目的明确门诊行裂隙灯显微镜下结膜囊肿取出术治疗结膜囊肿的疗效和安全性。方法在门诊病历系统收集2018年3月至2020年3月在中山大学中山眼科中心门诊行裂隙灯显微镜下结膜囊肿取出术共56例57眼结膜囊肿患者。手术过程:术前结膜囊清洁,...目的明确门诊行裂隙灯显微镜下结膜囊肿取出术治疗结膜囊肿的疗效和安全性。方法在门诊病历系统收集2018年3月至2020年3月在中山大学中山眼科中心门诊行裂隙灯显微镜下结膜囊肿取出术共56例57眼结膜囊肿患者。手术过程:术前结膜囊清洁,丙美卡因表面麻醉后,由高年资眼科专科护士在裂隙灯下采用负压抽吸囊肿,完整吸出囊膜,术毕涂抗生素眼药膏。术后随访观察眼表疾病指数(OSDI评分)、复发情况、并发症和患者就医体验。结果56例患者行裂隙灯显微镜下结膜囊肿取出术的手术成功率为100%,患者未出现并发症。患者术后28 d OSDI评分较术前降低,差异有统计学意义(P<0.001),患者就医体验良好,随访1个月、6个月、2年,回访无复发。结论门诊行裂隙灯显微镜下结膜囊肿取出术方便快速,创伤小,术后伤口愈合良好,具有安全性、可行性和有效性,效果好,患者就医体验良好。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
AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demode...AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.展开更多
AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually an...AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.展开更多
文摘目的明确门诊行裂隙灯显微镜下结膜囊肿取出术治疗结膜囊肿的疗效和安全性。方法在门诊病历系统收集2018年3月至2020年3月在中山大学中山眼科中心门诊行裂隙灯显微镜下结膜囊肿取出术共56例57眼结膜囊肿患者。手术过程:术前结膜囊清洁,丙美卡因表面麻醉后,由高年资眼科专科护士在裂隙灯下采用负压抽吸囊肿,完整吸出囊膜,术毕涂抗生素眼药膏。术后随访观察眼表疾病指数(OSDI评分)、复发情况、并发症和患者就医体验。结果56例患者行裂隙灯显微镜下结膜囊肿取出术的手术成功率为100%,患者未出现并发症。患者术后28 d OSDI评分较术前降低,差异有统计学意义(P<0.001),患者就医体验良好,随访1个月、6个月、2年,回访无复发。结论门诊行裂隙灯显微镜下结膜囊肿取出术方便快速,创伤小,术后伤口愈合良好,具有安全性、可行性和有效性,效果好,患者就医体验良好。
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。
基金Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.30306020240020219)Science and Technology Program of Guangzhou(No.202102020736)+1 种基金National Natural Science Foundation of China(No.82204532)Undergraduate Teaching Reform Research Project of Sun Yat-sen University in 2019(No.Jiaowu 2019285)。
文摘目的:基于医学生视角评估裂隙灯生物显微镜(以下简称“裂隙灯”)训练的必要性,对眼科见习期间的医学生裂隙灯训练达成共识。方法:在中山大学117名2017级临床医学专业学生中,开展见习前后对照研究。所有医学生在眼科见习期间均接受裂隙灯训练。使用自行设计的问卷调查,评估学生对裂隙灯教学的个人认知、个人需求与建议,并对眼科见习前后学生在这些方面的得分进行比较。此外,通过眼科见习后的学生主观评价来评估裂隙灯训练的效果。每个条目评分采用Likert 5级评分法。采用IBM SPSS软件(版本20.0;SPSS Inc.,Chicago,IL,USA)进行统计分析。结果:共有116名(99.1%)医学生完成了调查。见习前的平均得分为19.99±3.03分,显示学生对裂隙灯用途的认知水平高;见习后的得分显著增加至22.97±2.37分(P<0.001)。对于个人需求的平均得分,见习后高于见习前(24.62±3.15 vs 23.60±2.36,P=0.009)。此外,86.2%的学生见习后认为裂隙灯实操训练有助于显著改善见习质量。大于四分之三的被调查学生倾向于增加裂隙灯训练时间(见习前后分别为76.7%和77.6%)。结论:在眼科见习中,医学生更偏好于裂隙灯训练实操;鉴于对改善见习质量的潜在作用,应在眼科见习中推荐该训练。
基金Supported by the National Natural Science Foundation of China(No.82271052,No.82271058,No.U20A20386)the Taishan Scholar Program(No.tspd20150215,No.tsqn201909188)。
文摘AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.
文摘AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.
