Cataract surgery in aged patients:phacoemul-sification or small-incision extracapsular cataract surgery

AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.

The Study of G6PD in Erythrocyte and Lens in Senile and Presenile Cataract

The G6PD activity of erythrocytes in 113 male patients with senile and presenile cataract and 86 controls, and G6PD activity of lens in 30 patients with senile cataract and 42 controls were reported. The cataractous group had higher frequency of G6PD deficiency and lower average G6PD level in erythrocytes and lenses, but with out statistical significance. The frequency of G6PD deficiency of erythrocytes in presenile cataractous group was higher than that of senile cataractous group but with no statistic...

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS： The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector（E-CHAID） model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS： The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION： The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

Spontaneous Resolution of Cataract and Medical Management of Corneal Opacity in an Indian Parrot—<i>Psittacula krameri manillensis</i>

A 35-year-old Indian parrot (Psittacula krameri manillensis) was presented to the Department of Veterinary Surgery & Radiology, West Bengal University of Animal and Fishery Sciences with a history of blepharospasm and corneal lesion OS. Test with fluorescein dye was negative. The dense corneal opacity (macula) was identified as involving the posterior corneal layer. The further ophthalmic examination was done and hypermature phacolytic cataract was diagnosed. No other abnormality was detected. Medical management with topical nepafenac prednisolone and triple antibiotic was instituted. The corneal lesion subsided completely within one week followed by spontaneous resorption of the cataract. The treatment protocol was successfully eliminated the discomfort and intraocular lesions in the senile parrot.

Sensory exotropia subsequent to senile cataract

To evaluate the phacoemulsification and intraocular lens implantation in patients with sensory exotropia subsequent to senile cataract. The authors prospectively studied the role of phacoemulsification and intraocular lens implantation on 25 patients by observing visual acuity, ocular alignment, binocular vision and diplopia pre-, 1 month post- and 3 months post-operation. The patients underwent follow-up for three months. Postoperatively, one patient had a corrected visual acuity of 20/50, and 24 patients had 20/40 or better. The ocular alignment, binocular vision and diplopia were resolved spontaneously. Phacoemulsification and intraocular lens implantation performed together is effective on sensory exotropia subsequent to senile cataract.

Association of age at diagnosis of diabetes with subsequent risk of age-related ocular diseases and vision acuity

BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.

Clinical Study on Early Senile Cataract Treated by Shezhu Mingmu Powder(麝珠明目散)

Objective: To evaluate the clinical effect of Shezhu Mingmu Powder (SZMMP) in treatment of early senile cataract. Methods: A comparison was made between the treatment group, 162 eyes of 92 cases of early senile cataract treated by SZMMP, and the control group, 57 eyes of 30 cases treated by drops baineitini.The treatment periods were one to three months. Results: The total effective rate for the treatment group was79. 01 % and the rate of obvious improvement was 25. 31 %. In the treatment group both rateswere clearly higher than the rates (36. 84 % and 7. 02 % ) of the control group. After 4 to 8 months' following up, treatment of 42 cases showed that most of them reached the best curative effect within 1 to 3 months. Conclusion: SZMMP is obviously effective in improving visual acuity of early senile cataract, but the lens opacity was not changed.

Expression and effect of basic fibroblast growth factor on human cataract lens epithelial cells

OBJECTIVE: To detect the expression of basic fibroblast growth factor (bFGF) in human ocular tissues, and to assess the effect of bFGF on the proliferation of human cataract lens epithelial cells (LECs) and its correlation with age. METHODS: Enucleated eyes were subjected to immunostaining for bFGF protein. Human cataract LECs were cultured in vitro, and treated with bFGF for 48 hr. Proliferation was estimated by the positive area ratio of proliferating cell nuclear antigen (PCNA) in immunohistochemistry. RESULTS: bFGF protein was found in various human ocular tissues. bFGF stimulated human cataract LEC proliferation, and there was an age-related decrease in responsiveness of human cataract LECs to bFGF (P

Mitochondrial proteomic analysis of ecdysterone protection against oxidative damage in human lens epithelial cells

AIM: To investigate the protective effects of the natural medicinal monomer ecdysterone(ECR) with estrogenic activity against oxidative damage in human lens epithelial cells B3(HLE-B3) caused by hydrogen peroxide 21(H2 O2) and to pursue the possible mitochondrial proteomic regularity of the protective effects. · METHODS: HLE-B3 cells were treated with H2O2(300μmol/L),β-estuarial(E2; 10-8mol/L) and H2 O2,ECR(10-6mol/L) and H2 O2,or left untreated. Altered expression of all mitochondrial proteins was analyzed by protein array and surface-enhanced laser desorption ionization time of flight mass spectrometry(SELDI-TOF-MS). The mass/charge(M/Z) ratios of each peak were tested by the Kruskal-Wallis rank sum test,and the protein peak value of the M/Z ratio for each treatment by pair comparison was analyzed with the Nemenyi test. ·RESULTS: H2O2 up-regulated expression of two protein spots(with M/Z of 6 532 and 6 809). When E2 mitigated the oxidative damage,the expression of one protein spot(M/Z 6 532) was down-regulated. In contrast,ECR downregulated both of protein spots(M/Z 6 532 and 6 809). · CONCLUSION: ECR could effectively inhibite H2O2 induced oxidative damage in HLE-B3 cells. The protein spot at M/Z of 6 532 might be the target spot of ECR against oxidative damage induced by H2 O2.

术前情绪释放技术干预法在老年性白内障手术患者中的应用效果

目的 探讨术前情绪释放技术(EFT)干预法在老年性白内障手术患者中的应用效果。方法 选择2019年1月至2022年12月河北省沧州市人民医院收治的100例老年性白内障手术患者,根据随机数字表法将其分为甲组和乙组,每组50例。甲组采用常规护理,乙组在甲组基础上行术前EFT干预法。观察两组情绪状态及生理应激反应变化。结果 干预后,两组正性负性情绪量表中正性情绪评分均高于干预前,负性情绪评分低于干预前,且乙组正性情绪评分高于甲组,负性情绪评分低于甲组(P<0.05);干预后,两组收缩压、舒张压及心率水平均低于干预前,且乙组低于甲组(P<0.05)。结论 术前EFT干预法能够缓解老年性白内障手术患者负性情绪,并可减轻其生理应激反应。

针刺联合丙美卡因表面麻醉用于老年性白内障手术的临床研究

目的分析针刺联合丙美卡因表面麻醉用于老年性白内障手术的应用效果。方法纳入2019年2月—2020年1月择期进行白内障手术的老年患者100例作为研究对象,随机数字表法分为两组,对照组(50例)采用盐酸丙美卡因表面麻醉进行手术,观察组(50例)采用针刺联合丙美卡因表面麻醉进行手术,对比两组各时间点血压、心率、血氧饱和度(SPO_(2))、Ramsay镇静评分,疼痛评分等情况,以及术前术后焦虑情况等。结果麻醉后,T1、T2、T3、T4时刻观察组平均动脉压、心率、血氧饱和度水平比较,差异有统计学意义(P<0.05);观察组Ramsay镇静评分、VAS评分均低于对照组,组间比较差异显著(P<0.05);麻醉后两组SAS评分均有所降低(P<0.05),但与对照组比较,观察组SAS分值降低更为明显(P<0.05);观察组并发症发生率为6.0%(3/50),远低于对照组(24.0%,12/50),组间比较差异有统计学意义(P<0.05);观察组满意度为96.0%(48/50),远高于对照组(78.0%,39/50),组间比较差异有统计学意义(P<0.05)。结论针刺联合盐酸丙美卡因表面麻醉用于老年性白内障手术效果明确,让患者保持清醒的同时更具有良好的镇静镇痛效果,有利于血流动力学稳定,使患者保持呼吸循环平稳,保障手术的顺利进行;同时还可以减轻患者的疼痛,缓解患者的焦虑情绪,符合快速康复的理念。

“微单视”方案植入连续视程人工晶体对老年性白内障患者视觉质量的影响

目的探讨“微单视”方案植入连续视程(EDOF)人工晶体对老年性白内障患者视觉质量的影响。方法回顾性分析2020年1月—2023年12月收治的老年性白内障患者的临床资料。随机选取46例植入三焦点人工晶状体的患者纳入三焦点组,选取53例行“微单视”方案植入EDOF人工晶体治疗的患者纳入EDOF组。记录术前及术后3个月2组的双眼视力[裸眼远距离视力(UCDVA)、裸眼中距离视力(UCIVA)、裸眼近距离视力(UCNVA)]、视觉质量[视功能指数量表(VF-14)]。记录术后3个月2组的离焦情况、对比敏感度值(CS)、脱镜情况。结果术后3个月,2组患者UCDVA、UCIVA、UCNVA、VF-14评分高于术前,且EDOF组UCIVA、UCNV和VF-14评分高于三焦点组,差异有统计学意义(P<0.05)。术后3个月,2组患者在屈光度-4.00~2.00 D的视力均高于0.35,EDOF组在-1.50~1.50 D的视力均高于0.9,-2.50~-1.50 D的视力高于0.8;在0.50~2.00 D屈光度内,EDOF组视力高于三焦点组,且在-2.00~1.00 D区间内EDOF组视力较为平稳。在明视、暗视环境下,于不同空间频率(3、6、12、18周/度)时,EDOF组CS高于三焦点组,差异有统计学意义(P<0.05)。结论在老年性白内障患者中,“微单视”方案植入EDOF人工晶状体相较于三焦点人工晶状体,在视觉质量和中、近视力方面表现更优。

2.2 mm角膜微切口白内障超声乳化术治疗老年白内障的临床效果

目的探究2.2 mm角膜微切口白内障超声乳化术治疗老年白内障的效果及对角膜内皮功能、并发症发生率的影响。方法以2020年3月至2022年3月期间收治的113例老年白内障患者为研究对象,均行白内障超声乳化术治疗,根据切口大小将患者分为2.2 mm组(55例)及常规组(58例)。比较两组手术相关指标及手术前后视力恢复情况,对患者手术前后角膜切口内外口处厚度、角膜内皮细胞功能、角膜生理指标及泪膜功能进行分析评估,并统计患者术后一过性高眼压、角膜水肿的并发症发生率。结果2.2 mm组术后7 d裸眼远视力、最佳矫正视力(BCVA)的LogMAR值及角膜散光值小于常规组,差异有统计学意义(P<0.05);2.2 mm组术后1 d、7 d切口外口处角膜厚度及术后1 d的切口内口处厚度小于常规组,差异有统计学意义(P<0.05);2.2 mm组术后7 d的角膜内皮细胞(CECs)密度及六角形细胞比例大于常规组,CECs变异系数小于常规组,差异有统计学意义(P<0.05);2.2 mm组术后7 d的角膜阻力因数(CRF)大于常规组,Goldmann相关眼压(IOPg)及角膜补偿眼压(IOPcc)高于常规组,差异有统计学意义(P<0.05);2.2 mm组术后7 d的泪膜破裂时间(BUT)长于常规组,基础泪液分泌试验(ST-Ⅱ)值小于常规组,差异有统计学意义(P<0.05);2.2 mm组并发症发生率为1.82%(一过性高眼压1例),常规组并发症发生率为3.39%(一过性高眼压1例、角膜水肿1例),两组并发症发生率对比差异无统计学意义(P>0.05)。结论2.2 mm角膜微切口白内障超声乳化术治疗老年白内障,可有效提高患者术后视力,促进角膜切口愈合,并能改善角膜内皮细胞功能及泪膜功能。

延续性护理对2型糖尿病合并老年白内障患者术后的效果评价

目的探究延续性护理应用于2型糖尿病合并老年白内障术后患者中的效果。方法选取2022年3月—2023年3月莒县中医医院眼耳鼻喉科收治的72例2型糖尿病合并老年白内障术后患者为研究对象,根据不同的护理方法分为对照组(n=36)和研究组(n=36),对照组实施常规出院指导,研究组实施延续性护理,比较两组血糖水平(糖化血红蛋白、空腹血糖、餐后2 h血糖)、自我护理能力评分、生活质量评分(生理职能、心理职能、社会职能、总体健康)。结果研究组糖化血红蛋白、空腹血糖、餐后2 h血糖水平均低于对照组,差异有统计学意义(P均<0.05)。研究组自我护理能力评分、生活质量评分均高于对照组,差异有统计学意义(P均<0.05)。结论延续性护理应用于2型糖尿病合并老年白内障术后患者中,血糖水平控制效果更佳,且自我护理能力、生活质量有明显提升。

右美托咪定联合舒芬太尼对老年白内障手术患者的影响

目的:探讨右美托咪定联合舒芬太尼用于老年白内障手术患者的影响.方法:选取2017年2月至2019年3月本院收治的66例年龄≥60岁的进行手术治疗的老年白内障患者为研究对象.采用随机数字表法,将其分为联合组(n=33,采用右美托咪定联合舒芬太尼进行麻醉)和对照组(n=33,仅采用舒芬太尼进行麻醉).采用统计学方法,比较两组患者血压、心率、血氧饱和度(SaO_(2)),镇静效果,满意度及不良反应发生率.结果:术前、术中及手术结束时,两组患者血压、心率及SaO_(2)比较,差异无统计学意义(P>0.05);联合组组内不同时间点血压、心率及SaO_(2)比较,差异无统计学意义(P>0.05),而对照组组内术中血压与术前相比较,变化较大,差异有统计学意义(P<0.05).术前和手术结束时,两组患者Ramsay镇静评分比较,差异无统计学意义(P>0.05);而术中,联合组患者Ramsay镇静评分高于对照组,差异有统计学意义(P<0.05).联合组患者及医生对手术过程的满意度高于对照组,差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:右美托咪定联合舒芬太尼用于老年白内障患者手术麻醉效果较好,安全性好.

代谢性白内障与老年性白内障手术联合TORIC晶体植入的临床疗效对比研究

目的 探讨代谢性白内障与老年性白内障行超声乳化摘除联合Toric晶体植入术临床疗效及安全性比较。方法 随机选取我院2021年1月~2024年3月收治的42例(52眼)代谢性白内障合并角膜规则散光患者(散光≥1.0D),另随机选取同时期收治的45例(52眼)老年性白内障合并角膜规则散光患者(散光≥1.0D),均采取白内障超声乳化联合Toric晶状体植入手术治疗,分别比较两组患者术后1d,1w,1mo,3mo时的视力、散光的矫正及并发症情况。结果 代谢性白内障组的52眼中,术后1d、1w、1mo,3mo时的裸眼视力0.5以上者分别为21眼、30眼、35眼,45眼;而同样时间点散光残留低于0.75D者分别为25眼、33眼、35眼、47眼。老年性白内障组52眼中,术后1d、1w、1mo,3mo时的裸眼视力0.5以上者分别为32眼,41眼、45眼、47眼;而同样时间点散光残留低于0.75D者分别为36眼,44眼、46眼,48眼。两组患者在术后1d,1w,1mo时视力恢复(χ^(2)=4.656,χ^(2)=3.488,χ^(2)=5.417)以及残留散光(χ^(2)=4.789,χ^(2)=6.053,χ^(2)=6.755)比较差异有统计学意义(P<0.05),而两组患者在术后3mo时视力以及残留散光上比较差异无统计学意义(χ^(2)=0.377,P>0.05)。两组患者在术后高眼压发生上比较差异无统计学意义(χ^(2)=0.122,P>0.05)。两组患者在术后1mo并发黄斑囊样水肿并发症上比较差异有统计学意义(χ^(2)=5.626,P<0.05)。结论 伴有角膜规则散光的代谢性白内障与老年性白内障,同样实施白内障超声乳化联合Toric晶体植入,两者术后早期视力恢复及散光矫正效果有差异,而远期手术疗效则无明显差异。

Lack of spinal neuropeptide Y is involved in mechanical itch in aged mice

We propose that the lack of spinal NPY may be involved in certain types of pruritus in the elderly population.This study was designed to investigate the role of NPY in aging induced itch using the senile mouse model.The expression of NPY in the spinal dorsal horn was compared between the young(2 months old)and aged(24 months old)mice.Western blotting and immunohistochemistry showed that the expression of NPY was significantly reduced in the spinal dorsal horn in the aged mice.

老年性白内障日间手术手术室护理质量指标的构建

目的:构建科学、敏感、可量化的老年性白内障日间手术手术室单病种护理质量指标。方法:成立课题研究小组,以“结构-过程-结果”三维理论为基础,结合半结构访谈、文献回顾的方法,由课题小组讨论、分析各种影响因素,采用德尔菲法经过两轮专家函询,形成护理质量指标框架,并进行指标筛选和权重分析。结果:初步构建了以“结构”“过程”“结果”3项一级指标为基础,包括人力资源、组织管理、设施布局、培训考核、护理评估、安全管理、感染控制、物资管理、护理服务、护理质量缺陷、患者感受、健康教育12项二级指标以及58项三级指标的老年性白内障日间手术手术室护理质量指标。结论:构建的老年性白内障日间手术手术室单病种护理质量指标能够系统、全面地评价手术室的护理质量,为临床评价白内障日间手术的手术室护理质量提供依据。

老年性白内障患者术后发生感染性眼内炎的危险因素分析

目的:分析老年性白内障患者术后发生感染性眼内炎的危险因素,并提出相应的护理对策。方法:回顾性分析2020年5月—2022年4月福建医科大学附属第二医院眼科收治的178例老年性白内障患者的临床资料,采取单因素和多因素logistic回归分析老年性白内障患者术后发生感染性眼内炎的危险因素,并提出针对性护理对策。结果:178例患者中,共有20例(11.24%)术后发生感染性眼内炎,其中年龄>70岁、血清白蛋白水平<35 g/L、合并糖尿病、有开放性眼球外伤、有术中玻璃体溢出、手术时间>15 min是术后发生感染性眼内炎的危险因素(P<0.05)。结论:老年性白内障患者在行手术治疗后,会受年龄、血清白蛋白水平、合并糖尿病、手术时间、开放性眼球外伤和术中玻璃体溢出的影响,发生感染性眼内炎。

多形式化健康教育模式在老年性白内障手术护理中的实施效果分析

目的探讨老年性白内障手术患者实施多形式化健康教育模式的临床效果。方法随机选取2021年10月—2022年10月菏泽医学专科学校附属医院收治的90例老年性白内障手术患者作为研究对象,基于“随机数表法”规范化分组处理,划分为对照组(实行常规健康教育)与观察组(实行多形式化健康教育模式),各纳入45例。观察对比两组焦虑抑郁程度、健康知识掌握程度、生活质量、患者满意度。结果干预后,两组SAS、SDS评分均降低,且观察组更低,差异有统计学意义(P<0.05)。观察组健康知识(入院须知、白内障基础知识、手术配合、术后护理及注意事项)掌握程度评分均较对照组高,差异有统计学意义(P<0.05)。干预后,两组SF-36评分均大幅度升高,且观察组相对更高,差异有统计学意义(P<0.05)。观察组护理满意度为95.56%,高于对照组的80.00%,差异有统计学意义(χ^(2)=5.074,P<0.05)。结论老年性白内障手术患者实行多形式化健康教育模式,可显著提高健康知识认知度,并缓解焦虑抑郁等负性情绪,以强化治疗依从性,继而实现提高生活质量、改善预后的干预目标。