外伤、感染、先天性疾病等均可能破坏角膜的组织结构和细胞稳态，同时造成角膜干细胞缺损，进而导致组织无法正常愈合，引起角膜盲，是世界范围内致盲的重要原因之一。目前已有多种干细胞相关的技术方法应用于重建功能性角膜组织，取得了瞩目的治疗效果。本综述以角膜缘干细胞缺乏症为主，旨在介绍多种来源的干细胞在角膜重建中的研究现状和最新进展，同时对不同干细胞的特异性标志物的研究进展进行阐述。

Trauma, infection and congenital diseases may disrupt the tissue structure and cellular homeostasis of the cornea, while causing impaired function of corneal stem cell defects, which in turn may even lead to corneal blindness caused by the inability of the tissue to heal properly. Corneal blindness is one of the major causes of blindness worldwide. Several stem cell-related techniques have been applied to reconstruct functional corneal tissue with impressive therapeutic results. This review focuses on corneal limbal stem cell deficiency and aims to present the current status and recent progress of research on stem cells from multiple sources in corneal reconstruction, as well as to describe specific markers of corneal stem cells.

目的：调查抗VEGF药物治疗湿性年龄相关性黄斑变性(wet age-related macular degeneration, wAMD)5年的疗效。方法：2011年至2021年于北京医院眼科诊断为wAMD的患者共84人103只眼进行回顾性分析。抗VEGF治疗采用3+PRN方案。观察5年来的最佳矫正视力(best-corrected visual acuity，BCVA)、玻璃体腔注射次数、随访次数和病灶的解剖学变化。结果：治疗5年后平均BCVA为38.1个字母，与基线相比下降9.4个字母，差异有统计学意义(P<0.001)。23.3%的患眼5年后可维持初始视力。5年内平均注射次数为13.8次，第1年注射次数最多，平均为4.3次。5年内平均随访次数为24.3次，仅有34.0%的患眼可遵循每次随访间隔≤3个月。5年后有68.0%的患眼出现纤维瘢痕，27.2%的患眼出现地图样萎缩，69.0%(71/103)的患眼存在持续的色素上皮脱离(pigment epithelial detachment，PED)。年龄、基线BCVA、是否初始治疗、随访年限、注射次数、中心视网膜厚度 (central retina thickness，CRT)、地图样萎缩等对BCVA有显著影响。结论：多数患者在抗VEGF治疗1年内可维持视力，但5年以上维持效果不佳。早期诊治、提高注射频率，可能是未来改善预后的研究方向。

Objective:To investigate the efficacy of anti-VEGF injection in the treatment of wet age-related macular degeneration (wAMD) for 5 years. Methods: A total of 84 patients (103 eyes) wAMD diagnosed in Department of Ophthalmology in Beijing Hospital from 2011 to 2021 were analyzed retrospectively. 3 + PRN regimen was applied for anti-VEGF treatment. The changes of best corrected visual acuity (BCVA), the number of intravitreal injections and the number of follow-up visits, and the anatomical changes of the lesions in the past 5 years were collected. Results: The average BCVA after 5 years was 38.1 letters, indicating a decrease of 9.4 letters comparing to baseline, which was statistically significant (P<0.001). 23.3% of the eyes could maintain the baseline BCVA after 5 years. The average injection times within 5 years was 13.8, and the injection was concentrated in the first year, with an average of 4.3. The average number of follow-up visits within 5 years was 24.3, and only 34.0% of the affected eyes could keep the follow-up interval ≤3 months. After 5 years, 68.0% of the eyes developed fibrous scar, 27.2% developed geographic atrophy, and 69.0% (71/103) had consistent pigment epithelial detachment. Factors significantly affect BCVA include: age, baseline BCVA, initial treatment, follow-up time, injection times, central retinal thickness, geographic atrophy and so on. Conclusion: Most patients can maintain vision within the first year after anti-VEGF treatment, but the efficacy is poor for more than 5 years. Early diagnosis and treatment, and increased injection frequency may be the research direction for improving prognosis in the future.

眶尖部肿瘤为眼科罕见疾病，但因其所处位置特殊，对机体，特别是视神经功能危害极大，错误的诊断、不规范合理的治疗不仅不能解决问题，甚至会对机体造成严重的不可挽回的损害。目前针对眶尖部肿瘤的诊断、治疗多建立在医生的主观认知与经验的基础上，尚未达成共识。本文通过分析眶尖部肿瘤的临床特点，结合以往漏诊、误诊、误治的临床案例，阐述眶尖肿瘤正确诊断的关键要点；同时，结合不同临床案例，客观分析治疗方案，尤其是手术方式、路径，为眶尖部肿瘤的合理化治疗提供依据，以期规范眶尖部肿瘤的诊断和治疗，提高治疗成功率。

Although orbital apical tumor is a rare ophthalmic disease, its special location can cause great harm to the body, especially to the function of the optic nerve. Misdiagnosis and improper treatment are not only unable to solve the problem, but also irretrievably harmful to the body. At present, there is no consensus on the diagnosis and treatment of orbital apical tumors, which are mostly based on subjective cognition and experience of doctors. In this paper, the clinical characters of orbital apical tumors were analyzed through the past clinical cases of misdiagnosis and mistreatment, and the key points of proper diagnosis of orbital apical tumors were expounded. Meanwhile, by combining with different clinical cases, the treatment plans, especially the surgical approaches, were analysed to provide a basis for the appropriate treatment of orbital apical tumors, in order to standardize the diagnosis and treatment of orbital apex tumor, and improve the success rate of treatment.

息肉状脉络膜血管病变(polypoidal choroidal vasculopathy，PCV)是亚洲人中常见的眼底致盲性疾病，当PCV合并视网膜下出血或玻璃体积血(vitreous hemorrhage，VH)时，患者视力骤然下降，视力预后差异大。但目前聚焦于PCV合并VH的相关文献较少，因此研究和阐明PCV继发VH的治疗方法及预后具有重要的临床意义。目前临床上常选择手术干预，玻璃体切除术(pars plana vitrectomy，PPV)是临床上最常选择的一种术式。其他治疗方式包括玻璃体内注射抗血管内皮生长因子(vascular endothelial growth factor，VEGF)、眼内气体或硅油填充、眼内注射组织纤溶酶原激活剂(tissue plasminogen activator，tPA)和光动力疗法(photodynamic therapy，PDT)。PCV合并VH患者的视力预后决定因素是黄斑视功能的保留程度，也与年龄、术前视力、PCV病变部位、视网膜下出血量、视网膜脱离范围、基线黄斑中心厚度(central macular thickness，CMT)、是否出现术后并发症以及是否形成视网膜瘢痕等因素相关，目前也有研究发现视力预后与单核苷酸多态性(single nucleotide polymorphisms，SNP)相关。本文就PCV继发VH的临床特点、治疗及预后进行综述。

Polypoid choroidal vasculopathy (PCV) is a common fundus blinding disease in Asians. When PCV is associated with subretinal hemorrhage or vitreous hemorrhage (VH), patient's visual acuity decreases suddenly and the visual prognosis varies greatly. There are few relevant literatures focusing on VH secondary to PCV, so it is of great clinical significance to study and clarify the treatment methods and prognosis of VH secondary to PCV. At present, surgical intervention is often selected in clinical practice. Vitrectomy is the most commonly selected surgical procedure in clinical practice. The other treatment modalities include intravitreal injection of antivascular endothelial growth factor (VEGF), intraocular gas or silicone oil filling, intraocular injection of tissue plasminogen activator (tPA) and photodynamic therapy. The prognostic determinant of visual acuity in PCV

patients with VH is the degree of preservation of macular visual function. The prognostic is also related to age, preoperative visual acuity, PCV lesion location, amount of subretinal hemorrhage, extent of retinal detachment, baseline central macular thickness (CMT), postoperative complications and retinal scars. Recent studies also find that the prognosis of visual acuity is related to single nucleotide polymorphisms. This article reviews the clinical characteristics, treatment and visual prognosis of PCV associated with VH.

单纯疱疹病毒基质型角膜炎是引起角膜盲的主要原因之一，目前以局部使用糖皮质激素联合口服抗病毒药物治疗为主。传统治疗存在生物利用度低、药物不良反应等缺点，因此亟需寻找替代药物、开发新剂型。环孢素A和他克莫司等免疫抑制剂疗效明显、不良反应少，可能是糖皮质激素的潜在替代品。α干扰素联合阿昔洛韦可缩短病程，而单独使用效果有限。基质再生剂具有新的抗病毒机制，值得进一步研究。此外，纳米载体递送系统，如脂质体、纳米胶束、立方液晶纳米粒，由于能够增强药物角膜穿透性和延长药物释放，在治疗基质型单纯疱疹性角膜炎方面具有巨大潜力。

Herpes simplex virus stromal keratitis is one of the leading causes of corneal blindness. A topical corticosteroid

agent in conjunction with an oral antiviral agent is the preferred treatment, which has the disadvantages of low bioavailability and drug side effects. Therefore, there is an urgent need to find alternative drugs and develop new dosage forms. Immunosuppressants such as cyclosporine A and tacrolimus have obvious curative effects and few side effects, and may be potential substitutes for glucocorticoids. Interferon-α combined with acyclovir can shorten the course of disease, but the effect is not obvious when used alone. Matrix regenerating agents have new antiviral mechanisms and deserve further study. In addition, nanocarriers delivery systems, such as liposomes, nanomicelles and cubosomes, have great potential in the treatment of herpes simplex virus stromal keratitis due to their ability to enhance drug corneal penetration and prolong drug release.

目的：探讨先天性鼻泪管阻塞的临床治疗效果。方法：选取在咸阳彩虹医院接受治疗并有随诊记录的先天性鼻泪管阻塞患儿共630例(827眼)。根据年龄大小，采用4种方式统计治疗效果。结果：年龄0~2个月患儿230例(286眼)，选取泪囊按摩和局部点抗炎眼水治疗，182眼(63.63%)治愈；2~6个月患儿240例(340眼)，选取加压冲洗或泪道探通术治疗，338眼(96.74%)治愈；6~12个月患儿150例(188眼)，选取泪道冲洗+泪道探通术治疗，188眼(89.74%)治愈；1岁以上患儿10例(13眼)，选取泪道探通术加局部抗炎治疗，10眼(76.92%)治愈。结论：2~6个月是先天性鼻泪管阻塞治疗的最佳时间，泪道冲洗加探通技术在治疗婴幼儿先天性鼻泪管阻塞创伤小，疗效肯定，远期复发率低。

Objective: To discuss the therapeutic effects of congenital nasolacrimal duct obstruction. Methods: A total of 630 children (827 eyes) with congenital nasolacrimal duct obstruction who were treated in Xianyang Rainbow Hospital and had follow-up records were selected. According to the age, the therapeutic effects were carried out in four ways. Results: A total of 230 cases (286 eyes) aged 0–2 months were treated by massaging lacrimal sac withantiinflammatory eye water, 182 eyes (63.63%) were healed; 240 cases (340 eyes) aged 2–6 months were treated by pressor clysis and lacrimal passages probing, and among them 338 eyes (96.74%) were healed. 150 cases (188 eyes) aged 6–12 months were treated with lacrimal passage irrigation and lacrimal passage probing. 188 eyes (89.74%) were cured; 10 cases (13 eyes) aged over 1 year old were tread by probing of the lacrimal passages with anti-inflammatory eye water, 10 eyes (76.92%) were healed. Conclusion: 2 to 6 months is the best time for the treatment of congenital nasolacrimal duct obstruction, the therapy of pressor clysis with lacrimal passages probing chosen according to the age can treat the congenital nasolacrimal duct obstruction efficiently and decrease the long-term recurrence

目的：观察玻璃体腔内注射不同剂量康柏西普治疗早产儿视网膜病变(retinopathy of prematurity，ROP)的疗效以及术后的眼压变化。方法：前瞻性随机对照研究。将2018年1月1日至2021年6月30日在厦门市妇幼保健院确诊为Ι型阈值前期ROP、阈值期ROP、急进性ROP(aggressive ROP，A-ROP)的患儿纳入研究。随机分为减量组和常量组，分别玻璃体腔注射10 mg/mL康柏西普注射液0.015 mL(含康柏西普0.15 mg)和0.025 mL(含康柏西普0.25 mg)。测量并记录注射前5min、注射后5min、30min、1h、12h及24 h的眼压情况。术后1周开始随访眼底情况。疗效评价分为一次治愈、复发和加重。结果：共49例98眼纳入研究，常量组27例54眼，一次治愈成功率79.6%(43/54)，复发率16.7%(9/54)，加重率3.7%(2/54)；减量组2 2例44眼，一次治愈成功率68.2%(30/44)，复发率27.3%(12/44)，加重率4.5%(2/44)；两组间差异无统计学意义(χ 2=1.672，P=0.196)。治疗前5min两组眼压差异无统计学意义(P=0.494)；注药后5 min、1 h、12h两组眼压差异有统计学意义(均P<0.05)；注药后24 h两组间的眼压差异无统计学意义(P=0.101)。常量组注药前5 min和注药后24 h眼压差异有统计学意义(P=0.03)，减量组注药前5 min和注药后24h眼压差异无统计学意义(P=0.84)。结论：减量剂量康柏西普(0.15mg)治疗ROP有效，疗效与常规剂量(0.25 mg)相近，且术后眼压升高幅度较低，更快恢复至术前水平，更安全。

Objective: To evaluate the effectiveness of intravitreal injection of various doses of conbercept in the treatment of retinopathy of prematurity (ROP) and change of intraocular pressure (IOP) after operation. Methods: It was a prospective randomized controlled study. Children who were diagnosed with pre-threshold ROP, threshold phrase ROP, and aggressive ROP (A-ROP) in Xiamen Maternity and Child Healthcare Hospital from January 1, 2018 to June 30, 2021 were included in the study. The children were randomly divided into a reduction group and a constant group, and received intravitreal injection of10 mg/mL conbercept at 0.015 mL (containing 0.15 mg of conbercept) and 0.025 mL (containing 0.25 mg of conbercept) respectively. IOP was measured and recorded 5 min before injection, 5 min, 30 min, 1 h, 12 h and 24 h after injection. The fundus condition was followed up 1 week after the operation. The efficacy evaluation is divided into one cure, recurrence and exacerbation. Results: A total of 98 eyes of 49 cases were included in thestudy. For 27 cases of 54 eyes in the constant group, the one-time cure success rate was 79.6% (43/54), the recurrence rate was 16.7% (9/54), and the exacerbation rate was 3.7% (2/54). In the reduction group, there were 22 cases (44 eyes). The one-time cure success rate was 68.2% (30/44), the recurrence rate was 27.3% (12/44), and the exacerbation rate was 4.5% (2/44). There was no significant difference between the two groups (χ2=1.672,P=0.196). There was no significant difference in IOP between the 2 groups 5 min before treatment (P=0.494). There were statistically significantdifferences in IOP between the 2 groups at 5 min after injection, 1 h after injection, and 12 h after injection (all P<0.05). There was no difference in IOP between the two groups 24 h after injection (P=0.101). There was a statistically significant difference in IOP between 5 min before and 24 h after injection in the constant group (P=0.03), and there was no significant difference in IOP between 5 min before and 24 h after injection in the reduction group (P=0.84). Conclusion: Reduced dose of conbercept (0.15 mg) is effective in the treatment of ROP, and the efficacy is similar to that of conventional dose (0.25 mg). The reduction can help lower the increase of postoperative IOP, returning to the preoperative level more rapidly and safely.

目的：分析临床应用镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻的效果。方法：回顾性分析安康市中医医院2年期间，应用镜下改良眼轮匝肌手术治疗61例(112眼)儿童先天性下睑内翻，根据睑内翻程度决定缝线跨度、松紧度及去除肌皮瓣量，0/6缝线将睑缘下眼轮匝肌与下睑缩肌缝合，0/8缝线连续缝合皮肤伤口，并做好术后护理。结果：所有患儿随访6~24个月，刺激症状缓解，106眼治愈，2眼好转，4眼复发，总有效率达96.43%。结论：镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻美观、易操作、复发率低。

Objective: To analyze the clinical efficacy of modified orbicularis oculi surgery under microscope in the treatment of congenital lower eyelid entropion of children. Methods: Sixty-one cases (112 eyes) of children with congenital lower eyelid entropion treated by modified orbicularis oculi surgery in Ankang Hospital of Traditional Chinese Medicine from Aug 2020 to Sep 2022 were retrospectively analyzed. The suture span, tightness and the amount of myocutaneous flap removed were determined according to the degree of entropion. The orbicularis oculi muscle of lower eyelid margin was suturedwith 0/6 suture, and the skin wound was sutured continuously with 0/8 suture, and postoperative nursing was done well. Results: All children were followed up for 6–24 months, and the irritation symptoms were relieved, 106 eyes were cured, 2 eyes turned well, and 4 eyes relapsed. The total effective ratereached 96.43%. Conclusion: The modified orbicularis oculi surgery for treatment of children with congenital lower eyelid entropion conforms to visual aesthetics. In addition, it is easy to operate and have a low recurrence rate.

目的：研究早产儿视网膜病变患儿经不同治疗措施后屈光状态的改变。方法：将72例(127眼)早产儿视网膜病变患儿按治疗方式分为3组：激光光凝组、注药(抗血管内皮生长因子药物)组和自然消退组。并于治疗前，治疗后1、4、7、12个月对其进行睫状肌麻痹检影验光，对比分析3组的球镜和等效球镜的差异。结果：在治疗后1、4、7及12个月，三组患儿的球镜度和等效球镜度的差异有统计学意义(P<0.05)：注药组的球镜和等效球镜小于自然退化组及激光组(均P0.05)。治疗后12个月时激光光凝组、注药组和自然消退组近视发生率分别是2.4%、7.8%和2.0%，差异无统计学意义(P=0.356)。结论：经不同治疗措施的ROP患儿近视发生率无明显差异，但经玻璃体腔注射抗VEGF药物的ROP患儿正视化进程更快。

Objective: To observe the changes of refractive statues in infants with retinopathy of prematurity retinopathyof prematurity (ROP) after different treatments. Methods: According to different treatment methods, 72 cases(127 eyes) of infants with ROP were divided into 3 groups: laser photocoagulation group, intravitreal injectionof anti-vascular endothelial growth factor (VEGF) drugs group and natural regression group. Their sphere andspherical equivalent were measured by retinoscopy optometrist after the ciliary muscles paralyzed. The data beforetreatments and 1, 4, 7 and 12 months after treatments were recorded and analyzed. Results: The differences ofsphere and spherical equivalent among three groups were statistically significant: intravitreal injection of VEGFdrugs group was lower than natural regression group and the laser photocoagulation group, but there was no significant difference between natural regression group and laser photocoagulation group. Incidence of myopiaof laser photocoagulation, intravitreal injection of VEGF drugs, natural regression group were 2.4%, 7.8%, 2.0%,which was not statistically significant. Conclusion: There was no significant difference about the incidence rate ofmyopia among the three groups, but the emmetropization in infants with ROP after intravitreal injection of anti-VEGF drugs might be faster in the future.

目的：对儿童癔症性视力障碍的病因进行分析，比较试镜与人工泪液给药治疗的疗效。方法：纳入2013年10月至2020年10月以“癔症性突发视力下降”于深圳市儿童医院门诊就诊的36例患儿，其中男16例，女20例。按随机原则分为试镜组与人工泪液给药组。两组在治疗过程中都辅以语言暗示。两组治疗的首次有效率采用SPSS17.0软件Fisher精确概率检验。分析儿童癔症性视力障碍的发病原因，提出诊断要点和防治对策。结果：在辅以语言暗示的前提下，试镜组人工泪液给药组治疗方案的首次有效率分别为94.4%、83.3%，差异有统计学意义(P<0.05)。在相关病因分析中，学习压力相关的有20例，占55.6%，包括成绩下降、逃避考试、因成绩受到家长或老师的训斥，甚至体罚。家庭变故13例，占36.1%，父母离异为主要原因。留守儿童不愿返乡、同学纠纷、校园霸凌以及外伤等为其他原因。结论：试镜加语言暗示比人工泪液加语言暗示更能有效提高癔症性视力障碍的首次治疗有效率。学习压力、家庭变故相关因素为癔症性视力障碍的最常见原因

Objective: To analyze the causes of hysterical visual impairment in children, and to compare the efficacy of two treatments of trial frame and artificial tears administration. Methods: A total of 36 children with sudden hysterical visual impairment admitted to Shenzhen Children’s Hospital from October 2013 to October 2020 were enrolled in our study, including 16 males and 20 females. They were randomly divided into trial frame group and artificial tears group. Both groups were supplemented with verbal suggestion during the treatment. The primary effective rates of the two groups were compared by SPSS 17.0 Fisher’s exact test. The causes of hysterical visual impairment in children were analyzed, and the main points of specific diagnostic tests and treatments were summarized. Results: The primary effective rate of the trial frame group and the artificial tears group were 94.4% and 83.3% respectively.Thedifference was statistically significant (P<0.05). In this study, therewere 20 cases (55.6%) related to study pressure, including decline in academic performance, evasion of exams, reprimand by parents or teachers, and even corporal punishment. There were 13 cases (36.1%) caused by family accidents, and parents’ divorce was the main reason. Leftover children unwilling to return hometown, classmate disputes, campus bullying and trauma were other reasons. Conclusion: Trialframe is more effective than artificial tears therapy in improving primary effective rate of hysterical visual impairment. Study pressure, family accident are the most common causes of hysterical visual impairment