ObjectiveTo evaluate the effectiveness of using a six-dimensional eye-tracking system during femtosecond laser-assisted sub-Bowman keratomileusis (FS-SBK) surgery to correct myopia and astigmatism. MethodsA total of 23 patients (36 eyes) with ametropia undergoing FS-SBK were retrospectively analyzed and divided into the static cyclotorsion control (SCC) group (11 patients, 20 eyes) and the non-SCC group (12 patients, 16 eyes). According to the static eyeball rotation degrees, the SCC group was further divided into three subgroups: within ±2° group (5 patients, 9 eyes), ±2°-±5° group (4 patients, 7 eyes), and above ±5° group (2 patients, 4 eyes). The preoprative and postoperative one-month uncorrected visual acuity, best corrected visual acuity, diopter of spherical power, diopter of cylindrical power, corneal curvature, and the rotating degree in SCC were observed; the root-mean-square values of the total higher-order aberrations, spherical aberration, coma, Strehl ratio, etc. when the pupil diameter was 6.5 mm were extracted; and the therapeutic efficacy was observed. ResultsNo severe intraoperative or postoperative complications occurred in any subject. The effectiveness index of the SCC group was 0.947±0.145, and that of the non-SCC group was 1.005±0.141, with no statistically significant difference (P>0.05). Compared with the preoperative levels, in the two groups, the postoperative uncorrected visual acuity was significantly elevated; the postoperative diopter of spherical power, diopter of cylindrical power, and corneal curvature difference were reduced; the postoperative total higher-order aberrations, spherical aberration, and coma increased; all the differences mentioned above were statistically significant (P<0.05). In the SCC group, the difference between the preoperative and the postoperative Strehl ratio was statistically significant (P<0.05). There was no significant difference in postoperative indicators between the SCC group and the non-SCC group (P>0.05). The difference in postoperative increment of coma between the SCC group and the non-SCC group was statistically significant (P<0.05). In the SCC group, no statistically significant difference was found in postoperative increment of any indicator among the three subgroups (P<0.05). ConclusionsFS-SBK of six-dimensional eye-tracking system is effective in correcting myopia and astigmatism. FS-SBK can reduce lower-order aberrations while introducing higher-order aberrations, and whether SCC is performed intraoperatively is meaningless.
ObjectiveTo investigate whether the corneal shape recovered after discontinuation of long-term orthokeratology and whether orthokeratology increased the corneal astigmatism and ocular astigmatism.MethodsFrom December 2016 to April 2018, a retrospective study was conducted on 33 myopic patients who had undergone two times standard orthokeratology in the outpatient department of West China Hospital of Sichuan University, and had stopped wearing the first orthokeratology lens for one month before fitting the second orthokeratology lens. A total of 32 myopia frame glasses wearers were selected by simple random sampling as control. The changes of corneal flat meridian curvature (flat K), corneal steep meridian curvature (steep K), corneal astigmatism and ocular astigmatism before and after discontinuation of orthokeratology were analyzed.ResultsAmong the patients with baseline myopia diopter of −0.25～−2.75 D, the average annual change of corneal flat K was (−0.03±0.21) D in the frame glasses group and (−0.24±0.14) D in the orthokeratology group, the difference was statistically significant (t=5.555, P<0.001). Among the patients with baseline myopia diopter of −0.25～−2.75 D, the average annual change of corneal steep K was (0.20±0.42) D in the frame glasses group and (0.15±0.20) D in the orthokeratology group, the difference was not statistically significant (t=0.785, P=0.435). Among the patients with baseline myopia diopter of −3.00～−5.75 D, the average annual change of corneal steep K was (0.29±0.39) D in the frame glasses group and (−0.01±0.20) D in the orthokeratology group, the difference was statistically significant (t=2.758, P=0.014). The average changes of corneal astigmatism were analyzed according to the difference of eyes, gender, age and baseline corneal astigmatism, the difference was not statistically significant (P>0.05), respectively. For patients with baseline astigmatism absolute value less than or equal to 0.50 D, the astigmatism annual change of the frame glasses group was 0.00 (0.50) D, and that of orthokeratology group was −0.33 (0.48) D, the difference was statistically significant (Z=−2.301, P=0.021).ConclusionsThe flat K of the cornea becomes flatter and the steep K does not change after one month’s discontinuation of long-term orthokeratology. There was no difference in the increase of corneal astigmatism compared with those wearing frame glasses. When the baseline ocular astigmatism is less than or equal to 0.50 D, the increase of astigmatism may occur after discontinuation of orthokeratology.
Objective To explore the relation between stigma and substance use of patients with substance use disorder and explore the impact of learning addiction medicine massive open online course (MOOC) on patients’ stigma, depression and anxiety. Methods Patients with substance use disorder in Meishan Detoxification Center from January 11 to 18, 2020 were selected. The patients were randomly divided into control group and teaching group. Both groups participated in regular labor reform while the teaching group attended extra MOOC course. The general demographic data and the duration and amount of substance use were collected before intervention. Before and after intervention, all the patients completed scales including Chinese Version of Substance Use Stigma Mechanisms Scale (SUSMS-C), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS). The correlation between stigma and depression, anxiety, substance use characteristics were analyzed, as well as the changes of stigma, depression and anxiety before and after MOOC intervention.Results A total of 78 patients were included, including 41 in the control group and 37 in the teaching group. There was no correlation between the scores of SUSMS-C and the duration or amount of substances use (P>0.05). SAS score and SDS score were positively correlated with the total score of stigma, internalized stigma, enacted stigma (family) and enacted stigma (healthcare providers) (P<0.05). SDS scores and SAS scores had no correlation with the anticipated stigma (P>0.05). After intervention, the total score of stigma, anticipated stigma (family) and anticipated stigma (healthcare providers) in the teaching group decreased (P<0.05). In the control group, only anticipated stigma (family) decreased (P=0.047). There was no significant difference in other SUSMS-C items, SAS scores, or SDS scores between the two groups before and after intervention (P>0.05). Conclusions Stigma may not be able to protect patients with substance use disorder from using substances. Instead, stigma may potentially cause negative emotional consequences like depression and anxiety. The addiction medicine MOOC can be used as an intervention to reduce the stigma of patients with substance use disorder.
Objective To understand the incidence of stigma in non-dialysis chronic kidney disease (CKD) patients, and to explore its influencing factors, so as to provide a basis for scientific management of non-dialysis CKD patients. Methods Convenience sampling method was used to select non-dialysis CKD patients hospitalized in the Department of Nephrology, West China Hospital, Sichuan University between December 2019 and December 2020 as the research subjects. The general information questionnaire, Social Impact Scale and Social Support Rating Scale were used to investigate, and logistic regression analysis was used to explore the influencing factors of stigma in CKD patients without dialysis. Results A total of 300 questionnaires were distributed in this study, and 272 valid questionnaires were recovered, with an effective recovery rate of 90.67%. The age of the patients ranged from 15 to 83 years old, with an average of (38.34±13.64) years old. The disease course ranged from 1 month to 18 years, with a median of 3 years. The patients’ stigma score ranged from 23 to 86 points, with an average score of (40.14±1.67) points, of which 101 patients had a score of ≥48 (with stigma), accounting for 37.13%. Logistic regression analysis showed that gender [odds ratio (OR)=1.871, 95% confidence interval (CI) (1.018, 3.347), P=0.042], place of residence [OR=2.991, 95%CI (1.645, 5.824), P=0.001], personal monthly income [OR=0.575, 95%CI (0.260, 0.857), P=0.013], received CKD self-management education or not [OR=0.468, 95%CI (0.258, 0.843), P=0.011], and social support level [OR=0.418, 95%CI (0.230, 0.737), P=0.003] were influencing factors of stigma in CKD patients without dialysis. Conclusion The stigma of non-dialysis CKD patients is at a moderate level. Female, living in rural areas, personal monthly income ≤ 3000 yuan, not receiving CKD self-management education, and low social support level are risk factors for stigma in non-dialysis CKD patients.
ObjectiveTo compare the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing, and to investigate the effects of different orthokeratology design on corneal astigmatism.MethodsThe medical records of myopic adolescent patients who have been prescribed spherical and toric orthokeratology in the contact lens clinic of West China Hospital, Sichuan University between January 2019 and December 2021 were analyzed retrospectively.The differences of corneal astigmatism changes after wearing spherical and toric orthokeratology for a long time and one month discontinuation were compared. The influencing factors of corneal astigmatism changes were analyzed. ResultsA total of 156 patients were included. There were 76 cases (76 eyes) in spherical orthokeratology group and 80 cases (80 eyes) in toric orthokeratology group. There was no significant difference between the two groups in age, gender, baseline myopia diopter and total lens wearing time (P>0.05). There were statistically significant differences between the spherical orthokeratology group and the toric orthokeratology group in the baseline corneal flat K value [42.1 (41.3, 43.3) vs. 43.1 (42.0, 44.1) D], baseline corneal steep K value [(43.4±1.3) vs. (44.6±1.5) D], baseline corneal astigmatism [(1.1±0.5) vs. (1.6±0.6) D], and baseline total eye astigmatism [−0.6 (−1.2, 0.0) vs. −1.4 (−1.8, −1.0) D] before wearing the orthokeratology (P<0.05). Compared with the baseline value, 1 month after the two groups stopped wearing the orthokeratology, the corneal flat K values became flatter [spherical orthokeratology group: 42.09 (41.28, 43.34) vs. 41.73 (40.98, 43.16) D, toric orthokeratology group: 43.09 (41.95, 44.10) vs. 42.61 (41.52, 43.56) D; P<0.05], the changes of corneal steep K values were not statistically significant (P>0.05), but the corneal astigmatism values increased [spherical orthokeratology group: (1.05±0.49) vs. (1.37±0.56) D, toric orthokeratology group: (1.62±0.57) vs. (1.99±0.63) D; P<0.05]. There was no significant difference in the changes of corneal flat K value, corneal steep K value and corneal astigmatism between the two groups (P>0.05). Multivariate analysis showed that age (P=0.011) and the total duration of orthokeratology wearing (P=0.004) were the main factors affecting the changes of corneal astigmatism. ConclusionAfter 1 month of non-wearing, the flat K value of the cornea becomes flat, the steep K value remains unchanged, and the corneal astigmatism increases. There is no difference in the effect of the spherical and toric orthokeratology on corneal astigmatism. The change of corneal astigmatism is related to the patient’s age and the total duration of wearing the orthokeratology. The younger the age, the longer the duration of orthokeratology wearing, the more significant the increase of corneal astigmatism after stopping wearing the orthokeratology.