AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS...AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.展开更多
Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid adv...Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.展开更多
AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygiu...AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal(created by shaping the junction with the recipient conjunctiva into a wedge)or quadrangular conjunctival autograft transplantation.All patients completed a 6mo postoperative follow-up.The primary outcome measure was the incidence of graft retraction;secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.RESULTS:The study enrolled 58 participants,comprising 26(15 males,11 females)in the pentagonal graft group(mean age:54.9±13.1y),and 32(17 males,15 females)in the quadrangular graft group(mean age:57.6±10.4y).Graft retraction occurred in only 1 eye(3.8%)in the pentagonal autograft group,compared to 9 eyes(28.1%)in the quadrangular autograft group.No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group.Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft,the difference was not statistically significant(P>0.05).CONCLUSION:Designing the conjunctival autograft in a pentagonal shape—mimicking geodesic dome architecture and conforming to the eye’s spherical structure—enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces.This design effectively reduces the incidence of graft retraction and other related complications,providing a more favorable surgical option for pterygium treatment.展开更多
AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glauc...AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.展开更多
AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longit...AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.展开更多
目的:比较新型扫频源眼前节相干光层析成像仪(CASIA2)与三维眼前节分析仪(Pentacam)在有晶状体眼后房型人工晶状体(ICL)植入术后拱高及其相关参数测量中的差异性、相关性和一致性。方法:采用横断面研究,纳入2021年8月至2023年8月爱尔眼...目的:比较新型扫频源眼前节相干光层析成像仪(CASIA2)与三维眼前节分析仪(Pentacam)在有晶状体眼后房型人工晶状体(ICL)植入术后拱高及其相关参数测量中的差异性、相关性和一致性。方法:采用横断面研究,纳入2021年8月至2023年8月爱尔眼科四川眼科医院屈光手术科行ICL植入术的近视患者。收集患者ICL术后1 mo CASIA2和Pentacam测量的拱高(Vault)、角膜厚度(CCT)、瞳孔直径、前房深度(ACD)及角膜内皮到ICL前表面距离(ACD-ICL)。分析两种仪器测量数据的相关性、差异性、一致性。结果:本研究共纳入近视患者100例187眼。CASIA2和Pentacam测量CCT、ACD、瞳孔直径、ACD-ICL和拱高均有差异(均P<0.05)。相关性分析显示两种仪器测量CCT、ACD-ICL、拱高、ACD和瞳孔直径均呈正相关(r/r_(s)=0.99、0.91、0.91、0.71、0.49,均P<0.05)。Bland-Altman分析显示两种仪器测量CCT一致性良好,其余参数一致性欠佳。结论:CASIA2测得的拱高数据略高于Pentacam,除设备工作原理差异外,考虑为检查光源引起的瞳孔变化及调节所致。CASIA2测得的拱高数据更接近自然状态,Pentacam更接近强光状态。两种仪器联合使用可为临床提供更准确的评估。展开更多
文摘AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.
基金Supported by the Key Special Project of“Cutting-Edge Biotechnology”in the National Key Research and Development Program of China(No.2024YFC3406200)Sanming Project of Medicine in Shenzhen(No.SZSM202411007)Shenzhen Science and Technology Program(No.JCYJ20240813152704006).
文摘Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.
文摘AIM:To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.METHODS:This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal(created by shaping the junction with the recipient conjunctiva into a wedge)or quadrangular conjunctival autograft transplantation.All patients completed a 6mo postoperative follow-up.The primary outcome measure was the incidence of graft retraction;secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.RESULTS:The study enrolled 58 participants,comprising 26(15 males,11 females)in the pentagonal graft group(mean age:54.9±13.1y),and 32(17 males,15 females)in the quadrangular graft group(mean age:57.6±10.4y).Graft retraction occurred in only 1 eye(3.8%)in the pentagonal autograft group,compared to 9 eyes(28.1%)in the quadrangular autograft group.No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group.Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft,the difference was not statistically significant(P>0.05).CONCLUSION:Designing the conjunctival autograft in a pentagonal shape—mimicking geodesic dome architecture and conforming to the eye’s spherical structure—enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces.This design effectively reduces the incidence of graft retraction and other related complications,providing a more favorable surgical option for pterygium treatment.
文摘AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
文摘AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.
文摘目的:比较新型扫频源眼前节相干光层析成像仪(CASIA2)与三维眼前节分析仪(Pentacam)在有晶状体眼后房型人工晶状体(ICL)植入术后拱高及其相关参数测量中的差异性、相关性和一致性。方法:采用横断面研究,纳入2021年8月至2023年8月爱尔眼科四川眼科医院屈光手术科行ICL植入术的近视患者。收集患者ICL术后1 mo CASIA2和Pentacam测量的拱高(Vault)、角膜厚度(CCT)、瞳孔直径、前房深度(ACD)及角膜内皮到ICL前表面距离(ACD-ICL)。分析两种仪器测量数据的相关性、差异性、一致性。结果:本研究共纳入近视患者100例187眼。CASIA2和Pentacam测量CCT、ACD、瞳孔直径、ACD-ICL和拱高均有差异(均P<0.05)。相关性分析显示两种仪器测量CCT、ACD-ICL、拱高、ACD和瞳孔直径均呈正相关(r/r_(s)=0.99、0.91、0.91、0.71、0.49,均P<0.05)。Bland-Altman分析显示两种仪器测量CCT一致性良好,其余参数一致性欠佳。结论:CASIA2测得的拱高数据略高于Pentacam,除设备工作原理差异外,考虑为检查光源引起的瞳孔变化及调节所致。CASIA2测得的拱高数据更接近自然状态,Pentacam更接近强光状态。两种仪器联合使用可为临床提供更准确的评估。
