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    25 May 2016, Volume 25 Issue 3
    Fine management of diagnosis and treatment of dry eye
    LIANG Qing-feng
    2016, 25(3):  145-147.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.001
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     To the diagnosis and treatment of dry eye, the fine management should be paid attention to. These methods included the acquisition of dry eye patient history and standardization analysis of symptoms. Meanwhile, we should focus on the dry eye related standard inspection method and understand the purpose and clinical significance of every inspection method. The relationship between symptoms and signs of dry eye should be scientifically evaluated and asymptomatic dry eye disease should be made more concerns. At last, the personalized medication and meticulous management of anti-dry eye drug therapy should be carefully taken according to the characteristics of dry eye. With the meticulous management of dry eye diagnosis and treatment, the visual function and life quality of the patients with dry eye will be improved in the greatest degree.

    Application of  OCT-RTVue for the diagnosis of dry eye
    GAO Chao1, WANG Chun-fang1, LIANG Qing-feng2
    2016, 25(3):  148-153.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.002
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    Objective To evaluate the detection of tear meniscus by OCT-RTVue and the relativity between the parameters of OCT-RTVue and the traditional diagnosis parameters in dry eye. Design Prospective case series. Participants Sixty-nine patients with dry eye and forty-four healthy age-and sex-matched control subjects were included from June to December 2015. Methods All subjects were underwent the examinations sequentially as follows: evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index(OSDI), the examinations of OCT-RTVue, tear film interferometry, tear film break-up time (BUT), corneal and conjunctival staining (Oxford scale) and Schirmer I test. The parameters between dry eye group and the control group were compared. Spearmans correlation analysis was used to analyze the correlation of the parameters of dry eye group. Receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to describe the accuracy of each parameter to differentiate dry eyes from normal eyes. Main Outcome Measures OSDI score, BUT, Schirmer I, the score about lipid layer of the tear film, conjunctival staining, tear meniscus height (TMH), tear meniscus depth (TMD), tear meniscus area (THA). Results OSDI score and conjunctival staining were obviously higher in dry eye group (49.03±22.791, 1.18±1.84) than those in control group (8.91±4.99, 0.24±0.52) (P<0.001, 0.016). BUT and Schirmer I value were significantly lower in dry eye group (4.32±1.92 s, 4.29±3.77 mm) than those in control group (7.43±5.39 s, 7.48 ±3.65 mm) (P<0.001, 0.006). According to the score about lipid layer of the tear film, there wasn't significant differences in the two group (P=0.223). TMD, TMH, TMA were significantly higher in dry eye group (127.12±86.95 μm, 152.52±125.15 μm, 12119 ± 1342 μm2) than those in control group (188.25 ± 87.38 μm, 235.41±135.90 μm, 23099±1965 μm2)(P<0.001, 0.001, 0.001). TMD, TMH, TMA were correlated with OSDI,  Schirmer I, BUT in dry eye group (all P<0.05). AUC value of TMD, TMH, TMA was 0.934, 0.89, 0.925 respectively. Conclusion The examinations OCT-RTVue can reflect accurately the tear meniscus height and depth and may have potential applications for the diagnosis and evaluation of dry eye.
    Two-year observation of parents’ conjunctiva transplantation for wide range conjunctiva tumor in children
    JIE Ying1, LI Shang3, XU Xiao-lin2, RUAN Fang1, LI Bin2, LV Lan1, PAN Zhi-qiang1
    2016, 25(3):  154-157.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.003
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    Objective To analyze the clinical effect of parents’ cunjunvtiva transplantation for treating wide range conjunctival tumor in children. Design Retrospective case series. Participants 12 children with wide range conjunctival tumor in Tongren Eye Center from Jan. 2012 to Dec. 2014, aged from 4 to 10 years old. In which, 2 cases were diagnosed of the primary conjunctival melanosis and 10 cases were diagnosed of conjunctival papilloma. All the tumors invaded at least more than 270 degrees range of bulbar conjunctiva, some involving the fornical conjunctiva and the palpebral conjunctiva. Methods The tumors were completely resected and patched with parental conjuntiva. All patients were followed up for 2.5±0.3 years. Main Outcome Measures Histopathological examination and slit-lamp examination. Results No recurrence and eyelid ball adhesion occurred in all the patients with pigmented tumors. Scattered recurrence occurred in 3 patients with papillary tumors after six months, but cured after resection. Two patients with papillary tumor had mild symblepharon after surgery but the movement of the eyeball was not affected. All patients were satisfied with the appearance. Conclusion For children with large range of conjunctival tumors, resection combined with parents’ conjunctival transplantation could reconstruct ocular surface and restore normal ocular function and appearance effectively
    Protective effects of pentazocine on retinal Müller cells under high-glucose conditions
    CUI Le-le, WANG Yun-song, SHAN Ming-hua, ZHOU Yun-tao, TIAN Wei
    2016, 25(3):  158-162.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.004
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    bjective To study the protective effects and mechanism of Pentazocine (PTZ) on retinal Müller cells under high-glucose conditions. Design Experimental study. Participants The cultivated retinal Müller cells of SD rats. Methods  The  cultivated retinal Müller cells of SD rats were divided into three groups, control group with normal level of glucose (NG,5.5 mmol/L), high glucose group (HG, 30 mmol/L), Pentazocine treatment group (HG+PTZ, HG in the presence of PTZ 3 umol/L).  MTT is used to detect cellular activity at 6, 12, 24 and 72 h cultivated. Vascular endothelial growth factor (VEGF) and activating transcription factor 4 (ATF4) mRNA expression by the Müller cells in three experimental groups were examined by RT-PCR, production of VEGF and ATF4 was measured by Western blot. Main Outcome Measures Cellular activity, expression of mRNAs and proteins. Results  After 72 h, high glucose exposed, the HG group cells viabilities decreased significantly compared with NG(P<0.05), and the cells vitality of HG group were decreased by (23.3±0.1)% compared with NG group; HG+PTZ group cells activities was higher than the HG group (P<0.05). After the retinal Müller cells were exposed to HG (30 mmol/L), compared with NG, the expressions of VEGF, ATF4 mRNA and protein were up regulated (P<0.05). In addition, Pentazocine reduced HG-induced the expression of VEGF, ATF4 mRNA and protein, there was no statistical difference between NG and HG+PTZ groups (P>0.05). Conclusion  Pentazocine significantly improve the cellular acticvity and inhibited HG-induced VEGF and ATF4 mRNA and protein expression in retinal  Müller cells.
    Experimental study of biological membrane inhibiting conjunctival fibrous scar formation
    JIA Shan-shan1, MA Ke2, ZHAO Xiu-li1
    2016, 25(3):  163-168. 
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    Objective To observe the inhibition of conjunctival scar by biological membrane. Design Experimental study. Participants 39 New Zealand albino rabbits. Methods Rabbits were randomly divided into 3 groups, each group of 13: saline group, MMC group, and experimental group. A 8-mm trephine and Vannas scissors were used to produce lesions of the right bulbar conjunctiva to establish conjunctival injury model. Left eyes were not disposed. Saline group was placed 10 mm saline cotton for 2 minutes. MMC group was placed MMC cotton piece (size is 10 mm, concentration is 0.4 mg/ml) for 2 minutes. Experimental group was placed biological membrane (diameter is 10 mm and thickness is 2 mm), saline infiltration. The material and conjunctiva were sewed up around the wound using 10-0 atraumatic suture. Evaluate the fornix shrinkage rate, wound healing rate in different time after operation. HE staining was applied to observe and MASSON staining to assess degree of density and arrangement of collagen fibers at the 7, 14, 28 day after surgery. Main Outcome Measures Fornix shrinkage rate, wound healing rate, general cell types, and degree of density and arrangement of collagen fibers. Results At day 28, fornix shrinkage rate of saline group, MMC group, experimental group was 45.1%±1.2%, 25.5%±2.7%,  23.6%±2.0%. The fornix shrinkage rate of experimental group was obviously smaller than that of saline group (P<0.001). There was no significant difference between experimental group and MMC group (P>0.05).  At day 28, The healing rate of experimental group, MMC group,  saline group was 100%±0.0%,  41.8%±2.0%,  100%±0.0%. There was no significant difference between experimental group and saline group (P>0.05). The healing rate of experimental group was significantly higher than that of MMC group (P<0.001).  HE staining: at day 28, a small amount of fibroblasts were visible in saline group. Dense arrangement of collagen fibers were also found around the cells. The experimental group was similar to normal conjunctival tissue. The number of infiltrating cells in the MMC group also decreased. MASSON staining: at day 28, collagen fibers were dense arrangment in saline group. Collagen fibers were loose, but not arranged in MMC group and experimental gruop. Conclusion Biological membrane has an inhibitory effect on the proliferation of conjunctival fibrous tissue. It can inhibit subconjunctival scarring and fornix contraction. It also can promote the wound healing normally and the formation of normal subconjunctival matrix.
    Strategy of management and implementation of international medical aiding program-taking Bright Jounery Program in Ghana as an example
    WANG Jia-wei1, WEI Xian-jing1, ZHOU Zi-xiao2, CHEN Jia-yong3, LIANG Xiao-song1, LIU Wei-ci1
    2016, 25(3):  168-170.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.018
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    The “Bright Vision Journey” Project has been successfully implemented in Ghana with 208 cases of cataract extraction surgeries performed in November 2015. The program is highly valued and has gained respect in Ghana. This essay analysis and investigates the management and experience in the implementation of the program. The conclusion includes suggestions and advice for implementing similar programs in a sustainable and efficient way in the future.
    Effect of morin on proliferation and apoptosis of retinoblastoma cells
    BAI Shu-wei, LI Feng-zhi, YAO Qian
    2016, 25(3):  171-174.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.006
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    Objective To examine the effect of morin on the proliferation and apoptosis of cultured retinoblastoma cells. Design Experimental study. Participants The retinoblastoma cell lines Y79. Methods The retinoblastoma cell lines Y79 were treated with morin in increasing concentrations (0, 50, 100, 150, 250 μM respectively) for 24, 48, and 72 hours and then the cell proliferation rate was measured. Cell cycle was analyzed by flow cytometry, and cell apoptosis rate was measured by TUNEL staining. Main Outcome Measures The percentage of cell survival, the distribution of cell cycle, the percentage of apoptotic cells to total cells. Results After the morin acting on the Y79 cells at the concentrations of 150 μM or 250 μM for 48, 72 h respectively, the percentages of tumor cell survival rate decreased significantly (P<0.05) compared to those at the concentrations of 0, 50 or 100 μM. Correspondingly, the percentage of apoptotic cells to total cells was significantly (P<0.05) higher in the Y79 cells treated by morin at the concentrations of 150 μM or 250 μM than at the concentrations of 0, 50 or 100 μM. In a parallel manner, the cell cycle was significantly (P<0.05) altered in the Y79 cells treated by morin at the concentrations of 150 μM or 250 μM ,with increased percentages of Y79 cells in the G0/G1 arrest and reduced percentages of Y79 cells in the S phase. The morin caused concentration-dependent and time-dependent decreasing in cell proliferation and increasing in cell apoptosis. Conclusion Mrion added to cultures of retinoblastoma cells led to a reduced tumor cell proliferation, and an increased tumor cell apoptosis, which suggests that morin may be a potent drug for the treatment of retinoblastoma.
    Meta-analysis on efficacy of bevacizumab in pterygium treatment
    ZHOU Xiao-qing, WEI Rui--li
    2016, 25(3):  175-180.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.007
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    Objective To evaluate the clinical efficacy of bevacizumab for pterygium treatment. Design Meta-analysis. Participants The randomized controled trials on the efficacy and complications in treatment of pterygium by bevacizumab. Methods Search was conducted in Pubmed, EMbase, Cochrane Library, CNKI, Wanfang database, CBM and VIP, and hand-search was also performed.The qualities of the randomized controlled trials (RCT) were evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0. The softwares RevMan 5.0 and SPSS10.0 were used for Meta-analysis. Main Outcome Measures The Odds ratio(OR) of the recurrence rate and the complications in treatment of pterygium by bevacizumab. Results Only 7 trials were included, involving 398 eyes. Meta-analysis showed that significant difference was not found between the bevacizumab and the control in recurrence [OR=0.60, 95%CI(0.34-1.05), P=0.07, I2=7%]. There was also no difference in reducing the complications[OR=0.68, 95%CI(0.38-1.22), P=0.19,  I2=0%]. Conclusion Bevacizumab in pterygium treatment does not reduce pterygium recurrence.
    Comparison of value of single-field and multiple-field fundus photography for grading diabetic retinopathy
    MA Ying-nan, XU Jie, MAO Yu, XIAO Yuan-yuan, WANG Shuang, LI Yi-bin, XU Liang, LI Jian-jun
    2016, 25(3):  181-185.  doi:10. 13281/j. cnki. issn.1004-4469. 2016. 03. 008
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    Objective  To compare the sensitivity and specificity of single-field fundus photography and multiple-field fundus photography with FFA in grading diabetic retinopathy. Design Diagnostic test. Participants Eighty-five cases (162 eyes) with diabetes over 18 years old in Department of Ophthalmology of Beijing Tongren Hospital were selected. Methods Nonmydriatic single-field digital fundus photography, mydriatic two-field fundus photography, nine-field fundus photography and FFA were performed in all subjects. Grading of diabetic retinopathy was carried out by two ophthalmologists according to diabetic retinopathy international clinical classification. Main Outcome Measures Kappa value, sensitivity, specificity. Results The Kappa value of two ophthalmologists on single-field, two-field, nine-field fundus photography was 0.58, 0.79, 0.79 respectively. The sensitivity of  single-field, two- field, nine-field fundus photography for detecting the presence of diabetic retinopathy was 95.7%, 98.6, 100% respectively, and the specificity was 100%. The sensitivity of single-field, two-field, nine-field fundus photography for detecting the presence of severe non-proljferative diabetic retinopathy (NPDR) or more serious was 57.9%, 60.5%, 71.1% respectively, and the specificity was 100%. Conclusion The sensitivity of single-field fundus photography for the presence of diabetic retinopathy is more than 95%, and nearly 2/3 of NPDR or more serious can be accurately graded.
    Correlation analysis between change of corneal biomechanical parameters and measurement of intraocular pressure after LASIK
    SUI Dan-dan, HU Qi, WU Qiong, LI Xue, LI Qing-jun, YANG Fan, KANG Yang, DU Chun-yu
    2016, 25(3):  187-191.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.009
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    Objective To observe the relationship between the change of corneal biomechanical parameters and the measurement of intraocular pressure after LASIK. Design Prospective case series. Participants Eighty-one patients (162 eyes)with myopia were performed LASIK from Janurary to December in 2014 in the First Affiliated Hospital of Harbin Medical University. Methods  The corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP value (IOPg) and corneal-compensated intraocular pressure (IOPcc) were examined with ocular response analyzer (ORA) before and after LASIK. The intraocular pressures were measure using non-contact tonometer (NCT) as well. Main Outcome Measures NCT,IOPcc,IOPg,CH,CRF before and after LASIK. Results Postoperative 3 months, CH , CRF , IOPcc, IOPg, and NCT measured values decreased significantly compared with those preoperatively. The comparison among IOPcc, IOPg and NCT postoperatively shows the significant distinction (P<0.05). There is a negative correlation between △CH , △CRF and △IOPcc , △IOPcc-IOPg and △IOPcc-△NCT. There is a positive correlation between △CH , △CRF and △IOPg and △NCT(P<0.05). Conclusion The corneal biomechanics and the measurement of intraocular pressure after LASIK were lower than preoperatively. There is a correlation between the decline of the measurement of intraocular pressure and the decrement of CH and CRF. The level of intraocular pressure drop may be affected by corneal biomechanical properties.
    Distribution characters of corneal asphericity and its related factors in school-age children
    LI Qi2, WANG Jun1, LI Jia1
    2016, 25(3):  191-194.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.010
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    Objective To study the distribution characters of corneal asphericity (Q-value) in school-age children and the related factors. Design Cross-sectional study. Participants Using a random cluster sampling method, in total 950 students from 7 schools in Changping district, Beijing aged between 7 to 16 (10.87±2.58) were studied. Methods Aladdin anterior segment system was used to both obtain the Q-value and ocular biometry measurements of the children and conduct relevant analysis regarding distribution characters, ocular parameters (eye axis, intraocular pressure, corneal curvature, spherical aberration) as well as whole body parameter (age, sex, height, weight). Main outcome measures cornea Q value, spherical aberration, coma, corneal curvature, ocular axis, intraocular pressure, corneal horizontal diameter, anterior chamber depth. Results the mean Q value was -0.18±0.14 with normal distribution. The Q values of different genders (P=0.839) and different eyes (P=0.373) were not statistically different. The Q values was correlated with age (r=0.110, P=0.000), height (r=0.118, P=0.000), weight (r=0.117, P=0.000), spherical aberration (r=0.113, P=0.001), coma (r=0.087, P=0.009). The Q values of children aged 7~11 group is significantly smaller than that of 12~16 group (t=-5.51, P=0.000). No significant relation was found between Q value and either sphere, corneal curvature, corneal horizontal diameter, anterior chamber depth, ocular axis, and intraocular pressure (all P>0.05). Conclusion The morphology of the corneal anterior surface of school age children is oval. The Q values is positively correlated with age, height, weight, spherical aberration and coma.
    Clinical characteristics and prognosis of cytomegalovirus retinitis with acquired immune deficiency syndrome  without anticytomegalovirus therapy
    SUN Hui-yu, MAO Fei-fei, LI Dan, WANG Sheng-nan, LIU Yue-hong, XU Xue-jing, LIU Bin-bin, DONG Yu
    2016, 25(3):  195-198.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.011
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    Objective To analyze the clinical characteristics and prognosis of cytomegalovirus retinitis with acquired immune deficiency syndrome without anticytomegalovirus therapy. Design Retrospective cases series. Particpants 11 patients with cytomegalovirus retinitis combined with acquired immune deficiency syndrome who had not been anticytomegalovirus. Methods Visual acuity, intraocular pressure, slit lamp, visual field and fundus examination were evaluated and observed during the follow-up for 2 months to 5 years (26.2±23.8 months). Main Outcome Measures Vision, anterior segment, fundus. Results In the 21 eyes of 11 patients with cytomegalovirus retinitis, 14 eyes were no light perception, two eyes had vision of less than 0.05, one eye had vision of no less than 0.05 and less than 0.3, only 4 eyes of them had vision no less than 0.3. Five eyes of 21 eyes had pigmented KP only, 16 of 21 eyes had cataracts, 13 of 21 eyes had anterior and posterior synechia, 3 eyes of 2 patients had keratopathy. 9 eyes which can be seen fundus had fundus scars, 2 of them had retina detachment. Conclusion Patients who have cytomegalovirus retinitis with acquired immune deficiency syndrome without anticytomegalovirus therapy will have poor visual prognosis, can cause the anterior segment lesions, in addition to the fundus lesions.
    Efficacy of aspheric photochromic intraocular lens implantation in cataract surgery of children
    ZHANG Jing-shang, WANG Jin-da, XIONG Ying, LI Jing, WAN Xiu-hua
    2016, 25(3):  199-201.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.012
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    Objective To compare the differences of contrast vision and color vision after implanting yellow intraocular lens (IOL) with aspheric photochromic IOL in cataract surgery in children. Design Retrospective case series. Participants 43 cases (56 eyes) with cataract who were treated by phacoemulsification and IOL implantation. Methods According to the different IOL, patients were divided into two groups: 26 eyes in the yellow IOL group, 30 eyes in the aspheric photochromic IOL group. All eyes were reviewed after 3 months postoperatively. Visual acuity, intraocular pressure (IOP), slit lamp examination, fundus, contrast vision and color vision were examed and compared in the two groups. Main Outcome Measures visual acuity, contrast vision and color vision. Results The postoperative uncorrected visual acuity and corrected visual acuity had no significant difference between two groups. The aspheric photochromic IOL group had the better contrast vision (0.21±0.14) than yellow IOL group(0.39±0.11) in 40 lux, 5% contrast conditions (P=0.001). The total error scores of FM 100 test were not significantly different between the two groups in the photopic conditions (outdoor sunshine and indoor 1000 lux), but the total error scores of the yellow IOL group(48.51±16.73) was significantly higher than that of the aspheric photochromic IOL group(31.25±11.39) in the mesopic conditions (40 lux) (P=0.003). Conclusion There were no significant difference of contrast vision between the yellow IOL and the aspheric photochromic IOL under the photopic conditions, and the aspheric photochromic IOL can provide the better contrast vision and color vision under the mesopic conditions.
    Effects of posterior chamber phakic intraocular lens implantation on binocular stereopsis
    CHEN Ni1, LI Zhi-min2, GU Hao2
    2016, 25(3):  202-205.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.013
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    Objective To observe the effects on the stereopsis after posterior chamber phackic implantable collamer lens (pICL) implantation. Design Retrospective case series. Participants 77 eyes of 40 myopia patients were involved, who were performed pICL implantation in Affiliated Hospital of Guizhou Medical University from October 2014 to October 2015. Methods Preoperative best corrected visual acuity (BCVA) and stereopsis were compared with uncorrected visual acuity (UCVA) and stereopsis postoperative 1 month and 3 month respectively. Main Outcome Measures UCVA、BCVA and stereopsis. Results UCVA and BCVA preoperatively was (0.06±0.06) and (0.85±0.22) respectively. Postoperative 1 month and 3 month, mean UCVA was(0.92±0.24)and(0.97±0.25) respectively. The UCVA of postoperative 1 month and 3 month were obviously improved comparison with the BCVA of preoperative (all P=0.000). The preoperative near stereopsis was no statistically significant difference from that at postoperative 1 month(P=0.259). The near tereopsis at the postoperative 3 month more significant improve than preoperatively (P=0.016). In the group of the anisometropia less than 2.50 D, the near stereopsis at the postoperative 3 month more significant improve than preoperatively (P=0.046). In the group of the anisometropia greater than or equal to 2.50 D,  there was no statistically significant difference when comparison of the near stereopsis vision between the two groups (P=0.343,0.158,0.774, respectively). The far stereopsis at the postoperative 1 month and postoperative 3 month were more significant improve than preoperatively (P=0.010, 0.000, respectively). In the group of the anisometropia less than 2.50 D, the far stereopsis at the postoperative 3 month were more siginificant improve than preoperatively(P=0.001). In the group of the anisometropia greater than or equal to 2.50 D , the far stereopsis at the postoperative 3 month more siginificant improve than preoperatively (P=0.009). Conclusion The pICL implantation can significantly reduce anisometropia and improve the vision acuity, the near and distance stereopsis.
    Survey of ophthalmologists’ cognition and practice on grading of evidence in evidence-based medicine
    SUN Yun-yun, LI Shi-ming, KANG Meng-tian, WANG Ning-li
    2016, 25(3):  206-211.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.014
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    Objective To survey the status of the cognition and attitude of grading of evidence  in evidence-based medicine in ophthalmologists. Design Questionnaire survey. Participants Two hundred and thirty-three ophthalmologists presented in the 18th Congress of Chinese Ophthalmological Society. Methods 233 ophthalmologists were surveyed by a self-made questionnaire, including their basic information and their cognition and attitude of grading of evidence in evidence-based medicine. Besides, comparison was made between different groups by educational degree, medical title, the level of their hospital, the type of their hospital and city respectively. Main Outcome Measure The cognition and attitude of grading of evidence. As for the cognition, both self-evaluation of the cognition of grading of evidence and the accuracy of concerned specific questions were included. Results A total of 233 questionnaires were distributed, and 214 valid questionnaires were returned (the rate of effective questionnaires is 91.8%).  48.3% of the respondents believe that we should base clinical practice on evidence based medicine while the traditional clinical practice is complementary. But 25.1% of them stand on the opposite side. The percentage of the respondents choosing “well known” about grading of evidence is only 1.3 while those who choose “not-known” or “poorly-known” account for 72.4%. The ophthalmologists with a higher degree or higher level of the hospital they work in evaluate themselves higher level of the acknowledge of grading of evidence. The accuracy of five questions about its details is 0.9, 41.3, 41.5, 6.9, 12.7 percent respectively. The comparison among groups by educational degree, medical title, the level of their hospital, the type of their hospital and city respectively is also consistent with the result above. Besides, 65.4% of respondents think the grading of evidence “vital” or “certain important” while nobody see it as no importance to clinical practice. Conclusion The current cognitions of ophthalmologists on grading of evidence is not very well but most of them have recognized the importance of it to clinical practice. Training about grading of evidence should be started from the stage of undergraduate on. Besides, it’s also emergent to take measures to promote the practicing of grading of evidence in clinic adequately.
    Glaucoma management of ambulatory surgery
    YU Min-bin, LIN Ming-kai, YANG Yang-fan
    2016, 25(3):  212-214.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.016
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    The application and standardized management of ambulatory surgery has obvious advantages to resolve the shortage of medical resources,increase medical efficiency and decrease medical costs in China. The characteristics of ophthalmic surgery, such as short operative time, quick recovery, good general condition of the patients, and small anesthesia risk (usually local anesthetic) etc., determine its necessity and superiority that the ophthalmic surgery can apply ambulatory surgery as the main management mode. This paper explores the feasibility and the specific management of glaucomatous ambulatory surgery, based on the current situation of ambulatory surgery in China.
    Educational application of WeChat in ophthalmic clinic practice
    FAN Wen-ying
    2016, 25(3):  215-216.  doi:10.13281/j.cnki.issn.1004-4469.2016.03.017
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    WeChat, a newly-developed social communicating software, could overcome the deficiency in traditional clinic education practice and promote the efficiency in clinic teaching by building up an bridge of information between the teachers and students through message publishing, real time teaching of classical cases, real time communication among doctors, and tele-consultation of intractable cases. Therefore, application of WeChat could improve the quality of teaching in clinic practice and facilitate the training for the interns.