波前像差个性化的准分子激光手术患者围手术期护理

波前像差个性化的准分子激光手术是近年来眼科发展起来的以波前像差辅助的新一代屈光手术技术。波前像差技术能够检查出标准镜片无法检测的眼屈光非理想状态,精确显示每个患者的眼球屈光数据,并根据虹膜纹理定位,显示独一无二的虹膜数字地图自动识别患者,同时计算并补偿散瞳和小瞳以及从坐位检查到仰卧位手术之间的瞳孔偏移和眼球旋转,适时改变激光治疗的切削角度,使得术后视觉质量     

简述青光眼合并白内障的手术治疗策略

青光眼合并白内障是眼科临床上常见的一类疾病,如何能有效控制眼压同时又提高视力是此类手术的重点。青光眼合并白内障有单独手术、分阶段手术及联合手术3种治疗原则,现在随着眼科显微手术技术的研究和发展,采用青光眼、白内障联合手术一次治愈两种疾病已得到较广泛的应用。合并原发性闭角型青光眼（PACG）的患者中青光眼手术也可能会加速白内障的进展。因此,在面对青光眼舍并白内障的患者时,如何选择合适的治疗方案,达到既控制眼压又解决白内障的理想效果,是临床眼科医师亟待探索的重要问题。联合手术既有效控制眼压,又能复明,使患者避免分次手术带来的痛苦和麻烦,同时还减轻了患者的经济负担。     

白内障术后眼内炎防治措施临床研究进展

白内障手术是眼科手术的重要组成部分,随着手术技巧的不断提升以及新型人工晶体不断投入临床,医患双方对术后疗效的要求正在逐渐提高。白内障术后眼内炎是白内障手术最为严重的并发症之一,具有破坏性高、进展迅速的特点,是影响疗效的首要问题,若是不能及时、有效地进行处理,会严重影响患者的预后,甚至导致失明。因此,能否对术后眼内炎进行有效防治,成为白内障围手术期需要面对和解决的核心问题。为使眼科临床医师对该病有较全面的认识,该文就白内障术后眼内炎的发病率、致病菌、危险因素、预防、治疗及预后等予以综述。     

眼底横向显微成像系统的研制及应用

介绍了一套基于MEMS薄膜变形镜的人眼眼底横向显微成像系统。采用37单元MEMS薄膜变形反射镜作为波前校正元件,127微透镜阵列哈特曼夏克（Hartmann—Shack）波前传感器测量波前误差,在用计算机控制薄膜变形镜实现波前误差校正后,开启成像照明光源．用CCD相机记录视网膜图像。模拟眼试验表明．系统能够有效进行像差测量、校正和眼底成像,像差校正后成像质量达到衍射极限。临床试用表明,除少部分眼内比较浑浊的病人外,整个检查过程大部分病人都能够安全、快捷、可靠地进行。     

隐形眼镜配戴与波前像差的关系

目的了解软性和硬性透气性隐形眼镜配戴对波前像差的影响,探讨硬性透气性隐形眼镜减缓近视发展的可能机制。方法矫正视力正常的近视眼志愿者20人40眼,用像差仪检查同一志愿者配戴前、配软性和硬性透气性隐形眼镜后的波前像差。结果同一受试者配戴硬性透气性隐形眼镜后与配戴前的波前像差比较,第2、4阶像差明显减小（P〈0．05）,而配戴软性隐形眼镜后与配戴前的波前像差比较,第2、3、6阶像差明显增加（P〈0．05）。合并有散光的同一受试者配戴硬性透气性隐形眼镜后与配戴前比较,第2、4阶像差明显减小（P〈0．05）,配戴软性隐形眼镜后与配戴前比较,第4、6、7阶像差明显增加（P〈0．05）。结论硬性透气性隐形眼镜配戴可明显减小近视眼的波前像差,从而改善其视网膜成像质量;配戴软性隐形眼镜则可增加近视眼的波前像差。硬性透气性隐形眼镜配戴可能通过改善视网膜物像质量而减缓青少年近视的进一步发展。     

何氏眼科医院建筑介绍

何氏眼科医院是一所具有国际先进眼科技术的专科医院.1995年由归国博士何伟投资创办,医院全面应用国际先进的眼科技术开展临床、科研、教学和国际交流等活动,是集多功能性、国际性、普及性和公益性为一体的现代化眼科机构、医疗保险定点医院.医院装备了超声乳化治疗白内障、准分子激光治疗近视、玻璃体视网膜病治疗、斜弱视治疗、激光治疗青光眼及视网膜病变、角膜移植等十几个临床及科研部门,拥有国际上最先进查及手术设备,并以五个国内首家开展的眼科手术及七项发明专利享誉国内外眼科界.……     

飞秒激光白内障手术的新进展

传统的白内障超声乳化手术已经发展成熟。目前,随着飞秒激光技术在眼科手术领域的应用发展,这一技术也被从屈光手术领域引入白内障手术当中来。飞秒激光具有极高的精确性、自动化程度、可重复性,这使其十分适合应用于以精密操作为特点的白内障手术。从透明角膜切口的制作、晶状体前囊膜的切开、晶状体核的液化和粉碎,甚至术后散光矫正切口的制作,飞秒激光应用于白内障手术的各个步骤中。在各种对比研究中,飞秒激光的操作相对于人工操作的优势十分明显,不仅使操作更加精准、可控,还因为手术时间缩短,减少外部能量对眼内组织的扰动,使得手术的安全性显著提高。本文对目前飞秒激光白内障手术的主要研究方面和成熟技术进行了综述。     

老年白内障术前应用综合评估的临床意义

目的探讨老年白内障患者手术前综合评估的意义。方法对平煤神马医疗集团总医院眼科2012年10月-2015年5月期间收治89例(102眼)老年白内障患者的临床资料进行回顾性分析。术前运用综合评估方法与手术禁忌评定方法对白内障患者进行综合评估。结果具有眼部禁忌证患者5例,占5.62%,运用眼科B超和激光视网膜视力测定其手术后视力仍无法提高,未进行白内障手术;具有全身禁忌证患者23例,占25.84%,上述患者不能够直接接受手术治疗,需先进行内科治疗之后方可手术。结论老年白内障患者在手术前进行综合评估与手术禁忌证评定,可及时了解患者是否可耐受手术或手术后是否可明显提高视力,这种术前综合评估不仅可保证手术成功率,且可避免患者接受不必要的手术,减少并发症,老年白内障的治疗具有重要意义,值得推广。     

眼科日间手术预防性使用抗菌药物回顾性研究

目的 了解眼科日间手术预防性应用抗菌药物情况,为眼科手术患者合理预防性应用抗菌药物提供参考和依据. 方法 对2008年1-6月眼科(白内障、青光眼、斜视)日间手术住院患者进行回顾性分析,并与2004年同期、同类型眼科传统住院患者进行比较. 结果 2008年眼科手术预防应用抗菌药物妥布霉素滴眼液100.0%,氧氟沙星滴眼液84.1%,庆大霉素注射液结膜下或球后注射3.73%,林可霉素注射液肌内、静脉给药(术后<4 h)1.1%;与2004年预防应用抗菌药物相比,局部用药大致相仿,但全身用药显著减少. 结论 <抗菌药物临床应用指导原则>颁布实施后,眼科日间手术患者预防性应用抗菌药物较前取得了长足的进步.     

为眼睛换高清镜头

白内障手术是现代眼科显微手术中发展最快、技术最成熟的手术。在临床上，白内障手术的成功不仅与手术医师的技术水平、手术及检查设备密切相关，正确选择人丁晶状体也是非常重要的一个环节。 摘除自内障，远视1100度 人的自然晶状体起重要的屈光作用，摘除白内障的眼称为无品状体眼，大约相当于1100度远视，就好像照相机没有镜头一样，需要用光学方法矫正。普通眼镜厚而重，光学效果差，单眼不能戴。     

The impact of allocation of additional resources on the waiting time for cataract surgery

In 2001, the ophthalmology community in Manitoba lobbied the regional health authority to allocate additional resources for cataract surgery because of unacceptably long waits. Approval was given in principle for a partial increase in resources and this was implemented in March 2002. Cataract surgery in the region is monitored by a waiting list program that is used to track and prioritize all patients waiting. This monitored increase in funding provided an opportunity to measure exactly what impact additional resources would have on a cataract waiting list.     

对499例白内障患者防盲复明流行病学分析

目的探讨白内障患者术后的脱盲、脱残状况,为更好的开展防盲治盲工作提供有益的帮助。方法对2005年在我院“复明五号”流动眼科手术车上手术的白内障患者499例(581眼)进行回顾性分析。结果年龄相关性白内障脱盲率达99.34%,脱残率达92.28%。手术患者中年龄相关性白内障为518眼,占89.16%,位居第一位。农村患者获得防盲手术信息率低于县城患者(P<0.05)。结论防盲白内障手术是有效的、可靠的方法。对不同类型白内障患者,应采取不同的防治手段和有效的方法来提高农村患者的防盲力度。     

Survey of meticillin-resistant Staphylococcus aureus policies in UK eye departments

The purpose of this study was to investigate meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation practices for patients undergoing routine cataract surgery in ophthalmology departments across the UK. A postal questionnaire survey of all ophthalmology departments in the UK was carried out, with 75 of 152 (49.3%) questionnaires returned. Sixty-three percent of units had a departmental MRSA policy. Preoperative MRSA screening was performed in 50 (66.7%) units, three of which screened all preoperative patients and the remainder performed selective screening. The proportion of patients screened for MRSA ranged from 0 to 100%, with a median of 2% and a mean of 9.9% (95% confidence interval: 3.5–16.2%). Overall, 65.3% of respondents felt that their departmental policy was reasonable, although there was considerable dissatisfaction and confusion, with comments identifying lack of evidence and the need for guidelines applicable to day-case cataract surgery. The survey demonstrates significant inconsistencies in preoperative MRSA screening practice in ophthalmology departments throughout the UK. Current recommendations from the Department of Health suggest that day-case ophthalmology patients do not require routine screening, although the implication appears that high risk patients continue to do so. Further investigation is required to ascertain the scientific validity of these recommendations.     

五行徵调音乐在白内障超声乳化术中的应用

目的 探讨五行徵调音乐对白内障超声乳化患者术中焦虑和疼痛水平的影响.方法 将福建中医药大学附属人民医院眼科100例局麻下行白内障超声乳化患者,随机分为试验组和对照组,试验组术中播放五行徵调音乐.对照组术中不播放,对照组采用常规眼科治疗.两组均采用状态焦虑问卷(state anxiety inventory,S-AI)和...     

Reasons for cataract surgery cancellation]

To study the reasons for cancelling cataract surgeries, and to suggest actions to improve the efficiency of patient care. A cross-sectional study was carried out in a university hospital's ophthalmology clinic of the state of S?o Paulo, Brazil. Two hundred subjects were randomly selected. The mean age was 68+/- 11.4 years old. The reasons for cancelling surgery were: unpropitious clinical condition (23.1%); tight schedule (35.9%); and patient non-attendance (41%). Most of the reasons related to social issues and the hospital's administrative aspects.     

Patients' preoperative expectation and outcome of cataract surgery at jimma university specialized hospital -department of ophthalmology

Background

Patient''s satisfaction for a given treatment is an important clinical outcome because a satisfied patient is more likely to comply with treatments, attend follow-ups and advocate the service to others. Therefore, knowing patients'' expectations before a planned procedure or treatment and the actual level of satisfaction and fulfillment of their initial expectations thereafter is much helpful. As far as the knowledge and experience of the researchers is concerned, there has not been any study conducted in Ethiopia to find out about patients'' preoperative expectations and postoperative level of satisfaction for actual outcomes. This study was therefore, conducted to describe and find out the relationship between preoperative expectations of cataract patients and the actual postoperative experience and their satisfaction level following the surgery at ophthalmology department in Jimma University Specialized Hospital.

Methods

A prospective cohort study of patients undergoing first eye cataract surgery was conducted from July 10 to Oct., 10, 2007 in the Ophthalmology department of Jimma University Specialized Hospital. Detailed interviews that included general and vision specific health status measures and patients'' preoperative expectations for cataract surgery outcomes were performed followed by visual acuity testing. Postoperatively, visual acuity testing was taken again and patients'' level of satisfaction with attained postoperative vision was assessed. Data were collected and filled in a separate questionnaire form for each patient, and entered into a computer and analyzed using SPSS for Windows version 12.0.

Results

Of the 200 patients operated for cataract, 179 (89.5%) were followed for the whole five weeks. The average expected preoperative Visual Function-15 score was 96.3, compared to an achieved (postoperative) Visual Function-15 score of just 96.2. However, the most unrealistic expectations observed were reading small prints and doing fine handiwork. The final pinhole visual acuity postoperatively was ≤ 6/18 in 126 (70.4%) patients. Of the 78 (39%) patients who were bilaterally blind preoperatively, 5 (2.5%) patients remained blind postoperatively.

Conclusions

Significant improvements were obtained in clinical, functional, and perceived vision by cataract surgery involving extracapsular cataract extraction with posterior chamber intraocular lens implantations. Expectations regarding visual functioning after cataract surgery were very high, and in most cases and in most cases they were fulfilled.     

LenSx飞秒激光辅助白内障手术的安全性和有效性分析

目的:观察并分析LenSx飞秒激光辅助白内障手术的有效性和安全性.方法:选取2017年7月~2018年6月本院收治的白内障患者59例,使用LenSx飞秒激光辅助白内障手术,观察手术效果.结果:全部患者都顺利完成手术,所有操作项目的完成率均超过80%,无不良事件和器械缺陷发生.术后1个月最佳矫正远视力(CDVA)较术前明显提升,对比有统计学意义(P<0.05).通过Logistic回归分析结果显示,切口位置是影响角膜切口能否完成主要因素,与眼别无关.结论:LenSx飞秒激光辅助白内障手术安全性、有效性相对较高.     

Cost-effectiveness of cataract surgery in a public health eye care programme in Nepal.

Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost of US$5.06 per disability-adjusted life year (DALY). This places it among the most cost-effective of public health interventions. Sensitivity analysis indicates that cataract surgery remains highly cost-effective even under a very pessimistic set of assumptions. The estimated mortality rates of those who receive surgery and of those who do not are among the variables that most influence the cost per DALY.