Advances in ophthalmology practice and research最新文献_第2页

The efficacy of an irrigating eyelid retractor-facilitated ocular rinse on MMP-9 expression and dry eye disease 眼睑牵引器促进眼部冲洗对 MMP-9 表达和干眼症的功效

Advances in ophthalmology practice and research

Pub Date : 2024-05-20 DOI: 10.1016/j.aopr.2024.05.002

Natasha Mayer, Srinivas Sai A. Kondapalli, Nandini Venkateswaran, Hajirah N. Saeed

引用次数: 0

Evaluation and application of a Chinese version symptom questionnaire for visual dysfunctions (CSQVD) in school-age children 中文版学龄儿童视觉功能障碍症状问卷（CSQVD）的评估与应用

Advances in ophthalmology practice and research

Pub Date : 2024-05-11 DOI: 10.1016/j.aopr.2024.05.001

Fuyao Chen, Lixia Lou, Xiaoning Yu, Peike Hu, Weiyi Pan, Xuan Zhang, Xiajing Tang

Objective

To develop and evaluate a Chinese version of the Symptom Questionnaire for Visual Dysfunctions (CSQVD) to quantify visual dysfunction symptoms in school-age children with various eye diseases, and to explore the relationship between ophthalmological disorders and visual dysfunction symptoms.

Methods

Following standard scale adaptation procedures, the Symptom Questionnaire for Visual Dysfunctions (SQVD) was translated into Chinese (CSQVD). We employed random sampling to survey 198 outpatients aged 7–18 to assess the psychometric properties of the CSQVD. Using the reliable and validated questionnaire, we evaluated the determinants of visual dysfunction symptoms among 406 school-age patients at an eye center. The CSQVD scores were correlated with demographic and clinical variables, including gender, age, eye position, refractive power, and best-corrected visual acuity. Univariate analysis identified potential risk factors, followed by binary logistic regression and multiple linear regression analysis on factors with a P-value <0.05.

Results

The CSQVD scale's critical ratio (CR) values ranged from 6.028 to 10.604. The Cronbach's Alpha coefficient was 0.779, and Spearman-Brown split-half reliability was also 0.779. The I-CVI varied from 0.83 to 1.000, the S-CVI/Ave was 0.857, and the KMO value was 0.821. Multifactorial regression analysis indicated that high myopia (OR = 5.744, 95% CI [1.632, 20.218], P = 0.006) and amblyopia (OR = 9.302, 95% CI [1.878, 46.058], P = 0.006) were significant predictors of CSQVD symptoms. Multiple linear regression analysis showed that BCVA of amblyopic eyes (B = −5.052, 95% CI [−7.779, 2.325], P = 0.000) and SE power (B = −0.234, 95% CI [−0.375, 0.205], P = 0.001) significantly affected the CSQVD scale scores.

Conclusions

The Chinese version of the SQVD scale (CSQVD) demonstrates good feasibility, discriminatory power, validity, and reliability in assessing Chinese school-aged children. Furthermore, those who have severe myopia and amblyopia reported more visual dysfunction symptoms.

目的开发和评估中文版视觉功能障碍症状问卷（CSQVD），以量化患有各种眼疾的学龄儿童的视觉功能障碍症状，并探讨眼科疾病与视觉功能障碍症状之间的关系。方法按照标准量表改编程序，将视觉功能障碍症状问卷（SQVD）翻译成中文（CSQVD）。我们采用随机抽样的方法对198名7-18岁的门诊患者进行了调查，以评估CSQVD的心理测量学特性。利用这份可靠且经过验证的问卷，我们评估了眼科中心 406 名学龄儿童视功能障碍症状的决定因素。CSQVD 评分与人口统计学和临床变量（包括性别、年龄、眼位、屈光力和最佳矫正视力）相关。结果CSQVD量表的临界比率（CR）值介于6.028至10.604之间。Cronbach's Alpha 系数为 0.779，Spearman-Brown 分半信度也为 0.779。I-CVI 为 0.83 至 1.000，S-CVI/Ave 为 0.857，KMO 值为 0.821。多因素回归分析表明，高度近视（OR = 5.744，95% CI [1.632，20.218]，P = 0.006）和弱视（OR = 9.302，95% CI [1.878，46.058]，P = 0.006）是 CSQVD 症状的重要预测因素。多元线性回归分析显示，弱视眼的BCVA（B = -5.052，95% CI [-7.779, 2.325]，P = 0.000）和SE功率（B = -0.234，95% CI [-0.375, 0.205]，P = 0.001）对CSQVD量表评分有显著影响。此外，重度近视和弱视儿童报告的视功能障碍症状更多。

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引用次数: 0

TOC 技术选择委员会

Advances in ophthalmology practice and research

Pub Date : 2024-05-01 DOI: 10.1016/S2667-3762(24)00030-1

引用次数: 0

Association between glaucoma and stroke: A bidirectional mendelian randomization study 青光眼与中风之间的关系：双向孟德尔随机研究

Advances in ophthalmology practice and research

Pub Date : 2024-04-23 DOI: 10.1016/j.aopr.2024.04.003

Kai Wang , Xueqi Lin , Siting Sheng , Dan Chen , Xin Liu , Ke Yao

Purpose

Observational studies have reported positive associations between glaucoma and stroke; however, controversial results exist. Importantly, the nature of the relationship remains unknown since previous studies were not designed to test causality. Therefore, we aimed to investigate the possible causal relationships between glaucoma and stroke.

Methods

Our two-sample Mendelian randomization (MR) encompassed multi-ethnic large-scale genome-wide association studies with more than 20000 cases and 260000 controls for glaucoma, and more than 80000 cases and 630000 controls for stroke. Individual effect estimates for each SNP were combined using the inverse-variance weighted (IVW) method. To avoid potential pleiotropic effects, we adjusted the main results by excluding genetic variants associated with metabolic factors. The weighted median and MR-Egger methods were also used for the sensitivity analysis.

Results

Our MR analysis revealed that glaucoma and its subtypes, including primary open-angle glaucoma and primary angle-closure glaucoma, exhibited no causal role in relation to any stroke (AS), any ischemic stroke (AIS), large-artery atherosclerotic stroke (LAS), small-vessel stroke (SVS), or cardioembolic stroke (CES) across MR analyses (all P > 0.05). The null associations remained robust even after adjusting for metabolic-related traits and were consistent in both the European and Asian populations. Furthermore, reverse MR analyses also did not indicate any significant causal effects of AS, AIS, LAS, or CES on glaucoma risk.

Conclusions

Evidence from our series of causal inference approaches using large-scale population-based MR analyses did not support causal effects between glaucoma and stroke. These findings suggest that the relationship of glaucoma management and stroke risk prevention should be carefully evaluated in future studies. In turn, stroke diagnosis should not be simply applied to glaucoma risk prediction.

目的观察性研究报告了青光眼与中风之间的正相关关系，但结果存在争议。重要的是，由于以前的研究并不是为了检验因果关系而设计的，因此这种关系的性质仍然未知。因此，我们旨在研究青光眼与中风之间可能存在的因果关系。方法我们的双样本孟德尔随机化（MR）研究涵盖了多种族的大规模全基因组关联研究，其中青光眼有超过 20000 个病例和 260000 个对照，中风有超过 80000 个病例和 630000 个对照。采用逆方差加权法（IVW）合并了每个 SNP 的单个效应估计值。为避免潜在的多向效应，我们排除了与代谢因素相关的遗传变异，对主要结果进行了调整。结果我们的 MR 分析显示，在所有 MR 分析中，青光眼及其亚型（包括原发性开角型青光眼和原发性闭角型青光眼）与任何中风（AS）、任何缺血性中风（AIS）、大动脉粥样硬化性中风（LAS）、小血管中风（SVS）或心肌栓塞性中风（CES）均无因果关系（所有 P 均为 0.05）。即使在调整了代谢相关特征后，这种无效关联仍然很强，而且在欧洲和亚洲人群中都是一致的。此外，反向 MR 分析也未显示 AS、AIS、LAS 或 CES 对青光眼风险有任何显著的因果效应。这些发现表明，在未来的研究中应仔细评估青光眼管理与中风风险预防之间的关系。反过来，中风诊断也不应简单地应用于青光眼风险预测。

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引用次数: 0

Personalized treatment approaches in intraocular cancer 眼内癌的个性化治疗方法

Advances in ophthalmology practice and research

Pub Date : 2024-04-13 DOI: 10.1016/j.aopr.2024.03.005

Yating Liu , Alexander C. Rokohl , Yongwei Guo , Ke Yao , Wanlin Fan , Ludwig M. Heindl

Background

Intraocular malignant tumors represent a severe disease that threatens vision as well as life. To better extend the life of the patient, preserve visual function, and maintain ocular aesthetics, selecting the appropriate timing and methods of treatment becomes crucial.

Main text

With the continuous advancement of medical technology, the techniques and methods for treating intraocular malignant tumors are constantly evolving. While surgery was once considered the optimal method to prolong patient survival and prevent local recurrence, the discovery and application of various treatments such as radiotherapy, laser therapy, chemotherapy, cryotherapy, and monoclonal antibodies have led to a greater diversity of treatment options. This diversity offers more possibilities to develop personalized treatment plans, and thereby maximize patient benefit. This article reviews the various treatment methods for intraocular malignant tumors, including indications for treatment, outcomes, and potential complications.

Conclusions

Differentiating small intraocular malignant tumors from pigmented lesions is challenging, and ongoing monitoring with regular follow-up is required. Small to medium-sized tumors can be treated with radiotherapy combined with transpupillary thermotherapy. Depending on the tumor's distance from the optic disc, surgery with partial resection may be considered for distant tumors, while proximal tumors may require complete enucleation. Systemic chemotherapy has been widely applied to patients with retinal tumors, lymphomas, and intraocular metastatic cancers, but has limited efficacy in patients with choroidal melanoma. Antagonists of Vascular Endothelial Growth Factor (Anti-VEGF) drugs can improve patient vision and quality of life, while the efficacy of immunotherapy and molecular targeted therapy is still under research.

背景眼内恶性肿瘤是一种严重威胁视力和生命的疾病。正文随着医疗技术的不断进步，治疗眼内恶性肿瘤的技术和方法也在不断发展。手术曾被认为是延长患者生存期和防止局部复发的最佳方法，而放疗、激光治疗、化疗、冷冻治疗和单克隆抗体等各种治疗方法的发现和应用，使治疗方案更加多样化。这种多样性为制定个性化治疗方案提供了更多可能性，从而使患者受益最大化。本文回顾了眼内恶性肿瘤的各种治疗方法，包括治疗适应症、疗效和潜在并发症。结论将眼内小恶性肿瘤与色素性病变区分开来具有挑战性，需要定期随访进行持续监测。中小型肿瘤可采用放疗结合经瞳孔热疗的方法进行治疗。根据肿瘤与视盘的距离，远处的肿瘤可考虑手术部分切除，而近处的肿瘤可能需要完全去核。全身化疗已广泛应用于视网膜肿瘤、淋巴瘤和眼内转移性癌症患者，但对脉络膜黑色素瘤患者的疗效有限。血管内皮生长因子拮抗剂（Anti-VEGF）可改善患者的视力和生活质量，而免疫疗法和分子靶向疗法的疗效仍在研究中。

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引用次数: 0

Global incidence and prevalence of malignant orbital tumors 全球恶性眼眶肿瘤的发病率和流行率

Advances in ophthalmology practice and research

Pub Date : 2024-04-13 DOI: 10.1016/j.aopr.2024.04.002

Weina Zhang , Alexander C. Rokohl , Yongwei Guo , Ke Yao , Wanlin Fan , Ludwig M. Heindl

Purpose

Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide.

Methods

In this article, we retrieved orbital malignancy data from the MEDLINE database and analyzed the incidence and prevalence of orbital malignancies worldwide. We performed the literature search by searching on the Mesh terms for malignant orbital tumors ("orbital", "tumor", "lymphoma", "malignant", "cancer", "incidence", and "epidemiology"). All included studies were published between 1993 and 2023 and were written in English.

Results

Ocular or ophthalmic lymphoma most frequently occurred in the orbit, with a prevalence ranging from 47% to 54%. The incidence of malignant orbital tumors was increasing in the USA (2.0 per million (1981–1993), Netherlands (0.86 (1981–1985) to 2.49 (2001–2005) per million) and South Korea (0.3–0.8 per million (1999–2016)), respectively. Ophthalmic lymphoma which includes orbit lymphoma was increasing in Canada (0.17–1.47 per million (1992–2010)), Denmark (0.86 per million (1981–1985) to 2.49 per million (2001–2005)), respectively.

Conclusions

The predominant primary malignant orbital tumor in adults was lymphoma. Ocular or ophthalmic lymphoma most frequently occured in the orbit. The limited data available suggested an increasing trend in the incidence of malignant orbital tumors in each country included, which were mainly attributed to the increase in lymphoma. Generally, incidence rates were found to increase with advancing age, with no difference between males and females.

目的通过分析全球不同地区基于人群的发病模式，概述当代眼眶恶性肿瘤的流行病学。方法本文从 MEDLINE 数据库中检索眼眶恶性肿瘤数据，分析全球眼眶恶性肿瘤的发病率和流行率。我们以眼眶恶性肿瘤的 Mesh 关键词（"眼眶"、"肿瘤"、"淋巴瘤"、"恶性"、"癌症"、"发病率 "和 "流行病学"）进行文献检索。结果眼眶或眼部淋巴瘤最常发生在眼眶，发病率为 47% 至 54%。美国（1981-1993年）、荷兰（1981-1985年）和韩国（2001-2005年）的恶性眼眶肿瘤发病率分别为每百万人2.0例、每百万人0.86例和每百万人2.49例，1999-2016年为每百万人0.3-0.8例。包括眼眶淋巴瘤在内的眼眶淋巴瘤在加拿大（每百万人中有0.17-1.47例（1992-2010年））、丹麦（每百万人中有0.86例（1981-1985年）至2.49例（2001-2005年））分别呈上升趋势。眼部或眼眶淋巴瘤最常发生在眼眶。现有的有限数据表明，每个国家的恶性眼眶肿瘤发病率都呈上升趋势，这主要归因于淋巴瘤的增加。一般来说，发病率随着年龄的增长而增加，男女之间没有差异。

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引用次数: 0

Advances in ophthalmology practice and research

Pub Date : 2024-04-05 DOI: 10.1016/j.aopr.2024.04.001

Xiaojun Ju , Alexander C. Rokohl , Xueting Li , Yongwei Guo , Ke Yao , Wanlin Fan , Ludwig M. Heindl

Purpose

To explore the role of ultraviolet radiation (UVR) in the occurrence and development of various ocular malignancies.

Methods

In this article, we retrieved ocular malignancy data from the Global Cancer Observatory (GCO) and performed correlation analysis with the global UV index and sunshine duration. We searched for associated studies using the following databases: Embase, Pubmed, Cochrane Library, and Google Scholar. We conducted the literature by searching the Mesh terms denoting an exposure of interest ("UV radiation", "ultraviolet rays", and "ocular malignancies", All studies included are published until December 30, 2023 without language restrictions.

Results

The mechanisms and epidemiological statistics of UVR on the onset and progression of eyelid malignancies are the most studied and clear. The role of UVR in conjunctival melanoma is similar to that in eyelid melanoma. The relationship between uveal melanoma and UVR is controversial, however, it may have at least a certain impact on its prognosis. UVR causes ocular surface squamous neoplasia by further activating HPV infection.

Conclusions

UVR is a decisive risk factor for ocular malignancies, but the incidence of ultraviolet-induced tumors is also affected by many other factors. A correct and comprehensive understanding of the mechanisms of UVR in the pathogenesis of ocular malignant tumors can provide patients with more effective and selective immune regulation strategies.

目的探讨紫外线辐射（UVR）在各种眼部恶性肿瘤的发生和发展中的作用。方法本文检索了全球癌症观测站（GCO）的眼部恶性肿瘤数据，并对全球紫外线指数和日照时间进行了相关分析。我们使用以下数据库搜索相关研究：Embase、Pubmed、Cochrane Library 和 Google Scholar。结果紫外线对眼睑恶性肿瘤发病和进展的机制和流行病学统计是研究得最清楚、最明确的。紫外线辐射在结膜黑色素瘤中的作用与眼睑黑色素瘤相似。葡萄膜黑色素瘤与紫外线辐射之间的关系尚存争议，但至少可能对其预后有一定影响。结论紫外线辐射是眼部恶性肿瘤的决定性危险因素，但紫外线诱发肿瘤的发病率还受到许多其他因素的影响。正确、全面地认识紫外线辐射在眼部恶性肿瘤发病机制中的作用，可以为患者提供更有效、更有选择性的免疫调节策略。

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引用次数: 0

Ocular surface heat flux density as a biomarker related to diabetic retinopathy (pilot study) 作为糖尿病视网膜病变相关生物标志物的眼表面热通量密度（试点研究）

Advances in ophthalmology practice and research

Pub Date : 2024-03-26 DOI: 10.1016/j.aopr.2024.03.004

Lukyan Anatychuk, Roman Kobylianskyi, Oleg Zadorozhnyy, Taras Kustryn, Illia Nasinnyk, Andrii Korol, Nataliya Pasyechnikova

引用次数: 0

Integration of smartphone technology and artificial intelligence for advanced ophthalmic care: A systematic review 将智能手机技术与人工智能整合用于高级眼科护理：系统回顾

Advances in ophthalmology practice and research

Pub Date : 2024-03-25 DOI: 10.1016/j.aopr.2024.03.003

Kai Jin , Yingyu Li , Hongkang Wu , Yih Chung Tham , Victor Koh , Yitian Zhao , Ryo Kawasaki , Andrzej Grzybowski , Juan Ye

Background

The convergence of smartphone technology and artificial intelligence (AI) has revolutionized the landscape of ophthalmic care, offering unprecedented opportunities for diagnosis, monitoring, and management of ocular conditions. Nevertheless, there is a lack of systematic studies on discussing the integration of smartphone and AI in this field.

Main text

This review includes 52 studies, and explores the integration of smartphones and AI in ophthalmology, delineating its collective impact on screening methodologies, disease detection, telemedicine initiatives, and patient management. The collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases, glaucoma, cataract, visual impairment in children and ocular surface diseases. Moreover, the utilization of smartphone-based imaging modalities, coupled with AI algorithms, is able to provide timely, efficient and cost-effective screening for ocular pathologies. This modality can also facilitate patient self-monitoring, remote patient monitoring and enhancing accessibility to eye care services, particularly in underserved regions. Challenges involving data privacy, algorithm validation, regulatory frameworks and issues of trust are still need to be addressed. Furthermore, evaluation on real-world implementation is imperative as well, and real-world prospective studies are currently lacking.

Conclusions

Smartphone ocular imaging merged with AI enables earlier, precise diagnoses, personalized treatments, and enhanced service accessibility in eye care. Collaboration is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations, promising a potential revolution in care access and global eye health equity.

背景智能手机技术与人工智能（AI）的融合彻底改变了眼科医疗的面貌，为眼科疾病的诊断、监测和管理提供了前所未有的机遇。正文本综述包括 52 项研究，探讨了智能手机和人工智能在眼科领域的融合，描述了其对筛查方法、疾病检测、远程医疗计划和患者管理的共同影响。汇总研究结果表明，基于智能手机的人工智能筛查在各种眼科疾病（包括主要视网膜疾病、青光眼、白内障、儿童视力障碍和眼表疾病）的筛查中表现出色。此外，基于智能手机的成像模式与人工智能算法相结合，能够提供及时、高效和具有成本效益的眼部病变筛查。这种模式还能促进患者自我监测、远程患者监测，并提高眼科护理服务的可及性，尤其是在服务不足的地区。涉及数据隐私、算法验证、监管框架和信任问题的挑战仍有待解决。此外，对真实世界的实施情况进行评估也势在必行，而目前还缺乏真实世界的前瞻性研究。结论智能手机眼部成像与人工智能相结合，可实现更早的精确诊断、个性化治疗，并提高眼科护理服务的可及性。要想在负责任地利用这些创新技术的同时应对伦理和数据安全方面的挑战，合作是至关重要的。

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引用次数: 0

Application of sentiment and word frequency analysis of physician review sites to evaluate refractive surgery care 应用医生评论网站的情感和词频分析评估屈光手术护理

Advances in ophthalmology practice and research

Pub Date : 2024-03-07 DOI: 10.1016/j.aopr.2024.03.002

Victoria Vought , Rita Vought , Andrew S. Lee , Irene Zhou , Mansi Garneni , Steven A. Greenstein

Background

Online physician reviews increase transparency in health care, helping patients make informed decisions about their provider. Language processing techniques can quantify this data and allow providers to better understand patients' experiences, perspectives, and priorities. The objective of this study was to assess patient satisfaction and understand the aspects of care that are valued by patients seeking refractive care using sentiment and word frequency analysis.

Methods

Written reviews and Star ratings for members of the Refractive Surgery Alliance Society practicing in the United States were collected from Healthgrades, a popular physician rating website. Surgeons with at least one written review were included in the study. Reviews were scored from -1 (most negative) to +1 (most positive) using Valence Aware Dictionary sEntiment Reasoner (VADER). Reviews were stratified by demographic characteristics, namely gender, region, and years in practice. Word frequency analysis was applied to find the most common words and phrases.

Results

A total of 254 specialists and 3104 reviews were analyzed, with an average of 4.4/5 stars and mean 48 ratings each. Most physicians had positive reviews (96%, average VADER = 0.69). Younger physicians (<20 years since residency) had significantly higher Stars rating than senior peers (>20 years) (P < 0.001). A similar trend was observed in VADER score (0.71 vs 0.69), although not statistically significant (P = 0.06). No statistical differences were observed between Stars rating and VADER score by gender (P = 0.66, P = 0.83) or by geographical region (P = 0.74, P = 0.07). "Staff" (n = 1269), "professional" (n = 631), "office" (n = 523), "questions" (n = 424), and "friendly" (n = 386) were frequently used in reviews, along with phrases such as "the staff" (n = 273) and "my questions" (n = 174). "Surgery" (n = 719), "staff" (n = 576), "procedure" (n = 251), "experience" (n = 243), and "professional" (n = 240) were the most common words in positive reviews, while "surgery" (n = 147), "office" (n = 86), "staff" (n = 54), "time" (n = 47), and "insurance" (n = 28) were the most commonly used in negative reviews.

Conclusions

Both the average Stars and VADER sentiment score suggest a high satisfaction among refractive patients. Word frequency analysis revealed that patients value non-clinical aspects of care, including interactions with staff, insurance coverage, and wait-times, suggesting that improving non-clinical factors could enhance patient satisfaction with refractive surgery.

背景在线医生评论提高了医疗保健的透明度，有助于患者对其医疗服务提供者做出明智的决定。语言处理技术可以量化这些数据，让医疗服务提供者更好地了解患者的经历、观点和优先事项。本研究的目的是通过情感和词频分析来评估患者的满意度，并了解寻求屈光治疗的患者所重视的医疗服务方面。至少有一篇书面评论的外科医生被纳入研究范围。评论采用 Valence Aware Dictionary sEntiment Reasoner (VADER) 从-1（最负面）到+1（最正面）进行评分。根据性别、地区和从业年限等人口统计学特征对评论进行了分层。结果共分析了 254 位专家和 3104 条评论，平均 4.4/5 星级，平均 48 条评论。大多数医生都有好评（96%，平均 VADER = 0.69）。年轻医生（实习期满 20 年）的 Stars 评分明显高于资深医生（20 年）（P <0.001）。VADER 评分也有类似趋势（0.71 vs 0.69），但无统计学意义（P = 0.06）。按性别（P = 0.66，P = 0.83）或地理区域（P = 0.74，P = 0.07）划分，"星星 "评分和 VADER 分数之间没有统计学差异。评论中经常使用 "工作人员"（n = 1269）、"专业"（n = 631）、"办公室"（n = 523）、"问题"（n = 424）和 "友好"（n = 386），以及 "工作人员"（n = 273）和 "我的问题"（n = 174）等短语。"手术"（n = 719）、"工作人员"（n = 576）、"程序"（n = 251）、"经验"（n = 243）和 "专业"（n = 240）是正面评论中最常用的词语，而 "手术"（n = 147）、"办公室"（n = 86）、"工作人员"（n = 54）、"时间"（n = 47）和 "保险"（n = 28）则是负面评论中最常用的词语。结论平均星级和 VADER 情感评分都表明屈光患者的满意度很高。词频分析表明，患者重视护理的非临床方面，包括与工作人员的互动、保险范围和等待时间，这表明改善非临床因素可以提高患者对屈光手术的满意度。

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引用次数: 0