BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM ...BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.展开更多
AIM: To analyse the impact of ultrasound and optical intraocular lens(IOL) calculation methods on refractive outcomes of cataract phacoemulsification performed after penetrating keratoplasty(PK) in keratoconus. METHOD...AIM: To analyse the impact of ultrasound and optical intraocular lens(IOL) calculation methods on refractive outcomes of cataract phacoemulsification performed after penetrating keratoplasty(PK) in keratoconus. METHODS: Phacoemulsification cataract surgery was performed on 42 eyes of 34 patients with keratoconus who had previously undergone PK. The IOL power was determined by using both standard and corneal topography-derived keratometry using the SRK/T formula. We used two independent methods-ultrasound biometry(UB) and interferometry [optical biometry(OB)] for IOL calculation. The analysed data from medical records included demographics, medical history, best corrected visual acuity(BCVA) on Snellen charts, technique of IOL calculation and calculation formula and its impact on final refractive result.RESULTS: BCVA ranged from 0.01 to 0.4(mean 0.09±0.19) before surgery and ranged from 0.2 to 0.7(mean 0.38±0.14) at 1 mo and from 0.2 to 1.0(mean 0.56±0.16)(P<0.05) at 3 mo, postoperatively. The refractive aim differed significantly from the refractive outcome in both the UB and OB groups(P<0.05). There was no statistically significant difference in the accuracy of the two biometry methods.CONCLUSION: The refractive aim in keratoconus eyes post-PK is not achieved with either ultrasound or OB.展开更多
Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on pati...Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.展开更多
目的:探讨在Van Herick法基础上更方便准确评估前房角宽度的方法。方法:纳入2021-01/12于我院就诊的年龄相关性白内障患者58例69眼,参考Van Herick法分为房角宽度≥1/2颞侧角膜厚度(CT)组(37例44眼)和<1/2CT组(21例25眼),应用超声生...目的:探讨在Van Herick法基础上更方便准确评估前房角宽度的方法。方法:纳入2021-01/12于我院就诊的年龄相关性白内障患者58例69眼,参考Van Herick法分为房角宽度≥1/2颞侧角膜厚度(CT)组(37例44眼)和<1/2CT组(21例25眼),应用超声生物显微镜测量中央前房深度和周边房角度数。结果:房角宽度≥1/2CT组和<1/2CT组患者中央前房深度有明显差异(2.64±0.27 mm vs 2.23±0.29 mm,P<0.01),且两组间上方、颞侧、下方和鼻侧象限房角度数均有明显差异(P<0.01)。房角宽度≥1/2CT组患者上方与下方象限房角度数无显著差异(P>0.05),其余各象限房角度数均有差异(P<0.05);房角宽度<1/2CT组患者上方与鼻、颞侧象限,下方与颞侧象限房角度数均有差异(P<0.05)。结论:裂隙灯下采用Van Herick法评估颞侧房角宽度,同时评估下方象限房角宽度,可以更简单、快速、准确地评估前房角的整体情况。展开更多
Postoperative complications of phacoemulsification,such as corneal edema caused by human corneal endothelial cell(CEC)injury,are still a matter of concern.Although several factors are known to cause CEC damage,the inf...Postoperative complications of phacoemulsification,such as corneal edema caused by human corneal endothelial cell(CEC)injury,are still a matter of concern.Although several factors are known to cause CEC damage,the influence of ultrasound on the formation of free radicals during surgery should be considered.Ultrasound in aqueous humor induces cavitation and promotes the formation of hydroxyl radicals or reactive oxygen species(ROS).ROS-induced apoptosis and autophagy in phacoemulsification have been suggested to significantly promote CEC injury.CEC cannot regenerate after injury,and measures must be taken to prevent the loss of CEC after phacoemulsification or other CEC injuries.Antioxidants can reduce the oxidative stress injury of CEC during phacoemulsification.Evidence from rabbit eye studies shows that ascorbic acid infusion during operation or local application of ascorbic acid during phacoemulsification has a protective effect by scavenging free radicals or reducing oxidative stress.Both in experiments and clinical practice,hydrogen dissolved in the irrigating solution can also prevent CEC damage during phacoemulsification surgery.Astaxanthin(AST)can inhibit oxidative damage,thereby protecting different cells from most pathological conditions,such as myocardial cells,luteinized granulosa cells of the ovary,umbilical vascular endothelial cells,and human retina pigment epithelium cell line(ARPE-19).However,existing research has not focused on the application of AST to prevent oxidative stress during phacoemulsification,and the related mechanisms need to be studied.The Rho related helical coil kinase inhibitor Y-27632 can inhibit CEC apoptosis after phacoemulsification.Rigorous experiments are required to confirm whether its effect is realized through improving the ROS clearance ability of CEC.展开更多
文摘BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.
文摘AIM: To analyse the impact of ultrasound and optical intraocular lens(IOL) calculation methods on refractive outcomes of cataract phacoemulsification performed after penetrating keratoplasty(PK) in keratoconus. METHODS: Phacoemulsification cataract surgery was performed on 42 eyes of 34 patients with keratoconus who had previously undergone PK. The IOL power was determined by using both standard and corneal topography-derived keratometry using the SRK/T formula. We used two independent methods-ultrasound biometry(UB) and interferometry [optical biometry(OB)] for IOL calculation. The analysed data from medical records included demographics, medical history, best corrected visual acuity(BCVA) on Snellen charts, technique of IOL calculation and calculation formula and its impact on final refractive result.RESULTS: BCVA ranged from 0.01 to 0.4(mean 0.09±0.19) before surgery and ranged from 0.2 to 0.7(mean 0.38±0.14) at 1 mo and from 0.2 to 1.0(mean 0.56±0.16)(P<0.05) at 3 mo, postoperatively. The refractive aim differed significantly from the refractive outcome in both the UB and OB groups(P<0.05). There was no statistically significant difference in the accuracy of the two biometry methods.CONCLUSION: The refractive aim in keratoconus eyes post-PK is not achieved with either ultrasound or OB.
文摘Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.
文摘目的:探讨在Van Herick法基础上更方便准确评估前房角宽度的方法。方法:纳入2021-01/12于我院就诊的年龄相关性白内障患者58例69眼,参考Van Herick法分为房角宽度≥1/2颞侧角膜厚度(CT)组(37例44眼)和<1/2CT组(21例25眼),应用超声生物显微镜测量中央前房深度和周边房角度数。结果:房角宽度≥1/2CT组和<1/2CT组患者中央前房深度有明显差异(2.64±0.27 mm vs 2.23±0.29 mm,P<0.01),且两组间上方、颞侧、下方和鼻侧象限房角度数均有明显差异(P<0.01)。房角宽度≥1/2CT组患者上方与下方象限房角度数无显著差异(P>0.05),其余各象限房角度数均有差异(P<0.05);房角宽度<1/2CT组患者上方与鼻、颞侧象限,下方与颞侧象限房角度数均有差异(P<0.05)。结论:裂隙灯下采用Van Herick法评估颞侧房角宽度,同时评估下方象限房角宽度,可以更简单、快速、准确地评估前房角的整体情况。
文摘Postoperative complications of phacoemulsification,such as corneal edema caused by human corneal endothelial cell(CEC)injury,are still a matter of concern.Although several factors are known to cause CEC damage,the influence of ultrasound on the formation of free radicals during surgery should be considered.Ultrasound in aqueous humor induces cavitation and promotes the formation of hydroxyl radicals or reactive oxygen species(ROS).ROS-induced apoptosis and autophagy in phacoemulsification have been suggested to significantly promote CEC injury.CEC cannot regenerate after injury,and measures must be taken to prevent the loss of CEC after phacoemulsification or other CEC injuries.Antioxidants can reduce the oxidative stress injury of CEC during phacoemulsification.Evidence from rabbit eye studies shows that ascorbic acid infusion during operation or local application of ascorbic acid during phacoemulsification has a protective effect by scavenging free radicals or reducing oxidative stress.Both in experiments and clinical practice,hydrogen dissolved in the irrigating solution can also prevent CEC damage during phacoemulsification surgery.Astaxanthin(AST)can inhibit oxidative damage,thereby protecting different cells from most pathological conditions,such as myocardial cells,luteinized granulosa cells of the ovary,umbilical vascular endothelial cells,and human retina pigment epithelium cell line(ARPE-19).However,existing research has not focused on the application of AST to prevent oxidative stress during phacoemulsification,and the related mechanisms need to be studied.The Rho related helical coil kinase inhibitor Y-27632 can inhibit CEC apoptosis after phacoemulsification.Rigorous experiments are required to confirm whether its effect is realized through improving the ROS clearance ability of CEC.
