目的：评价丙泊酚-阿芬太尼-利多卡因混合剂在成人白内障日间手术中的麻醉镇静效果与不良反应。方法：回顾性分析2021年1月至2021年6月中山大学中山眼科中心接受丙泊酚-阿芬太尼-利多卡因静脉镇静下白内障日间手术的患者(静脉镇静组，n=30)，并匹配同一主刀医师、诊断相似且在丙美卡因表面麻醉下白内障手术患者(表麻组，n=30)。比较两组患者围手术期血流动力学变化、手术中眼位评级、手术中断的次数、手术时间、手术后苏醒时间、出院时间、术中手术体验以及术后不良事件等指标。结果：所有患者均在原麻醉方式下顺利完成手术；与表麻组相比，静脉镇静组手术中断次数显著降低(P<0.05)，围手术期血压更平稳，且术后满意度评价明显升高(P<0.05)。结论：丙泊酚-阿芬太尼-利多卡因静脉镇静能显著提升白内障日间手术患者的就医体验，而不影响手术进程。

Objective: The aim of this study is to observe the efficacy and safety of propofol-alfentanil-lidocaine mixture in adult patients for cataract ambulatory surgery. Methods: Thirty adult patients undergoing cataract ambulatory surgery sedated by propofol-alfentanil-lidocaine mixture from January 2021 to June 2021 were enrolled in this retrospective study (sedation group, n=30). Meanwhile, another thirty patients with similar diagnosis performed by the same surgeons under topical anesthesia were matched in this study (topical anesthesia group, n=30). The scores of intraoperative eye position, the number of surgical interruptions due to poor cooperation, surgical time, emergence time, time to discharge, changes in blood pressure, surgical experience, as well as any adverse events were compared between the two groups. Results: The surgeries were successfully completed in all patients in both groups. Compared to topical anesthesia group, patients under sedation showed less surgical interruptions and more stable hemodynamics during the surgery, as well as better surgical experience (all P<0.05). Conclusion: Sedation with propofol-alfentanil-lidocaine mixture can significantly improve the surgical experience of patients undergoing cataract ambulatory surgery without prolonging duration of the surgery.

囊袋阻滞综合征(capsular block syndrome，CBS)是白内障手术较为罕见的并发症，可发生在白内障术中、术后早期及晚期。本文报道1例23岁的女性患者，为发生在白内障术后早期的CBS，因左眼激素性白内障而实施左眼白内障超声乳化联合后房型人工晶状体(intraocular lens，IOL)植入术，术后患者因屈光不正、后囊膜及IOL之间较宽间隙而诊断为CBS，行Nd:YAG激光后囊膜切开治疗后，患者视力恢复至正常，后囊膜及IOL贴合紧密，随访期间未出现黄斑水肿及视网膜脱离等并发症。

Capsular block syndrome (CBS), a fairly rare complication of phacoemulsification, can develop into one of the three following possible clinical scenarios: intraoperative, early postoperative, and late postoperative, depending primarily on the timing of its occurrence following surgery. This paper reported a patient who developed early capsular block syndrome. A 23-year-old patient complained of poor distant vision after undergoing phacoemulsification combined with intraocular lens (IOL) implantation because of steroid-induced cataract. Anterior segment examination confirmed the diagnosis of capsular block syndrome. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy resulted in complete resolution of her symptoms. No complication happened during follow-up.

目的：观察表面麻醉下不同吸氧方式对白内障超声乳化手术患者生命体征变化的影响，探讨适宜的超声乳化手术中吸氧的方式。方法：选取2020年4月至2020年9月于中山大学中山眼科中心行白内障超声乳化摘除术的患者291例，随机分成3组，分别为简易面罩吸氧组(面罩组)97例、鼻导管吸氧(鼻导管组)97例、无吸氧组(对照组)97例，其中面罩组和鼻导管组的吸氧流量均为氧流量2~4 L/min。监测患者进入手术室时(T0)、手术开始时(T1)以及手术结束时(T2)的血压、心率以及血氧饱和度(SpO2)。结果：三组患者在进入手术间时生命体征差异无统计学意义，三组患者术中 血压变化不显著(P>0.05)。在T2时点，氧气吸入的患者其SpO2高于对照组(P<0.05)，但均在正常范围内。结论：表面麻醉下白内障超声乳化手术的患者在无严重基础疾病的情况下，术中适当吸氧及监测血流动力学可以增加患者的舒适度及临床安全，对患者使用的吸氧方式应以不影响术中操 作及患者舒适度的方式。

Objective: To observe the effects of different oxygen inhalation methods on the changes of vital signs in adult patients undergoing phacoemulsification under topical anesthesia, and to explore the appropriate oxygen inhalation methods in phacoemulsification. Methods: A total of 291 patients who underwent phacoemulsification for cataract extraction in Zhongshan Ophthalmic Center, Sun Yat-sen University from  April 2020 to September 2020 were randomly divided into 3 groups: the simple mask oxygen inhalation group (n=97), the nasal catheter oxygen inhalation group (n=97), and the oxygen-free group (n=97). The oxygen flow of the mask group and the nasal catheter group was 2–4 L/min. Blood pressure, heart rate, and oxygen saturation (SpO2) were monitored at entry into the operating room (T0), at the beginning of surgery (T1), and at the end of surgery (T2). Results: There was no significant difference in vital signs among the 3 groups when entering the operating room, and no significant change in intraoperative blood pressure among the 3 groups (P>0.05). At T2, the blood oxygen saturation of patients with oxygen inhalation was higher than that of the oxygen-free group (P<0.05), but within the normal range. Conclusion: For cataract phacoemulsification patients under topical anesthesia without serious comorbidities, appropriate oxygen inhalation and monitoring hemodynamics can increase the comfort and safety of patients, and oxygen inhalation should be used without affecting surgery manipulation and comfort of patient. 

目的：探索白内障术眼低视力的原因。方法：对2011年10月至2013年3月在汕头国际眼科中心行白内障手术，术前无法窥清眼底，术后1周最佳矫正视力<0.3的患者进行视力、最佳矫正视力、眼压测量、裂隙灯检查、眼底镜检查、眼底照相及光学相干断层扫描(optical coherence tomography，OCT)，若未发现任何视网膜器质性病变，再进行视觉诱发电位检查及视野检查。由2位医生对检查结果进行分析，对不同的眼底病变做出诊断，统计分析白内障术眼低视力的原因。结果：共纳入行白内障手术患者5 608例，术后1周最佳矫正视力<0.3的患者共49例(共49眼)，其中男20例，女29例，右眼31只，左眼18只，年龄(69.11±12.05)岁。白内障术后低视力比例为0.87%。其中高度近视性脉络膜视网膜病变12例(24.5%)，椭圆体带连续性破坏10例(20.4%)，糖尿病性视网膜病变8例(16.3%)，黄斑孔5例(10.2%)，老年性黄斑变性4例(8.1%)，黄斑前膜3例(6.1%)，黄斑区视网膜厚度变薄1例(2.0%)，视网膜色素变性1例(2.0%)，视网膜劈裂症1例(2.0%)，视网膜分支动脉阻塞1例(2.0%)，白塞氏病1例(2.0%)，缺血性视神经病变1例(2.0%)，视网膜前膜1例(2.0%)。结论：在本组白内障术眼低视力的患者中，高度近视性脉络膜视网膜病变占主要部分，为24.5%，其次分别为椭圆体带连续性破坏、糖尿病性视网膜病变、黄斑孔、老年性黄斑变性和黄斑前膜。利用OCT可发现影响白内障术后视力的细微视网膜结构变化，对于白内障术前眼底可见的患者常规行OCT有利于判断手术预后，便于医患沟通，提高手术满意度。

Objective: To explore the causes of low vision after cataract surgery. Methods: Patients who underwent cataract surgery at Joint Shantou International Eye Center of Shantou University and the Chinese university of Hong Kong ( JSIEC) from October 2011 to March 2013, whose fundus status could not be seen before surgery, and the best corrected visual acuity <0.3 in the first week after surgery, underwent a series of detailed ocular examinations, including visual acuity, best corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, fundus photography and optical coherence tomography. If no organic lesions of the retina were found, then visual evoked potential examination and visual field examination were performed. Two doctors analyzed the examination results of the examination, made the diagnosis of different fundus diseases, and statistically analyzed the causes of low vision after cataract surgery. Results: A total of 5 608 cataract surgeries were performed in our hospital from October 2011 to March 2013. A total of 49 patients (49 eyes) with best corrected visual acuity worse than 0.3 within postoperative 1 week 20 male and 29 female, 31 right eyes and 18 left eyes, aged (69.11±12.05) years on average. The proportion of low vision after cataract surgery was 0.87%. 12 cases (24.5%) of high myopic chorioretinopathy, 10 cases (20.4%) of ellipsoidal band defect, 8 cases (16.3%) of diabetic retinopathy, 5 cases (10.2%) of macular holes, 4 cases (8.1%) of age-related macular degeneration, 3 cases (6.1%) of macular epiretinal membrane, 1 case (2.0%) of thinning macular retinal thickness, 1 case (2.0%) of retinitis pigmentosa, 1 case of retinoschisis (2.0%), 1 case of branch retinal artery occlusion (2.0%), 1 case of Behcet’s disease (2.0%), and 1 case of ischemic optic neuropathy (2.0%), 1 case of epiretinal membrane (2.0%). Conclusion: Among patients with low vision after cataract surgery, high myopic chorioretinopathy accounts for 24.5%, followed by ellipsoidal band defect, diabetic retinopathy, macular hole, age-related macular degeneration, and macular epiretinal membrane. The use of optical coherence tomography can detect subtle microscopic retinal structural changes that affect vision after cataract surgery. For patients with visible fundus before cataract surgery, routine optical coherence tomography contributes to evaluating the prognosis of the operation, facilitating doctorpatient communication, and improving the degree of surgical satisfaction.

目的：总结大批量白内障扶贫手术的护理安全管理经验。方法：回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况，分析其安全隐患，并在护理过程中采取相应的安全措施。术前充分评估和准备，对患者进行健康指导；术中对手术环境规范管理；指导加强术后患者的自我管理。结果：8批次共1 064例白内障摘除联合人工晶体植入术顺利完成，无1例发生术后感染。结论：建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节，做好术前的评估和准备工作，落实患者的健康教育及术后患者自我管理指导，才能确保手术顺利进行。

To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: This is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. The following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed. Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety.

目的： 探讨儿童双目视力筛查仪在先天性白内障中的应用。 方法： 本文为回顾性分析，选择 2017 年 7 月 至 2018 年 5 月在厦门市儿童医院眼科的 3 个月至 2 岁婴幼儿 336 例(672眼)，均由2个固定的医生分别采用小瞳孔红光反射及儿童双目视力筛查仪检查，同时详细记录病史资料。所有患儿均给予裂隙灯检查、复方托品卡胺散瞳后行眼底检查，对眼底无法窥入的者必要时给予眼部B超检查或眼部MRI检查，以排除眼底病变。结果：依据2009年出版的第5版《Harley’s小儿眼科学》的先天性白内障临床分类方法，本组病例中先天性白内障的类型依次为皮质(核)白内障2 7例(35眼)，其中胚胎核2例( 4眼)，板层2 3例(29眼)，核性2例( 2眼)；囊膜性白内障1 9例(28眼)，缝合性白内障2例( 4眼)，极性白内障3例( 6眼)，全白内障2例( 3眼)。儿童双目视力筛查仪筛查出先天性白内障的灵敏度为81.58%，特异度为79.87%，诊断符合率为80.06%；红光反射筛查的先天性白内障的灵敏度为51.32%，特异度为69.97%，诊断符合率为67.86%；两组结果比较均有统计学意义。儿童双目视力筛查仪对皮质(核)性白内障筛查率为97.14%，而红光反射的筛查率为37.14%，结果比较具有统计学意义。结论：儿童双目视力筛查仪在先天性白内障筛查中，具有低漏诊率和误诊率，较高的诊断一致性的优势，尤其对皮质(核)性白内障有高的检出率，将有利于在日常儿童眼保健的辅助筛查工作中，及早发现先天性白内障患儿。

Objective: To explore the application of children’s binocular vision screening instrument in screening congenital cataract. Methods: This was a retrospective analysis of 336 infants aged 3 months to 2 years (672 eyes) who were admitted to the Ophthalmology Department of Xiamen Children's Hospital from July 2017 to May 2018. They were examined by two fixed doctors with the pupil red light reflex and binocular vision screening instrument, and the medical history was recorded in details. All the children received slit lamp examination, compound tropicamide mydriasis and fundus examination. If necessary, the children who could not see fundus were given with B-ultrasonic examination or MRI examination. Results: According to the clinical classification of congenital cataracts published in the 5th edition of Harley’s pediatric ophthalmology in 2009, In this group, there were 27 cases (35 eyes) of congenital cataract, including 2 cases (4 eyes) of embryonic nucleus, 23 cases (29 eyes) of lamellar layer, 2 cases (2 eyes) of nuclear cataract, 19 cases (28 eyes) of capsular cataract, 2 cases (4 eyes) of suture cataract, 3 cases (6 eyes) of polar cataract and 2 cases (3 eyes) of total cataract. The sensitivity of children’s binocular vision screening instrument screening congenital cataract was 81.58%, the specificity was 79.87%, and the diagnostic coincidence rate was 80.06%; the sensitivity of red reflection screening congenital cataract was 51.32%, the specificity was 69.97%, and the diagnostic coincidence rate was 67.86%; the results of the two groups were statistically significant. The screening rate of children's binocular vision screening instrument for cortical (nuclear) cataract was 97.14%, while that of red reflex was 37.14%. The results were statistically significant. Conclusion: In the screening of congenital cataract, the binocular vision screening instrument for children has the advantages of low missed diagnosis rate, high misdiagnosis rate and high diagnostic consistency, especially for cortical (nuclear) cataract. It is helpful to find the congenital cataract early in the auxiliary screening of children’cares eye health