叶黄素类物质为膳食类胡萝卜素，主要存在于视网膜组织中，为黄斑色素发挥抗氧化活性和蓝光滤过作用。近年来，有研究证实，叶黄素类物质可降低色差，提高视力及对比敏感度等功能，并对于年龄相关性黄斑变性、视网膜光损伤等疾病具有防治作用。

Xanthophylls is a kind of dietary carotenoid, which is mainly located in retina, and plays an important role in antioxidant and blue light ffltration. Lutein, zeaxanthin and meso-zeaxanthin can enhance visual performance by decreasing chromatic aberration and enhancing contrast sensitivity, and they can also prevent age-related macular degeneration and retinal light-induced injury. 

目的：了解中山大学中山眼科医院门诊重症疑难眼病会诊的现状，探讨门诊重症疑难眼病会诊亚专科的分布情况及会诊效果，为建立科学的门诊重症疑难眼病会诊体系提供支持和依据，同时也为合理安排会诊流程提供依据。方法：对中山大学中山眼科医院2016年3月至2017年4月收集的265例门诊重症疑难病例，通过时间、地区、性别、年龄、会诊原因、会诊亚专科、会诊后的转归及效果等方面进行统计分析，所有数据均通过Excel软件进行录入，根据分析目的和资料的类型，采用相应的统计指标进行描述，并进行统计推断，检验水准为α=0.05。结果：2016年3月至2017年4月期间中山大学中山眼科医院门诊重症疑难眼病会诊人数265例。在地区分布中，广东省地区最多，为145例，外国最少，为3例。人群分布中，男167例，女98例，男女比例为1.70:1。年龄分布中，30~44岁及45~59岁的病例数最多，均为53例(20%)，70岁以上老年病例最少，为13例(4.9%)。中山大学中山眼科医院门诊重症疑难眼病会诊中，2016年3月至2017年4月期间，各眼科亚专科共参加会诊714次，眼底外科参加会诊次数最多，为147次(20.5%)，结膜科参加会诊的次数最少，为1次(0.1%)。在分析会诊原因方面，因诊治涉及多个专科而会诊的病例数最多，为161例，因病因不明会会诊的病例最少，为20例；会诊后比会诊前明确治疗方案的病例数增加190例。结论：中山大学中山眼科医院门诊组织实施重症疑难眼病会诊使明确治疗方案率大幅提高，在提高疑难眼病治疗效果方面起到一定的促进作用。

Objective: To understand the current situation of the consultation for outpatients with severe eye disease in Zhongshan Ophthalmic Center, and to explore the distribution and effects of sub-specialty consultation for outpatients with severe eye disease. To set up a scientific system of the consultation for outpatients with severe eye disease, and also provide a basis for reasonable arrangement of consultation process. Methods: We analyzed 265 severe cases from March 2016 to April 2017 in Zhongshan Ophthalmic Center by time, region, gender, age, cause of consultation, sub-specialty, and outcomes after consultation. And all data was analyzed by Excel software, according to the purpose and the type of data, and the corresponding statistical index and statistical inference, inspection level for α=0.05. Results: There were 265 cases with severe eye disease from March 2016 to April 2017. As for the regional distribution, Guangdong province was the largest, with 145 cases, while the lowest number was from foreign countries, which was 3 cases. In the population distribution, 167 cases were males, 98 were females and the ratio was 1.70. In age distribution, patients aged from 30 to 44 years and 45 to 59 years predominated and the number of cases were both 53, accounting for 20% of the total number. Patients over 70 were the least which were 13 cases, accounting for 4.9% of the total number. From March 2016 to April 2017, all sub-specialties attended consultation for 714 times, as Ocular Fundus Department attended the most, accounting for 20.5% of the total number while Conjunctive Department attended the least, for only one, accounting for 0.1% of the total number. As for the reason of the consultation, the number of cases involving multiple specialties was the largest, with 161 cases, while the lowest number of cases due to unexplained causes, which were 20 cases. The number of cases of explicit treatment was increased by 190 after consultation. Conclusion: Consultations organized by Zhongshan Ophthalmic Center improves the treatment for outpatients with severe eye disease.

目的：探讨中心性晕轮状视网膜脉络膜萎缩不同病变阶段的眼底影像学特征。方法：回顾分析中心性晕轮状视网膜脉络膜萎缩患者眼部检查及眼底荧光血管造影(fundus fluorescein angiography，FFA)检查，分析不同病变阶段荧光素眼底血管造影的影像学特征，总结该病发展转归的临床规律。结果：I期：眼底彩色照相：黄斑区轻度色素紊乱，可累及或未累及中心凹。FFA示：中心凹附近高荧光，RPE和脉络膜毛细血管的萎缩面积及程度尚不足以透见下方粗大的脉络膜血管。II期：眼底可见一类圆形的低色素区域，荧光造影可见与眼底彩照对应的高荧光区，随造影过程延长可见萎缩区荧光素渗漏。III期：黄斑区萎缩灶外围边界模糊，其中可见一部分边界清晰、稳定的完全萎缩灶。FFA：萎缩灶内边界清晰的部分视网膜色素上皮细胞(retinal pigment epithelium，RPE)及脉络膜完全萎缩，周边在造影晚期可见未完全萎缩的脉络膜毛细血管渗漏区域。IV期：黄斑区边界清晰的视网膜脉络膜萎缩灶，黄斑中心凹累及。FFA可见与眼底像相对应的脉络膜萎缩灶，其中可透见粗大的脉络膜血管。周围部分未见活动性荧光素渗漏，病变稳定。结论：荧光素眼底血管造影能反映的脉络膜萎缩程度是不同阶段病变阶段的主要指标。

Objective: To investigate the imaging features of fundus fluorescein angiography in central areolar choroidal dystrophy at different stages. Methods: Ocular examination and fundus fluorescein angiography were carried out, imaging features of fundus ffuorescein angiography were retrospectively analyzed. Results: Stage I: fundus photography showed mild macular pigment disorders, which was involved with the fovea. Fundus fluorescein angiography (FFA): high fluorescence was close to the fovea, the area and the extent of RPE and choroidal capillaries atrophy were insufffcient to see through the thick choroidal vessels beneath. Stage II: fundus showed a round of low pigment area, fluorescein angiography showed high fluorescence corresponding region, with the angiography procedure the ffuorescein leakage could be observed. Stage III: boundaries of macular atrophy lesions were unclear which showed part of a clear boundary, stable completely atrophy lesions. FFA: part of retinal pigment epithelium (RPE) and choroidal uncompletely atrophy surrounded was visible, in the late of angiography choroidal atrophy capillary leakage could be seen. Stage IV: boundary of macular retinal choroidal atrophy was clear, foveal involvement. FFA: choroidal atrophy lesions were clear which could be seen through the thick choroidal vessels. Fluorescein leakage disappeared and the disease was stable. Conclusion: The extend of choroidal atrophy in fundus ffuorescein angiography is an important indictor reflecting the progression of different stages. 

目的：探讨标准操作程序在玻璃体腔内注药术护理中的应用效果。方法：选择 2018 年 9 至 12 月中山大学中山眼科中心眼底专科门诊 504 例玻璃体腔内注药术患者作为研究对象，对护理人力资源的整合、患者等待手术时间、患者和家属的满意度、医护人员满意度进行评价。结果：标准操作程序后明确护士岗位职责，护士操作水平和综合能力有效提升，患者手术等待时间由原来的预约 2 周缩短为 2 d。患者和家属的满意度分别由 92.0% 和 91.0% 提高到 98.5% 和 97.0%。医护人员满意度的评价由 95% 提到至 98.4%。结论：玻璃体腔内注药术标准操作程序不仅提升了工作效率，更提升了患者和家属、医务人员的满意度，规范化的标准操作程序是玻璃体腔内注药的安全保障。

Objective: To investigate the effect of standard operation procedure in the intravitreal injection. Methods: A total of 504 patients visiting the fundus clinics of our hospital from September to December 2018 were selected in this study. The integration of nursing human resources, patient waiting time, patient and family satisfaction, and medical staff satisfaction were evaluated. Results: The nurses’job responsibilities were clarified, and the Nurses’operation level and comprehensive ability were improved. The patients’waiting time for surgery was shortened from 2 weeks to 2 days. Patient and family satisfaction increased from 92.0% and 91.0% to 98.5% and 97.0%, respectively. The evaluation of the satisfaction of medical staff was elevated from 95% to 98.4%. Conclusion: The standard operation procedure of intravitreal injection not only improves the work efficiency, but also significantly increases the satisfaction of patients and their families and medical staffs. Therefore, the standard operation procedure can guarantee the safety of intravitreal injection.

本文总结了 15 例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查，给予患儿及其家属个性化的心理护理，进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理，饮食、疼痛、眼部用药以及弹力绷带包扎护理，关注有无并发症的发生及给予相应的护理，并对患儿及其家属做好出院指导。15 例患儿均顺利完成手术，术后均出现术眼疼痛，2 例出现眶压增高，1 例出现呕吐，均得到妥善处理。术后随访 3~18 个月，患儿均获得了较为满意的眼部外观，生活质量得到了提高。

This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye, and the life quality was improved. 

目的：评估Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症。方法：收集汕头国际眼科中心2011至2016年门诊确诊的水液缺乏型干眼患者300例(600眼)，进行Smart plug泪小管塞治疗，随访观察术后临床并发症，中位随访时间为术后3年(术后1~5年)。结果：3例患者(3眼)术后患有泪小管炎(0.5%)，发病时间为术后1~3(中位2)年，取出泪小管塞后并给予局部抗生素滴眼液治愈。2例患者 (4眼)因植入上下泪小管塞后流泪症状不能耐受，单纯取出下泪小管塞后症状缓解(0.7%)；4例患者(8眼)因只植入下泪小管塞症状未能明显好转，1个月后再次植入上泪小管塞(1.3%)；291例患者干眼主观症状改善，有效率为97.5%，长期随访未发现并发症。结论：虽然Smart plug泪小管塞治疗水液 缺乏型干眼具有明确的疗效，但Smart plug泪小管塞植入后的长期并发症不容忽视，需要长期观察。

Objective: To evaluate the long-term complication associated with the use of the Smart plug in the treatment of aqueous tear deficiency dry eye. Methods: A total of 300 patients (600 eyes) were collected in Joint Shantou International Eye Center from 2011 to 2016, all the patients accepted the treatment with Smart plug, and were followed up for clinical complications. The median follow-up time was postoperative 3 years (1–5 years after surgery). Results: Three patients (3 eyes) developed canaliculitis, the rate was 0.5%. The median time from Smart plug insertion to the onset of canaliculitis was 2 (1–3) years, leaving the Smart plug and resolved the application of topical antibiotics. Two patients (4 eyes) could not suffer from implantation of the upper and lower Smart plug, removed the below, the ratio was 0.7%; 4 patients (8 eyes) need upper Smart plug insertion after implantation of the lower one month later, the rate was 1.3%; 291 cases of dry eye improved by long-term followup, the effective rate was 97.5%. Conclusion: Although the Smart plug is effective in the treatment of aqueous tear deffciency dry eye, the later complications of Smart plug insertion cannot be neglected and need the long-term follow-up.

目的：自行设计并应用眼科表格式护理记录单，探讨眼科日间病房精细化护理管理工作的方法。方法：于中山大学中山眼科中心眼底病中心，根据日间手术流程，设计和运用眼底病中心24 h出入院护理记录单、眼底病中心日间病房交班记录单和眼底病中心日间病房手术记录单，书写方法基本以打勾、数字或简单文字记录为主。结果：新的表格式护理记录单大大节省护理记录和交班时间，提高护理工作效率，得到临床护理人员的广泛认可，提高医护对护理工作的满意度。结论：突出专科特色的表格式护理记录单能统一规范临床护理工作，提高护理工作效率和护理质量，保障护患安全，落实精细化护理管理。

Objective: To explore ffne management method of day ward in ocular department, through applying self-designed table format of eye nursing records. Methods: According to the day surgery process, the tables of 24-h nursing records and shifting records and surgery records were designed and applied to day ward of the ophthalmic fundus center. The basic writing methods included ticking, number and filling in the blanks. Results: The new nursing records tables decreased the time consumed in recording and shifting, improving the work efficiency, accepted widely by clinical staffs. Conclusion: The new table format with highlight of special features of the nursing records can unify and standard the clinical nursing work, improve the nursing work efficiency and nursing quality, ensure patients’ safety, and implement fine management. 

目的：探讨下乡行大批量白内障扶贫手术的手术器械管理方法。方法：对大批量白内障扶贫手术专用的眼科器械实施规范化管理流程，运输过程严格保护，并培训当地护理人员、定人定岗，实行责任制管理，对清洗流程的质量检测及术中严格的无菌操作把控，确保手术安全进行。结果：眼科手术器械得到规范处理和保养，基层护理人员的规范培训提升其对眼科手术器械处理的能力。结论：建立下乡扶贫规范化的手术器械管理流程和培训制度，是大批量白内障扶贫手术顺利完成的基础保障。

Objective: To investigate the methods of management of surgical equipment in large quantities of cataract poverty alleviation surgery for the countryside patients. Methods: The standardized management of cataract poverty alleviation surgery was implented, the ophthalmic equipment on the transport was strictly protected, and nursing training, fixed posts, responsibility system management, cleaning process quality testing and aseptic control were performed to ensure the safety of operation. Results: The processing and maintenance of the surgical equipment were standardized. Nursing training enhanced their ability to manage ophthalmic surgical equipment. Conclusion: A standardized system of surgical equipment management guarantees the successful completion of large quantities of cataract poverty alleviation surgery.

目的：探讨个性化护理在眼科患儿全身麻醉手术中的应用效果。方法：选取于2015年7月至2016年8月中山大学附属第一医院收治的50例眼科全身麻醉手术患儿，按手术例数单、双号顺序分组，单 数为对照组，采用传统常规护理，双数为观察组，采用个性化护理。比较两组麻醉配合度与家属对护理满意度。结果：50例患儿手术顺利。对照组在麻醉及复苏过程出现烦躁与躁动情况的患儿18例，观察组为3例,对照组明显高于观察组；观察组麻醉配合度与家属对护理满意度明显高于对照组，差异均有统计学意义(P<0.05)。结论：眼科全身麻醉手术患儿运用个性化护理，可改善患儿心理状态，提高配合度，增加患儿家属的满意度。

Objective: To detect the effect of individualized nursing on ophthalmic children under general anesthesia operation. Methods: Ophthalmic children under general anesthesia operation in First Afifliated Hospital of Sun Yat-sen University were included from July 2015 to August 2016. All of children were divided into odd and even groups by the operation sequence number. The children with odd numbers were in control group and accepted traditional nursing. The children with even numbers were in experimental group and accepted individualized nursing. Anesthesia cooperation degree and family members’ satisfaction on nursing were compared between the two groups. Results: Fifty operations were proceeded successfully. 18 children appeared irritability and restlessness during anesthesia and recovery process in the control group. Irritability and restlessness were only showed in 3 children in the experimental group. The satisfaction in experimental group was much higher than  the control group, the differences were statistically signiffcant (P<0.05). Conclusion: Individualized nursing can improve the mental state and the degree of cooperation. It can also improve family members’ satisfaction.