ABSTRACT
Objective:To compare and observe the curative effect of different body positions after pars plana vitrectomy (PPV) combined with inert gas filling for rhegmatogenous retinal detachment (RRD).Methods:A retrospective clinical study. From October 2019 to September 2021, 192 eyes of 192 RRD patients who were diagnosed and received PPV combined with inert gas filling in Qingdao Eye Hospital of Shandong First Medical University were included in the study. Best corrected visual acuity (BCVA), intraocular pressure, ultra-wide-angle fundus photography, optical coherence tomography, and B-mode ultrasonography were performed in all affected eyes. The BCVA examination was performed using a standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the post-operative position requirements, the affected eyes were divided into the face-down positioning group and the adjustable positioning group, with 97 eyes in 97 patients and 95 eyes in 95 patients, respectively. Age ( Z=0.804), course of disease ( Z=-0.490), eye type ( χ2=0.175), logMAR BCVA( Z=-0.895), intraocular pressure ( Z=0.178), lens status ( χ2=1.090), number of detached clocks ( Z=0.301) and macular involvement ( χ2=0.219), number of holes ( Z=-1.051) and number of lower holes ( χ2=0.619) were compared, there was no significant difference ( P>0.05). The gender composition ratio was compared, and the difference was statistically significant ( χ2=5.341, P<0.05). The follow-up time after surgery was more than 3 months. The retinal reattachment rate in one operation, the improvement of BCVA and the incidence of complications were observed. The independent sample Mann-Whitney test was used for the comparison of continuous variables between groups; the χ2 test was used for the comparison of categorical variables. Results:In the face-down positioning group and the adjustable positioning group, retinal reattachment in one operation was performed in 92 (94.8%, 92/97) and 89 (93.7%, 89/95) eyes, respectively; logMAR BCVA was 0.45±0.34, 0.41±0.21. There was no significant difference in the retinal reattachment rate in one operation ( χ2=0.120, P=0.729) and logMAR BCVA ( Z=-0.815, P=0.416) between the two groups. After surgery, the intraocular pressure increased in 11 (11.3%, 11/97) and 5 (5.3%, 5/95) eyes in the face-down positioning group and the adjustable positioning group, respectively; the secondary epimacular membrane was 2 (2.1%, 2/97), 3 (3.2%, 3/95) eyes. There was no significant difference in the incidence of elevated intraocular pressure and secondary epimacular membrane between the two groups after surgery ( χ2=2.320, 0.227; P=0.128, 0.634). Conclusion:It is safe and effective to adopt adjustable positioning after PPV combined with inert gas filling for RRD, which is equivalent to the effect of face-down positioning.
ABSTRACT
Objective:To explore the aging care willingness and requirements for long-term care services among elderlies with different activity of living(ADL).Methods:7 070 elderlies aged 60 years and above were subject to a questionnaire survey using stratified multistage random cluster sampling in three municipalities of Shandong province from August through September, 2017. Data information was obtained by a customized questionnaire and ADL scale. Rank sum test and multivariate logistic regression were used for statistical analysis.Results:According to the ADL scoring, the participants were divided into 3 groups: normal, decreased function, and dysfunction, with 5 467(77.3%), 1 283(18.2%), and 320(4.5%)people respectively. Elderlies with different ADL had different aging care willingness, and the difference was statistically significant( Z=8.704, P<0.05). The factors influencing long-term care services need varied with the degree of ADL. The willingness was a common factor for long-term care services needs of the three elderly groups. The age and living arrangements were factors among the normal ADL group. The living arrangements and chronic diseases were those among the decreased function group, and the education and self-rated economic status were those among the dysfunction group. Conclusions:The demand for long-term care service were diversified with the degree of ADL. Targeted interventions should be taken to meet the needs of elderlies of different ADL.