Objective: To evaluate the agreement in spectacle parameter measurements between a digital device (Eye-ruler2) and a manual method (combination gauge). It also aimed to explore how these parameters affect corrective prescriptions and provide evidence and insights for achieving precision in spectacle fitting and enhancing visual quality. Methods: We enrolled 103 university students (aged 18-23 years) who were wearing spectacles from Guangzhou Xinhua University. The vertex distance, pantoscopic tilt, face form, and pupillary distance of their existing eyewear were measured using both Eye-ruler2 and a combination gauge. We applied the Martin formula and the vertex power formula to calculate the changes in prescription power induced by vertex distance, pantoscopic tilt, and face form. Results: The measurements obtained from Eye-ruler2 and the combination gauge demonstrated excellent agreement for pupillary distance (ICC=0.95), good agreement for left vertex distance (ICC=0.80) and right vertex distance (ICC=0.76), and moderate agreement for pantoscopic tilt (ICC=0.67). However, poor agreement was observed for face form (ICC=0.37). The total refractive power change in the prescription, calculated based on vertex distance, pantoscopic tilt, and face form, was (-0.12 ± 0.15)D. The individual parameter contributions (and their proportions) were as follows: Vertex distance:(-0.04±0.11)D (40.61%), Pantoscopic tilt: (-0.06±0.09)D (41.83%), Face form: (-0.01±0.01)D (16.57%); No significant difference was found between the contributions of pantoscopic tilt and vertex distance (P=0.851), and both being significantly greater than that of face form (all P<0.001). The baseline spherical equivalent positively correlated with refractive changes. Pantoscopic tilt dominated for prescriptions ≤-6.00 D, while vertex distance prevailed between -12.00 D and -6.00 D. Conclusions: Eye-ruler2 and the combination gauge demonstrated a high level of agreement in parameter measurements. Given its efficiency and user-friendliness, the digital technology is recommended to replace traditional methods for clinical use. Vertex distance and pantoscopic tilt have a significant impact on prescription power. Although face form has a minimal quantitative effect, it may induce against-the-rule astigmatism, which can compromise visual quality. For personalized spectacle fitting, it is essential to routinely measure vertex distance, pantoscopic tilt, and face form.
The ultrasound biomicroscope (UBM), leveraging the characteristics of high-frequency ultrasound (50-100 MHz), has overcome the limitations of optical examinations and emerged as a crucial tool for measuring and evaluating anterior segment structures. It is widely applied in various fields, including corneal diseases, glaucoma, cataracts, ocular trauma, and refractive surgery. However, several issues persist in current UBM parameter measurements: the lack of parameter standardization results in different names for the same parameter or inconsistent definitions for parameters with the same name; non-standardized measurement methods lead to poor comparability across different studies; and inadequate and non-detailed image quality standards affect measurement accuracy. These problems undermine the precision of measurements and constrain multi-center research and data interoperability. To address these challenges, this review systematically outlines standardized measurement methods for UBM parameters related to the cornea, anterior chamber, anterior chamber angle, iris, posterior chamber, lens and zonular fibers, and ciliary body. It also summarizes contradictions in parameter definitions across different studies. Furthermore, factors contributing to measurement errors are analyzed, including discrepancies between the assumed and actual sound velocities, interference from contact-based operation on the eyeball, variations in operator experience, and objective differences compared to measurements from other devices. Building on this analysis, we propose improvement strategies, such as establishing standardized examination protocols, clarifying parameter definitions and measurement methods, developing scenario-specific image quality standards, and implementing unified device calibration schemes. In the future, UBM parameter measurement is expected to achieve automated parameter measurement with the aid of artificial intelligence (AI). By integrating three-dimensional imaging technology and Doppler techniques, it will enhance the comprehensiveness of parameters and evolve toward intelligence and multi-dimensionality, providing more holistic support for precision ophthalmic diagnosis and treatment.
Objective: Glaucoma is the leading cause of irreversible blindness worldwide. This study aimed to use the Global Burden of Disease (GBD) 2021 database to analyze the epidemiological patterns of glaucoma-related blindness in the Chinese mainland from 1990 to 2021, providing evidence for the development of blindness prevention strategies. Methods: Data on glaucoma-related blindness and demographics information from the Chinese mainland were extracted from the GBD 2021 database. Joinpoint regression analysis was used to evaluate the temporal trends in the burden of glaucoma-related blindness.This was achieved by calculating the annual percentage change (APC), the average annual percentage change (AAPC), and their corresponding 95% confidence intervals (CI). Additionally, the age-period-cohort model was employed to assess the impacts of age, period, and cohort on the burden of blindness. This was done by calculating net drift, local drift, period relative risk, cohort relative risk, and fitted longitudinal age curves. Results: Between 1990 and 2021, the total number of cases of glaucoma-related blindness in the Chinese mainland increased. However, the prevalence rate of blindness decreased significantly, dropping from 56.83 cases per 100,000 population (uncertainty interval [UI]:45.93 to 69.96) in 1990 to 23.32 cases per 100,000 population (UI: 18.46 to 28.84) in 2021, with an AAPC of-2.63 (95% CI: -2.75 to -2.50, P<0.001). The burden of glaucoma-related blindness was higher among males than among females, but the decline in the prevalence of blindness was more marked in males. The risk of glaucoma-related blindness increased substantially with age, while risks associated with the period and cohort showed a decreasing trend. Conclusions: Since 1990, the burden of glaucoma-related blindness in the Chinese mainland has witnessed a significant reduction, which reflects the success of blindness prevention efforts. Continuously optimizing comprehensive strategies for eye health management is crucial to further reduce the incidence of blindness associated with glaucoma.
Objective: To present a case of refractory pediatric glaucoma that was successfully managed using carbon dioxide laser-assisted deep sclerectomy (CLASS) after gonioscopy-assisted transluminal trabeculotomy (GATT) failed. Additionally, it seeks to analyze the etiological factors contributing to postoperative intraocular pressure (IOP) elevation and review the current surgical strategies for pediatric refractory glaucoma. Methods: This case report details the clinical management of a 3-year-and-5-month-old male child with bilateral congenital glaucoma who had previously undergone trabeculectomy. The patient developed persistent IOP elevation following bilateral cataract surgery with intraocular lens implantation. Conservative treatment methods proved ineffective, leading to sequential GATT procedures. Although the IOP in the left eye stabilized after the GATT procedure, the right eye continued to exhibit refractory hypertension, despite the presence of patent anterior chamber angles on gonioscopy (with only minimal peripheral anterior synechiae observed). Subsequently, a CLASS procedure was performed on the right eye, with systematic monitoring of postoperative IOP changes and assessment of the scleral lake condition. Results: Over the 36-month follow-up period, the right eye maintained stable IOP levels (ranging from 16 to 20 mmHg) without any surgical complications or the need for antihypertensive medications. At the 2-month and 3-year postoperative follow-up visits, anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) revealed the presence of a well-formed scleral lake. Conclusions: The incidence of elevated IOP following cataract surgery is notably high in pediatric patients with glaucoma. When IOP remains uncontrolled after GATT, the choice of reoperation warrants careful consideration. In this case, the application of CLASS for refractory pediatric glaucoma with uncontrolled IOP after GATT achieved favorable outcomes, offering a new therapeutic approach for such patients.
Objective: To investigate the effects of a modified eye-patching technique, which combines the use of an eye shield on one eye and an eye patch on the other, on the quality of life and anxiety levels of strabismus patients during the recovery period after binocular correction surgery. Methods: A total of 80 patients who underwent bilateral strabismus correction as day surgery at our hospital between September and October 2024 were recruited for this study. Based on whether their admission week was odd or even, they were randomly assigned to two groups: the combined patching group (n=40) and the conventional patching group (n=40). In the combined patching group, patients wore a multiple-aperture plastic eye shield on the eye with fewer operated muscles or the dominant eye, while the other eye was covered with a conventional eye patch. In the conventional patching group, patients received bilateral eye patches. The primary outcome measure was vision-related quality of life on the first postoperative day. Secondary outcomes included the sleep quality score, pain score, conjunctival hyperemia and edema, incision appearance on the first postoperative day, and patient satisfaction one week after surgery. Results: There were no statistically significant differences in baseline characteristics, such as gender, age, preoperative strabismus status, or the number of operated muscles, between the two groups. Compared to the conventional patching group showed significantly better vision-related quality of life and sleep quality on the first postoperative day, as well as higher patient satisfaction one week after surgery (P<0.05). On the first postoperative day, there were no significant differences between the two groups in pain level, conjunctival hyperemia, incision appearance, or degree of strabismus improvement (P>0.05). Conclusions: The application of a modified eye-covering method, which combines an eye shield on one eye and an eye patch on the other, after bilateral strabismus correction surgery, can effectively enhance postoperative vision-related quality of life and sleep quality. Moreover, it can maintain recovery outcomes and increase patient satisfaction. This approach holds clinical value and is worthy of wider promotion.
Objective: To investigate the anterior segment parameters and the relative position of the ciliary process in patients with neovascular glaucoma (NVG), and to provide research data to support laser photocoagulation treatment of the ciliary body. Methods: A total of 14 patients diagnosed with NVG and 15 healthy control subjects were recruited in this study. All subjects underwent ophthalmic A-scan and ultrasound biomicroscopy (UBM) examinations to measure several parameters, including anterior chamber depth, lens thickness, axial length, angle between the trabecular and ciliary processes, angle between the trabecular meshwork and iris processes, height of the ciliary process, atrial angle opening distance, and the projection position of the ciliary process on the surface of the eye. The parameters were compared between the two groups. Results: Compared with the healthy control group, patients with NVG exhibited significantly smaller angle opening distances and trabecular-iris angle (P<0.05). No statistically significant differences were observed between the two groups in terms of the angle between the trabecular and ciliary processes and height of the trabecular ciliary process (P<0.05). Regarding the surface projection of the ciliary process, it was positioned more anteriorly in the NVG group (P<0.05). Additionally, no statistically significant differences were found in anterior chamber depth, lens thickness, axial length, or the relative position of the lens between NVG the two groups (P<0.05). Conclusions: Compared with healthy controls, patients with NVG have narrower anterior chamber angles and more anterior ciliary processes. UBM can be effectively used to measure the position of the ciliary process in NVG patients thereby providing personalized guidance for transscleral cyclophotocoagulation.
Objective: To identify key differentially expressed genes (DEGs) in retinoblastoma (RB) through bioinformatics methods. Subsequently, functional enrichment analysis, immune infiltration assessment, and sensitive drug prediction were carried out. Methods: Three RB gene expression microarray datasets were downloaded from the GEO database and merged. R software was employed to carry out a s series of analysis, including differential gene expression analysis, gene enrichment analysis, identification of key DEGs using machine learning algorithms, and immune infiltration analysis. Single-cell sequencing analysis was performed using the tumor immune single-cell hub (TISCH) database, and drug enrichment analysis was carried out based on the drug signature database (DSigDB) dataset. Results: A total of 556 DEGs were identified between tumor and normal samples. Gene Ontology (GO)/ Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that these genes were primarily involved in biological processes such as the p53 signaling pathway and cellular senescence. Weighted gene co-expression network analysis (WGCNA) combined with the support vector machine-recursive feature elimination (SVM-RFE) machine learning algorithms jointly identified 12 key feature genes. Among them, SALL1 was significantly upregulated, while ZNF385B was downregulated in tumor samples. Immune infiltration analysis revealed that M1 macrophages and nature killer (NK) cells were significantly enriched in RB tissues compared to normal controls. Single-cell analysis further confirmed the differential expression patterns of these key feature genes across distinct cell subtypes. Drug enrichment analysis predicted potential sensitive drugs, including glyburide, cyclophosphamide, azathioprine, and daidzein. Conclusions: The dysregulation of the 12 key feature genes is closely linked to the pathogenesis of RB and may exert a significant influence on the tumor immune microenvironment. These findings suggest that these genes hold potential as therapeutic targets for RB treatment.
Retinal astrocytes, as key elements of the neurovascular unit, fulfill a multitude of roles in preserving retinal homeostasis. These roles include providing structural support, supplying nutrients, facilitating metabolic waste clearance, and regulating immune responses. This review presents a systematic and in-depth exploration of their embryonic origin, molecular markers, as well as the fundamental disparities between them and Müller cells in terms of developmental origin, spatial distribution, and functional coupling. Under physiological conditions, astrocytes migrate outward to form a "honeycomb" - like template. This template acts as a guiding framework for the orderly migration of vascular endothelial cells, facilitating the establishment of the superficial vascular plexus. This is achieved through the secretion of N-cadherin, fibronectin, and laminin. The end-feet of astrocytes extensively wrap around the capillary basement membrane and are actively involved in the formation of the blood-retinal barrier. When it comes to nutrient supply, astrocytes take up glucose via glucose transporter type 1 (GLUT1). Subsequently, they generate lactate through aerobic glycolysis and store glycogen as an emergency energy reserve to meet potential demands. In terms of metabolic waste clearance, as the primary producers of glutathione in the retina, astrocytes are capable of eliminating reactive oxygen species and converting glutamate into non-toxic glutamine. This process effectively shields neurons from oxidative stress and excitotoxicity, thereby maintaining the normal function of the retinal neural network. Under pathological conditions, such as hypoxia and inflammation, astrocytes exhibit a dual role in either promoting or inhibiting retinal neovascularization (RNV). Hypoxia leads to the stabilization of hypoxia-inducible factor-1α (HIF-1α) and activates the nuclear factor kappa-B (NF-κB) pathway. This activation, in turn, promotes the release of factors like vascular endothelial growth factor-A (VEGF-A), fibroblast growth factor 2 (FGF2), interleukin-6 (IL-6), and matrixmetalloproteinase-2/9 (MMP-2/9), ultimately resulting in pathological RNV. On the contrary, astrocytes can also polarize into A2-type reactive astrocytes. These reactive astrocytes secrete thrombospondin-1 (TSP-1), pigment epithelium-derived factor (PEDF), and exosomes loaded with anti-angiogenic proteins. These secretions inhibit excessive vascular proliferation and facilitate orderly repair, thereby counteracting the pathological process of RNV. A more profound understanding of their precise regulatory mechanisms of retinal astrocytes may pave the way for the development of targeted RNV therapies. These potential therapies could involve strategies such as safeguarding the integrity of astrocyte network, reprogramming the phenotypes of reactive astrocyte, and utilizing exosome-based delivery systems to precisely modulate the biological functions of astrocytes and achieve effective treatment of RNV.
This paper proposes a standardized framework for the operation of a Flying Eye Hospital based on a domestically produced aircraft. This initiative, prompted by China's first successful ophthalmic surgery performed aboard an indigenous plane, addresses regional disparities in eyecare resources by mobilizing specialized medical services. The standard defines the roles of key components—the airborne hospital, ground base hospital, and mobile 5G clinics—and establishes integrated clinical pathways from preoperative to postoperative stages. It details coordination protocols between air and ground teams to ensure uniform quality, supported by a comprehensive safety and quality management system covering medical procedures, aircraft operations, and data security. Furthermore, it introduces a model for training local medical staff via live surgery broadcasts and hands-on instruction and outlines standardized procedures for international cooperation. This framework demonstrates a systematic approach for improving healthcare accessibility and building sustainable capacity through innovative service delivery, offering significant insights for mobile health initiatives globally.
Ferroptosis, a unique form of regulated cell death marked by iron-dependent lipid peroxidation, has attracted considerable attention in recent ophthalmic research due to its cruciall role in the pathogenesis of various ocular disorders. This process entails the build-up of lipid peroxides, which results in oxidative damage to cellular membranes and subsequent cell death. In the field of ophthalmology, ferroptosis has been implicated in the pathological mechanisms of several degenerative diseases, offering fresh insights into potential therapeutic interventions. Specifically, in retinal degenerative diseases, ferroptosis disrupts the balance between retinal cell survival and death, thereby accelearating disease progression. This mechanistic understanding has identified ferroptosis as a potential therapeutic target for alleviating retinal degeneration. Moreover, emerging evidence highlights the involvement of ferroptosis in the pathogenesis of ocular surface diseases. Advances in clarifying the regulatory mechanisms of ferroptosis, along with the development of targeted therapeutic strategies, have gradually revealed its significance and therapeutic potential in ocular surface pathologies. This review focuses on elaborating the roles of four common ferroptosis signaling pathways in the ferroptosis process: The System Xc-/GSH/GPX4 pathway inhibits ferroptosis by regulating glutathione synthesis and antioxidant activity; the FSP1/CoQ10/NAD(P)H pathway neutralizes lipid peroxidation free radicals independently of GPX4; the Nrf2/HO-1 pathway exerts a protective effect by regulating redox homeostasis and the expression of genes related to iron metabolism; the GCH1/BH4 pathway participates in ferroptosis regulation by modulating tetrahydrobiopterin synthesis. Additionally, the review offers a comprehensive overview of its intrinsic molecular mechanisms and crosstalk with inflammatory processes. It also summarizes recent progress in understanding ferroptosis in ocular surface diseases. Collectively, these insights pave the way for the development of innovative therapeutic approaches for corneal injury and other ocular surface disorders.
This standard defines a comprehensive data management and security framework for an innovative aircraft-based mobile ophthalmic hospital model. In alignment with the strategic direction outlined in China's 15th Five-Year Plan for National Economic and Social Development, particularly the promotion of deep integration between artificial intelligence and mobile healthcare, the framework focuses on the ground operational phase of airborne ophthalmic missions. It specifies technical requirements across four core dimensions: air-ground communication, medical data governance, AI application management, and information security. Within the communication architecture, the physical layer defines functional coverage, key performance parameters, and validation methods. The data link layer standardizes real-time transmission, storage backup, and quality control requirements for sensitive medical data, including ophthalmic imaging and electronic medical records. The application layer specifies deployment environments, validation procedures, and evaluation metrics for AI-assisted diagnostic algorithms. The security layer incorporates critical measures such as encrypted data transmission, logical network isolation, and secure data erasure, forming a defense-in-depth security architecture. A phased implementation strategy is adopted to ensure operability and adaptability within the complex aviation-medical environment. The framework enables improved accessibility and efficiency of primary eye care services while ensuring medical quality and patient data privacy through standardized governance, supporting the scalable development of interdisciplinary mobile medical services.
Objective: To observe the effect of TREK-TRAAK K2P activation on the phagocytic function of oxidative damaged human retinal pigment epithelial cells (RPE). Methods: Immunofluorescence staining was used to detect the expression of TREK-1, TREK-2 and TRAAK channel proteins in human RPE cells, and the RPE cell oxidative damage model was induced by tert-butyl hydroperoxide (t-BHP) at different time and concentration gradients. The study was divided into control group, t-BHP model group, riluzole plus t-BHP group, and riluzole group. 2×107/mL fluorescent microspheres or FITC-labeled porcine photoreceptor outer segment membrane discs were added to each group for 6h incubation, fluorescence photos were obtained after fixation and staining, and the phagocytosis rate and phagocytosis index of RPE cells was analyzed and calculated by Image-Pro Plus 6.0 software. Results: TREK-1, TREK-2, and TREEK channel subtype proteins were all highly expressed in the human RPE cytoplasm. The survival rate of human RPE cells after t-BHP intervention was concentration- and time-dependent. There was no statistical difference in the survival rate between 200 μmol/L t-BHP intervention for 6 hours and the control group (P>0.05), and 400 μmol/L t-BHP intervention for 6 hours induced half death. Specific phagocytic index: The t-BHP group was lower than other groups (P<0.001). Specific phagocytosis rate: the t-BHP group was lower than other groups, with no statistical difference (P>0.05).Nonspecific phagocytic index: the t-BHP group was lower than other groups (P<0.001); nonspecific phagocytic rate: the t-BHP model group was lower than the riluzole plus t-BHP group, with no statistical difference (P>0.05), and only the riluzole group was higher than the t-BHP model group (P<0.05) in pairwise comparison. Conclusions: Activation of TREK-TRAAK K2P can protect the phagocytic function of human RPE cells damaged by oxidative stress.
With the continuous advancement and innovative application of aviation medical technology, Flying Eye Hospital, as a novel and advanced model integrating aviation technology and medical services, is progressively gaining widespread recognition and practical implementation globally. The onboard operating room, serving as the most critical core component of Flying Eye Hospital, must not only fully meet the fundamental requirements of traditional ground-based operating rooms regarding functional design, standard procedures, and safe operation but also adequately address various complex factors inherent to the high-altitude environment, such as atmospheric pressure changes, temperature and humidity fluctuations, spatial constraints, and vibrations. Consequently, establishing a set of scientific, rational, systematic, rigorous, and operable construction standards and management specifications has become an urgent and critical priority in the field of aviation medicine. By elaborating on the architectural design, equipment configuration, personnel, materials, and environmental management—among other construction standards and normative management aspects—of the operating room within the flying eye hospital, this paper aims to promote the development and implementation of standards for onboard operating room construction. Such efforts will not only ensure the safety, precision, and success rates of ophthalmic surgeries conducted in flight but also significantly enhance the overall medical experience for patients during transport and treatment. Thereby, it will lay a solid foundation for the standardization, specialization, and high-quality development of the aviation medical industry, contributing to the continuous improvement of global public service and emergency response systems.
Objective: To investigate the application of environmentally-sustainable reagents in ophthalmic tissue pathology techniques. Methods: We prospectively collected 190 surgical specimens submitted to the pathology department of Zhongshan Ophthalmic Center between June 2023 and March 2024. Each specimen was divided into two sets, one treated with environmentally-sustainable reagents and the other with conventional reagents for fixation, dehydration, clearing, infiltration, staining, and mounting. The quality of histological sections from both groups was evaluated and compared. Results: Compared to the traditional reagent group, environmentally-sustainable reagent group showed good dehydration performance, moderately soft and hard tissue sections with intact cut surfaces and no cracks. H&E staining sections prepared with environmentally-sustainable reagents exhibited clear nuclear structures, distinct nuclear-cytoplasmic contrast, and clean backgrounds. The excellent section rates were 97.9% and 98.4% for the two, respectively. There was no significant difference in section quality between the two groups (Z=-0.645, P=0.519). Tissue antigenicity is well-preserved during immunohistochemical procedures, with strong positive signals and accurate localization without background staining. Conclusions: The use of environmentally-sustainable reagents as a replacement for conventional reagents in the dehydration and staining of ophthalmic tissue yields satisfactory results, meeting the daily requirements for routine histological sectioning and staining. The entire process is xylene-free, environmentally-sustainable, cost-effective and worth being applied widely.
Retinitis pigmentosa (RP) is an inherited retinal degenerative disease. Typical fundus changes associated with RP are characterized by bone-spicule-shaped pigment deposits, attenuated retinal vessels, and a waxy-pale appearance of the optic nerve. These changes lead to a range of visual impairments, including night blindness, vision loss, progressive loss of the peripheral visual field. Cataract is one of the most frequently occurring complications in patients with RP. It typically presents posterior subcapsular opacification, which can severely affect vision and often necessitates surgical intervention. However, RP patients frequently exihibit anatomical abnormalities, such as zonular dialysis or dehiscence, a shallow anterior chamber, and a narrow anterior chamber angle. These abnormalities place them a higher risk of developing angle closure glaucoma. Performing phacoemulsification in these patients is highly challenging, as there is a high incidence of complications. Moreover, the prognosis for visual acuity is often poor and difficult to predict precisely. In this review, we provide a comprehensive summary of the clinical characteristics of RP patients. We also conduct a thorough review of the preoperative evaluation process, preventive strategies for surgical complications, and postoperative follow-up procedure for cataract patients with RP. Our aim is to offer practical guidance for clinical practice.
The inaugural Guangdong Province Ophthalmology Resident Clinical Skills Competition was jointly organized by the Ophthalmologists Branch of the Guangdong Medical Association and Zhongshan Ophthalmic Center, Sun Yat-sen University in August 2024. This event drew participants from 30 ophthalmology residency training programs throughout Guangdong Province, with second- and third-year residents taking part. The competition was structured around four standardized stations: image interpretation, case analysis, basic clinical skills (including ocular medication administration and bandaging), and Wet lab surgery (specifically corneal and scleral wound repair). Through these stations, it provided a comprehensive and systematic assessment of the participants' overall clinical competencies in key areas such as imaging analysis, clinical reasoning, basic procedures skills, and microsurgical techniques. Not only did the competition evaluate the individual abilities of the participants, but also served as a significant indicator of the quality of residency training at each participating institution. Based on the teaching practices and competition experiences of Zhongshan Ophthalmic Center, Sun Yat-sen University, this article conducts a systematic analysis of the main issues that emerged during the competition regarding trainees' performance in anterior segment image interpretation, clinical reasoning, basic skills, and microsurgical techniques. Accordingly, we propose that teaching reforms should be promoted through the model of “using competitions to drive teaching and learning”. On the one hand, efforts should be directed towards enhancing the development of ophthalmic disease image databases, optimizing clinical teaching methods, standardizing skill operation protocols, and implementing systematic faculty training. On the other hand, competitions can be used to stimulate trainees' learning motivation, foster exchanges among training programs, and encourage the regular and multi-level organization of such competitions. This study provides valuable insights and practical directions for the continuous improvement of the quality of ophthalmic residency training. It may also serve as a useful reference for residency training competitions and teaching reforms in other medical specialties.
Objective: To explore the application of oxybuprocaine hydrochloride eye drops in early postoperative analgesic nursing for strabismus surgery under general anesthesia. Methods: A total of 82 patients who underwent strabismus correction surgery under general anesthesia at Zhongshan Ophthalmic Center, Sun Yat-sen University, from January to March 2025 were enrolled. Using a randomized double-blind method, the patients were divided into an observation group (41 cases) and a control group (41 cases). The Self-rating Anxiety Scale (SAS) was administered to both groups 30 minutes before surgery. In the control group, after surgery and upon removal of the laryngeal mask, one drop of normal saline was applied to the conjunctival sac of the operative eye, followed by sealing of the operative eye with tobramycin eye ointment. In the observation group, after surgery and upon removal of the laryngeal mask, one drop of oxybuprocaine hydrochloride eye drops was applied to the conjunctival sac of the operative eye, followed by sealing of the operative eye with tobramycin eye ointment. Both groups received postoperative analgesic nursing measures, including pain assessment, medication nursing, cognitive nursing, and psychological nursing. The Numerical Rating Scale (NRS) for pain at 30 minutes postoperatively, the incidence of postoperative complications, and patient satisfaction with the postoperative analgesic effect and analgesic nursing were compared between the two groups. The correlation between the SAS scores at 30 minutes preoperatively and the NRS scores at 30 minutes postoperatively was analyzed in both groups. Results: The NRS score in the observation group was 1 (0, 3) point, which was lower than the 3 (2, 3) points in the control group, with a statistically significant difference (P=0.001). There were no statistically significant differences in the incidence of postoperative operative eye pricking pain, operative eye tearing, or nausea between the two groups (P>0.05). The incidence of postoperative eye distension pain in the observation group was lower than that in the control group (P=0.001). There were no statistically significant differences in satisfaction with the postoperative analgesic effect or satisfaction with analgesic nursing between the two groups (P>0.05). A weak positive correlation was observed between the SAS scores at 30 minutes preoperatively and the NRS scores at 30 minutes postoperatively in both groups. Conclusions: After strabismus correction surgery under general anesthesia, the use of oxybuprocaine hydrochloride eye drops in the conjunctival sac can reduce the early postoperative pain score and the incidence of some postoperative complications, leading to greater patient satisfaction.
Topical ocular anesthesia is conducted by the instillation of topical anesthetics into the conjunctival sac to temporarily block sensory nerve conduction in the ocular surface area, thereby anesthetizing the area of cornea and conjunctiva. Now, topical anesthesia has become main important anesthetic method for day-case ophthalmic surgery. This expert consensus systematically elaborates on the clinical applications of topical anesthesia, including the characteristics and selection principles of commonly used topical anesthetics. It also emphasizes the types of ophthalmic surgeries which are suitable for topical anesthesia and outlines the standardized operational procedures in ophthalmic surgery, including preoperative assessment, administration methods, and efficacy evaluation. It also details measures for the prevention and management of complications and provides medication recommendations for special populations. The aim is to offer a safe and effective implementation guideline for topical anesthesia, promoting the rational application of topical anesthetics in ophthalmic surgery.
Objective: To explore management strategies and evaluate the effectiveness of improving the on-time start rate of the first ophthalmic day surgery through the implementation of a multi-disciplinary team (MDT) management model. It also seeks to identify optimal management practices to enhance overall operational efficiency. Methods: This single-center, retrospective, and controlled observational study utilized data from hospital information systems, operating room anesthesia management systems, DingTalk scheduling systems, and energy consumption systems. The study compared the punctuality rate of the first surgery between the pre-MDT implementation period (baseline: January 1, 2023 to December 31,2023) and the post-MDT intervention period (January 1, 2024 to December 31,2024). Secondary indicators included surgical volume, operating room utilization rate, nurses' overtime hours, and operating room energy consumption. The aim was to evaluate the effectiveness of the MDT management model in improving the punctuality rate of the first surgery in daytime surgeries. Results: Following the application of the MDT management model, the on-time start rate of the first surgery increased significantly from 77% to 90% (P<0.01). Despite a 7% increase in surgical volume and no change in staffing levels, nurse overtime hours decreased by 41%, and operating room energy consumption dropped by 7%. Conclusions: The establishment of an MDT collaborative mechanism effectively broke down traditional interdepartmental barriers, significantly improving the on-time start rate of first-day surgeries. This model enhanced operating room efficiency, facilitated the optimal allocation of medical resources, and provided a replicable management framework for ensuring the smooth, safe, and efficient execution of day surgeries.
Conjunctival sac irrigation is a fundamental ophthalmic procedure that is extensively employed for preoperative eye cleaning and disinfection, emergency management of chemical eye injuries, cleaning in cases of infectious eye diseases, and removal of foreign objects from the eye, among other applications. Due to substantial disparities in disease care and technical operations across provinces, cities, and regions nationwide, along with ongoing debates with domestic and international hospitals regarding various aspects of the implementation of conjunctival sac irrigation technology, a unified standard has yet been established, Consequently, clinical norms for this technology are still lacking. To ensure the safety and efficacy of the conjunctival sac flushing process and enhance the professional skills and quality of ophthalmic nursing staff, there is an urgent to develop technical specifications for conjunctival sac flushing that are tailored to different application scenarios. This can be achieved through scientific methods such as evidence-based nursing and expert demonstrations, thereby providing guidance and standardized benchmarks for the clinical implementation of conjunctival sac flushing. In response to this need, the Guangdong Nursing Society, in collaboration with multiple hospitals, issued the group standard "Technical Specification for Conjunctival Sac Rinsing" in December 2023. This standard aims to offer relevant guidance and requirements for different medical institutions to carry out conjunctival sac rinsing and to standardize the implementation process of conjunctival sac rinsing operation technology. This article integrates the research evidence and clinical practice process involved in formulating the group standard. It provides a comprehensive interpretation of the drafting background, significance, and main content of the standard. Additionally, it offers suggestions for its application, with the goal of promoting technological homogenization, standardize clinical nursing practices, and fostering the professionalization of ophthalmic nursing.
