简介：目的探讨运用示教与反示教在年龄相关性白内障患者滴眼药护理中的效果。方法将100例患者随机分为实验组和对照组各50例，对照组采用传统的健康教育。实验组采用示教与反示教进行健康教育。由培训过的责任护士对患者有计划地从入院到出院，给予全程、个体化的示教与反示教健康教育。结果实验组患者在滴眼药知识、技能掌握及对护理工作满意度方面优于对照组，差异有统计学意义（P0．05），术后一周并发症的发生率明显低于对照组（P〈O．05）。结论运用示教与反示教对患者实施健康教育，可达到提高患者滴眼药的技能，自我效能感增加，遵医行为增强，自护能力提高，减少术后并发症，提高护理满意度。

简介：AIM:Toexaminethemechanismofthedevelopmentofpseudoexfoliation(PSX)syndromeviabothcytokineformationandendothelialvasorelaxingandgrowthfactorsthatwillprovideusnewtherapeuticinsightsforthetreatment.METHODS:Thisisacrosssectionalstudyincludedtwogroups;Group1:controlpatientswithnuclearcataract(n=20,aged51-80years).Group2:PSXpatientswithnuclearcataract(n=18,aged50-90years).Patientswithotherophthalmicproblemsandsystemicdiseaseswereexcluded.Vascularendothelialgrowthfactor(VEGF),interleukin-6(IL-6)andinterleukin-1β(IL-1β)andnitrotyrosinelevelsweredeterminedthroughserumsamplesbyEnzyme-linkedimmunosorbentassay(ELISA)method.Nitrite-nitratelevelsweremeasuredwithphotometricendpointdetermination.RESULTS:Therewerenosignificantdifferencesbetweenthegroupsintermsofage,VEGF,IL-1β,nitrite-nitrateandnitrotyrosine.ThesignificantresultswerethemeanIL-6levelsthatwerehigherinPSXgroup2(37.68±29.52pg/mL)comparedtothatincontrolgroup1(15.32±10.08pg/mL)(P<0.001).CONCLUSION:SeveralinteractingandextendingbiochemicalpathwaysmayleadtothepromotionofVEGFandIL-6expressions.IL-6whichistheonlyalteredmarkerinourstudymayindirectlycauseanincreaseofvascularpermeabilityandneovascularization.WesuggestinflammationasafactorthatcanbeinvolvedinetiopathogenesisofPSX.

简介：AIM:Topresentretinalmicrostructure,metabolismandfunctionabnormalitiesinthecourseofmultipleevanescentwhitedotsyndrome(MEWDS)byHeidelbergspectralismodalityimagingplatformandobserveitsoutcomebyEDI-SD-OCTandtwowavelengthautofluorescence.METHODS:Acaseofmultipleevanescentwhitedotsyndromeina23-year-oldfemalepresentedinitiallywitha15-dayhistoryoffloatersandacentralscotomaintherighteye.Toestablishthediagnosis,multimodalityimagingwasperformed,namely,bluelight-fundusautofluorescence(BL-FAF,excitation488nm,emission>500nm),near-infraredfundusautofluorescence(NIR-FAF,excitation787nm,emission>800nm)usingaconfocalscanninglaserophthalmoscope,fundusfluoresceinangiography(FFA),indocyaninegreenangiography(ICGA),spectrum-domainenhancedepthimagingopticalcoherencetomography(SD-EDI-OCT),multifocalelectroretinography(mf-ERG)andfundusphotograghwereperformedandfollowedupattheeighthmonthafterinitiallyvisiting.RESULTS:Opticalcoherencetomography(OCT)showedatransientdisruptionofthefovealphotoreceptoroutersegmentsincorrespondencetofovealgranularity.NIR-FAFshowedhypoautofluorescentareas,≤40μminsize,mostlyconcentratedaroundtheposteriorpoleanditstemporalsidelessthanthatinBL-FAF.Mf-ERGshowpinnacledisappearedinfoveaandmaculaandresponsesdecreasedmarkedlycomparedwiththefolloweye.Attheeighthmonthfollowup,hyperfluorescenceinBL-FAFweredisappear,while,NIR-FAFHypofluorescentspotsinearlystageofsuchlesionwerereduced.ButOCTdemonstratedthestructurewasrecoveredinresidualHypofluorescentareainNIR-FAF.Thesubfovealchoroidalthicknesswasdecreasedfrom372μmto307μmslightlyandcostlinewasrecovered.CONCLUSION:MEWDSisabenignself-healingdiseaseandthereisnopathologicalevidencetoinvestigatethenaturalcourseofsuchdisease.SD-OCTallowshighlydetailedimagesapproachinghistopathologytocertifythemicrostructura

简介：AIM:ToevaluatethecornealendothelialcelldensityandmorphologyinChinesepatientswithpseudoexfoliationsyndrome(PEX).·METHODS:Medicalrecordsof16patients(20eyes)withPEXwhopresentedtoourinstitutionbetweenJuly2008andJune2010wereretrospectivelyreviewed.Thirteeneyeshadcombinedglaucoma.Theinformationoffiveapparentlynormalfelloweyesinthesepatientswasalsorecorded.Lefteyesof20patientswithbilateralsenilecataractsbutnoothereyediseasewereincludedascontrols.Specularmicroscopywasperformedinalleyestoanalyzeforcornealendothelialcelldensityandmorphology.Celldensity,coefficientofvariationincellsize,andpercentageofhexagonalcellsincornealendotheliumwereevaluated.·RESULTS:ThemeancornealendothelialcelldensityinthePEXeyeswas2298±239cells/mm2,significantlylowerthanthatinthecataracteyes(2652±18cells/mm2,P=0.026),buttherewerenosignificantdifferencesincoefficientofvariationofcellsizeandfrequencyofhexagonalitybetweenthesetwogroups.NosignificantdifferencesinthethreeparameterswerefoundbetweentheapparentlynormalfelloweyesandthePEXeyesorthecataracteyes,orbetweenthePEXeyeswithandwithoutglaucoma.·CONCLUSION:CornealendothelialcelldensitymaydecreaseinChinesepatientswithPEX.ThedevelopmentofglaucomainPEXeyesdoesnotseemtoberelatedwiththechangeincornealendothelialcelldensityormorphology.

简介：<正>在文献中对白内障手术和人工晶体(IOL)植入后的炎性反应、IOL前纤维样膜形成的机理及引起继发性青光眼的原因已有详细的报道,但未提及由纤维样膜堵塞房角并可引起难以降低的高眼压。1993年以来我科在白内障囊外摘除和人工晶体植入术后的病例中,先后观察到13眼因房角膜性堵塞引起的高眼压,它们的临床表现不同于通常白内

简介：目的：研究近视患者LASIK术后视疲劳的发生与融合范围的关系，及同视机融合功能训练改善LASIK术后视疲劳的疗效观察。方法：对60例120眼近视患者（．1．50--8．00D）施行LASIK手术，于术前戴全矫眼镜用同视机法测定融合范围，并进行视疲劳的问卷调查。术后将其随机平分为两组：A组进行同视机融合功能训练30d，B组不进行同视机融合功能训练，分别对其术后1wk；1mo行同视机法测定融合范围，并进行视疲劳的问卷调查及统计学分析。结果：A、B组术后融合范围均较术前减小。术后1wk时融合范围两组分别为18．58±8．91和13．45±8．87，二者差异有统计学意义（P〈0．05）。术后1mo时，两组融合范围分别为20．55±7．23和18．12±6．10，二者差异无统计学意义。术后1wk时A组视疲劳评分3．92±1．65，B组评分5．16±2．34，二者差异有统计学意义（P〈0．05）。术后1mo时两组评分分别是1．28±0．96和1．45±0．99分，二者差异无统计学意义。结论：近视眼LASIK术后双眼的融合功能下降是出现视疲劳的一个重要因素。术后早期进行同视机融合功能训练可以有效的改善视疲劳症状。