Influencing factors of ocular pain in dry eye disease patients at high altitude

AIM:To quantify the severity and frequency of ocular pain in Tibetan plateau patients with dry eye,and to evaluate the related factors affecting ocular pain.METHODS:A retrospective study included 160 cases of dry eye disease(DED)patients who were treated from July 2022 to June 2023.Age,gender,occupation,illness course,anxiety,plateau duration,plateau protection,ocular surface disease index scale(OSDI),break-up time(BUT),Schirmer I test(SIT),conjunctivitis,history of ophthalmic medication,autoimmune disease,the workload of daily near vision range,smoking and overnight stay were obtained via comprehensive ophthalmic assessment,and their duration was followed up.Logistic regression analysis was used to determine the related factors affecting ocular pain.RESULTS:Totally 77.5%(124/160)of DED patients had ocular pain,of which the severity of ocular pain was mild,moderate,and severe in 30.0%,36.3%,and 11.3%of patients,respectively.Frequency of ocular pain was reported occasional,half the time,frequent,and persistent pain in 19.4%,36.9%,16.9%,and 4.4%.OSDI score was 19.67±5.70(13 to 36),and the level of pain was lowly correlated with OSDI(rs=0.316,P<0.001).Logistic regression showed that in plateau DED patients,increased anxiety led to increased severity and frequency of ocular pain[odds ratio(OR)=3.662,5.613,2.387,and 4.870;all P<0.05],professional eye protection and improvement of daily sleep quantity decreased pain(OR=0.307,0.572,0.418,and 0.789;all P<0.05),while smoking and general protection of plateau did not affect the severity and frequency of ocular pain(all P>0.05).CONCLUSION:Ocular pain is a common complaint in high-altitude DED patients during the pandemic.Anxiety,eye protection,and adequate sleep during the epidemic period are significantly associated with the severity and frequency of ocular pain in patients with plateau DED,while symptoms of DED have relatively little influence on them.

双眼视功能训练对间歇性外斜视患者术后双眼视功能重建的影响

目的:探讨双眼视功能训练对间歇性外斜视患者术后双眼视功能重建及维持术后眼位稳定的作用。方法:收集2010-01/2015-12在我院行斜视手术的资料完整的间歇性外斜视患者142例,按术后是否进行双眼视功能训练分为治疗组(术后采用DV-100诊疗系统的三级视功能训练光盘针对双眼情况行同时视、融合功能及立体视功能光盘训练)和对照组(术后未行干预治疗)。分析两组患者术前、术后1、3、6mo,1a的斜视度数和双眼视功能情况,比较两组患者双眼视功能和眼位情况的差异。结果:术后6mo,1a,治疗组的眼位情况好于对照组,差异均有统计学意义(P<0.05)。术后1、3、6mo,1a,治疗组的三级视功能均显著优于对照组,差异均有统计学意义(P<0.05)。结论:间歇性外斜视患者通过手术获得眼位正位后,其双眼视功能可有一定程度恢复。术后通过视知觉学习,行双眼视功能训练,可以更快、更好地促进患者双眼视觉的恢复和重建,从而获得立体视觉,可以更好地稳定眼位,有利于减少术后眼位回退。

SMILE术中眼球移位对角膜切削精准度和屈光状态的影响

目的:评估飞秒激光小切口角膜基质透镜取出术(SMILE)激光扫描时眼球轻微移位对角膜切削精准度及术后屈光状态的影响。方法:纳入2019-01/2021-03于本院行SMILE手术的患者32例62眼,依据术中眼球有无轻微移位分为移位组和固视组,并选取单眼眼球轻微移位的患者进行双眼配对,比较移位组和固视组组间和单眼眼球轻微移位患者双眼间术后1mo实际与术前预估角膜切削厚度偏差绝对值(ACE)、散光偏差(AE)、屈光偏差绝对值(ARE)及视力偏差绝对值(AVE)的差异,并将手术图像量化,分析眼球移位幅度与AE的相关性,观察眼球轻微移位所处区域、层面及移位方向对ACE的影响。结果:移位组和固视组各观察指标均无差异(P>0.05)。术中单眼眼球轻微移位的患者双眼AE具有差异(0.57±0.31D vs 0.33±0.27D,P<0.05),且眼球移位幅度与术后1mo AE具有正相关性(r=0.564,P<0.05)。眼球轻微移位所处不同区域(中心区/周边区)、层面(透镜上层/透镜下层)及方向(鼻侧/颞侧)的患者术后1mo ACE比较均无差异(均P>0.05)。结论:SMILE手术中激光扫描时眼球轻微移位对角膜切削精准度无明显影响,主要引起偏中心切削,导致角膜散光改变,但对等效球镜度及视力影响甚微。