Vision & the Ageing Surgeon: A Review.

IF 1.6 4区 医学 Q3 SURGERY
Lloyd R Kopecny, Ashish Agar, Shing Wai Wong
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Abstract

Populations in the developed world are ageing and their surgeons are no exception. Accurate vision is essential for the surgeon to operate effectively, yet optimal vision has an expiry date in advancing age. This review examines the effects of ageing on the eye with particular focus on the visual changes of significance to senior surgeons who currently account for 20%-25% of the surgeon workforce. The major age-related diseases of the eye, which include cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy, are surmised; together with physiologic ocular changes that accompany normal ageing, including loss of accommodation (presbyopia), reduced pupil size (senile miosis), reduced contrast sensitivity, and impaired binocular vision, amongst others. The aforementioned conditions may impair operative visualisation in the elderly surgeon and potentially impact surgical performance. Strategies and available technologies that support operative visualisation-particularly magnification aids, illumination systems and fluorescent dyes in surgery-are appraised with consideration to the senior surgeon who may be affected by the aforementioned visual changes associated with ageing. To inform minimum standards of visual function for safe surgical practice, future prospective studies are needed which report on individual surgeon-related measures of visual function together with postoperative outcomes. This vein of future research will allow for an evidence-based evaluation of proposed safety measures for which the data are currently lacking, thereby providing clarity regarding whether requisite age-based visual assessments improve surgical outcomes, and if so, at what age and frequency should such evaluations take place.

视力与老年外科医生:综述。
发达国家的人口正在老龄化,他们的外科医生也不例外。准确的视力是外科医生有效操作的必要条件,然而最佳视力随着年龄的增长而失效。这篇综述研究了老化对眼睛的影响,特别关注对目前占外科医生劳动力20%-25%的高级外科医生有重要意义的视觉变化。主要的与年龄有关的眼睛疾病,包括白内障、青光眼、与年龄有关的黄斑变性和糖尿病视网膜病变;伴随正常衰老而来的眼部生理变化,包括调节能力丧失(老花眼)、瞳孔缩小(老年性瞳孔缩小)、对比敏感度降低、双眼视力受损等。上述情况可能损害老年外科医生的手术可视化,并可能影响手术表现。支持手术可视化的策略和现有技术——特别是手术中的放大辅助设备、照明系统和荧光染料——在评估时要考虑到可能受到上述与衰老相关的视觉变化影响的资深外科医生。为了了解安全手术中视力功能的最低标准,未来的前瞻性研究需要报告个体手术相关的视力功能测量以及术后结果。未来的研究将允许对目前缺乏数据的拟议安全措施进行循证评估,从而明确必要的基于年龄的视觉评估是否能改善手术结果,如果是这样,应该在什么年龄和频率进行这种评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ANZ Journal of Surgery
ANZ Journal of Surgery 医学-外科
CiteScore
2.50
自引率
11.80%
发文量
720
审稿时长
2 months
期刊介绍: ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
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