eyeball in 1 patient, cytomegalovirus infection in 1 patient, congenital macular dysplasia 1 patient and Coats disease in 1 patient. Conclusion: Oral FFA with RetCam3 is an effective and safe detection method for infants. Standard and proper nursing can ensure the examination can be performed accurately and smoothly.
目前Wetlab眼科手术教学采用猪眼球作为教学模型，与实际手术差别较大，且无法满足外眼手术教学的需求。通过使用带有眼球、眼外肌、眶组织、眶骨及眼睑结构的全眼模型，可高度模拟真实手术场景，覆盖更多眼科手术教学需求。基于全眼模型构建多个眼科手术教学平台，依照培养阶段设计手术课程，创建新的评价体系，改变传统将“内眼”“外眼”分开的教学理念，可使年轻医师从一开始就建立眼科“分科而不分割”的整体思维，从而使眼科手术培训更加规范和完善。
Porcine eyes have been used as animal model in ophthalmic surgery training. However, it differs greatly from real surgery and cannot meet the needs of external eye surgery teaching. Porcine orbit model with eyeball, extraocular muscles, orbital tissue, bones and eyelids can be more realistic simulation of real surgeries and cover more needs for ophthalmic surgery teaching. By setting up ophthalmic surgery teaching platforms, designing staged course and creating new assessment methods based on porcine orbit model, the traditional concept about separation of internal and external eye is changed. This helps young doctors to establish a holistic view from the very beginning,that ophthalmic surgeries should not be split because of subspeciality. In this way, ophthalmic surgery training will become more standardized and perfected.
