铁离子在维持角膜细胞正常代谢、DNA合成和修复等生理活动中发挥关键作用，但过量的铁离子可能引发铁稳态失衡继而导致细胞毒性损伤和死亡。圆锥角膜是最常见的扩张性角膜疾病，其典型的Fleischer环是铁稳态失衡的直接证据。圆锥角膜与铁代谢相关的前期研究显示，铁稳态失衡有可能是诱发圆锥角膜发生和发展的潜在致病机制。文章总结了人体及角膜中正常的铁代谢循环以及圆锥角膜铁稳态失衡的证据，并从维持铁稳态角度出发探索可能的治疗策略，为扩张性眼病治疗提供新的思路。

Iron ions are essential for normal metabolism, DNA synthesis, and cellular repair in corneal cells. Nevertheless, an excess of these ions can disrupt iron homeostasis, leading to cellular toxicity, damage, and death. Keratoconus, the most prevalent ectatic corneal disorder, is often marked by the Fleischer ring, which indicates an imbalance in iron homeostasis. A review of early studies on keratoconus and iron metabolism suggests that this imbalance may be a potential pathogenic mechanism contributing to the onset and progression of the disease. This article aims to provide a comprehensive overview of normal iron metabolism in the human body and cornea, highlighting the evidence of iron homeostasis imbalance in keratoconus. It also explores potential therapeutic strategies focused on maintaining iron homeostasis, thereby offering novel insights into the treatment of ectatic eye diseases. 

目的：分析某三甲眼科专科医院近5年临床诊疗涉及非手术常规血液检验项目的申请检测情况，为眼科医师了解检验辅助诊断概况、专科医院的实验室项目管理和开展新项目提供依据。方法：从中山大学中山眼科中心医学检验信息管理系统导出2018年1月1日至2022年12月31日期间到院申请进行血液检测的12 866例门诊患者的22 453份样本(共94 081项检验项目)相关检验记录。将申请检测科室及专科医师按照中华医学会眼科学分会推荐分为10个亚专科，对疾病诊断和检测项目等资料进行统计分析，采用文字、柱状图及折线图的形式进行描述。结果：5年间申请进行血液检测的12 866例门诊患者，男性患者6 356例(49.4%)，女性患者6 510例(50.6%)。基于首诊眼病诊断分类，排名前三位的眼病分别为眼整形/眼肿瘤病5 214例 (40.5%)、眼底病 3 487例(27.1%)、角膜病1 711例(13.3%)。申请检测样本量从2018年的3 163份增至2022年的5 903份，总体呈上升趋势。从申请的专科医师分析，眼整形/眼眶病专科医师申请单最多，有6 751份(占30.1%)，其中自身免疫性疾病检测所占比例最高，为49.1%，甲状腺疾病相关检测占41.9%；眼免疫专科医师申请检测量为4 214份(占18.8%)，以自身免疫性疾病检测为主占55.7%，感染性项目检测占32.5%；眼底病专科医师申请检测量为3 629份(16.2%)，其中自身免疫性疾病检测和感染性项目检测分别占47.8%和39.6%；角膜病专科医师申请数为1 436份(占6.4%)，其中过敏性疾病检测比例为41.2%。基于一份申请单可同时检测多个项目，眼整形/眼眶专科申请检测总项最多，有33 513项，甲

状腺疾病检测占65.0%；角膜病专科申请16 482项，过敏性疾病检测占83.4%，眼底病专科和眼免疫专科分别为8 794项和8 047项，均以自身免疫性疾病检测为主，分别占42.5%和40.4%。结论：眼科专科医院中非手术常规检验项目在各亚专科的申请数量明显分布不均，项目构成受亚专科疾病特点的影响。眼科实验室应针对性加强非手术常规检测项目的宣传和管理。

Objective: To analyze the application and testing of non-surgical routine blood test items in clinical diagnosis and treatment in a top-tier ophthalmic hospital over the past five years, providing ophthalmologists with insights into the overview of laboratory-assisted diagnosis, laboratory project management in specialized hospitals, and the basis for launching new projects. Methods: Relevant test records of 22,453 samples (totaling 94,081 test items) from 12,866 outpatient patients who applied for blood tests at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 1, 2018, to December 31, 2022, were retrieved from the medical laboratory information management system. The departments applying for tests and specialist physicians were divided into 10 subspecialties according to the recommendations of the Ophthalmology Branch of the Chinese Medical Association. Statistical analysis was performed on disease diagnosis and test items, and the results were described in the form of text, bar graphs, and line graphs. Results: Among the 12,866 outpatient patients who applied for blood tests over the five-year period, 6,356 (49.4%) were male and 6,510 (50.6%) were female. Based on the classification of first-visit ophthalmic diseases, the top three were ophthalmic plastic surgery/ocular tumor diseases (5,214 cases, 40.5%), fundus diseases (3,487 cases, 27.1%), and corneal diseases (1,711 cases, 13.3%). The number of samples applied for testing increased from 3,163 in 2018 to 5,903 in 2022, showing an overall upward trend. From the perspective of specialist physicians applying for tests, ophthalmic plastic surgery/orbital disease specialists had the highest number of applications, with 6,751 (30.1%), among which autoimmune disease testing accounted for the highest proportion, at 49.1%, and thyroid disease-related testing accounted for 41.9%. The number of applications from ophthalmic immunology specialists was 4,214 (18.8%), with autoimmune disease testing accounting for 55.7% and infectious disease testing accounting for 32.5%. The number of applications from fundus disease specialists was 3,629 (16.2%), with autoimmune disease testing and infectious disease testing accounting for 47.8% and 39.6%, respectively. The number of applications from corneal disease specialists was 1,436 (6.4%), with allergic disease testing accounting for 41.2%. Since multiple tests could be performed on a single application, the ophthalmic plastic surgery/orbital disease subspecialty had the highest total number of tests applied for, with 33,513 tests, of which thyroid disease testing accounted for 65.0%. The corneal disease subspecialty applied for 16,482 tests, with allergic disease testing accounting for 83.4%. The fundus disease subspecialty and ophthalmic immunology subspecialty respectively applied for 8,794 and 8,047 tests, both primarily focused on autoimmune disease testing, accounting for 42.5% and 40.4%, respectively. Conclusions: The number of applications for non-surgical routine test items in ophthalmic specialized hospitals is significantly unevenly distributed among various subspecialties, and the composition of the items is influenced by the characteristics of diseases in each subspecialty. Ophthalmic laboratories should strengthen the promotion and management of non-surgical routine test items in a targeted manner.

目的：探讨白内障人群角膜屈光力(corneal refractive power,CRP)的分布特点及与眼生物学参数的相关因素分析。方法：回顾性横断面研究福州眼科医院2019年3月至2022年7月就诊的40岁以上白内障人群共23035眼，使用OA-2000测量其眼轴(axial length,AL)、CRP、前房深度(anterior chamber depth,ACD)、晶状体厚度(lens thickness,LT)、角膜水平直径即白到白(white-to-white,WTW)、中央角膜厚度(central corneal thickness,CCT)。绘制各眼生物学参数及年龄Spearman相关性热力图，绘制CRP与AL、CRP与WTW散点拟合图。将CRP与上述参数及年龄进行Spearman相关性分析，分段数据的线性关系使用Pearson分析及线性回归分析。结果：白内障人群CRP为(44.36±1.52)D，在总体数据中CRP与AL为非线性相关；但在分段数据中存在线性相关：当AL≤25.06 mm，CRP与AL负线性相关(R² =0.397，P<0.001)；当AL>25.06 mm，CRP与AL正线性相关(R² =0.045，P<0.001)；无论AL长短，CRP与WTW、CCT均呈负相关。在总体数据中，CRP与WTW也存在非线性关系；但在分段数据中存在线性相关：当10.52 mm≤WTW≤12.46 mm，CRP与WTW负线性相关(R² =0.149，P<0.001)，并与AL、ACD、CCT呈负相关。结论：CRP与AL、WTW呈非线性相关，使用CRP优化计算人工晶状体(intraocular lens,IOL)屈光力时需适当考虑AL、WTW与CRP的相关性。

Objective: To investigate the distribution characteristics of corneal refractive power (CRP), and analyze the correlation between corneal refractive power and ocular biometric parameters in cataract patients. Methods: A retrospective cross-sectional study was conducted on 2,3035 eyes of cataract patients over 40 years old, who visited Fuzhou Eye Hospital during the period between March 2019 and July 2022. The subjects' examination results of axial length (AL), corneal refractive power (CRP), anterior chamber depth (ACD), lens thickness (LT), horizontal corneal diameter (WTW), central corneal thickness (CCT) were measured by OA-2000. Spearman correlation thermograms of bilological parameters and age for each eyes were worked out. The plot scatter fitting plots of CRP and AL, CRP and WTW were made. Spearman correlation analysis was made among CRP, above-mentioned parameters and age. Linear relationships of the segmented data were analyzed with Pearson and linear regression analysis. Results: In the cataract patients, CRP was (44.36 ± 1.52) D. There was a non-linear correlation between CRP and AL in the total data. However, there was a linear relationship in the segmented data. When AL ≤ 25.06 mm, CRP was negatively linearly correlated with AL (R² =0.397, P<0.001). When AL>25.06 mm, CRP was weakly positively correlated with AL (R² =0.045, P<0.001). Regardless of the length of AL, CRP was negatively correlated with WTW and CCT. There was also a nonlinear relationship between CRP and WTW in the total data. But there was a linear correlation in the segmented data.When 10.52 mm ≤ WTW ≤ 12.46 mm, the negative linear correlation was found between CRP and WTW (R² =0.149, P<0.001), while there was negative correlation among CRP, AL, ACD, and CCT. Conclusion: There is a non-linear correlation among CRP, AL and WTW. To optimize the calculation of intraocular lens (IOL) refractive power with CRP, it is necessary to consider the correlation between AL, WTW, and CRP.

该文报道一例激光原位角膜磨镶(laser-assisted in situ keratectomy,LASIK)术后行白内障超声乳化摘除联合多焦点散光矫正型人工晶状体植入术的病例。该患者为42岁女性患者，20年前外院行双眼LASIK手术，现因右眼视物模糊1年就诊。术前IOLMaster检查患者右眼眼轴长度29.66 mm，前房深度3.18 mm，晶状体厚度4.75 mm，白到白距离11.6 mm，前表面及全角膜散光分别为1.01 D@67 °及0.91 D@56 °。Pentacam角膜地形图15 °范围模拟角膜屈光力得到的角膜散光为1.2 D@58.1 °，为规则领结型。患者眼底检查未见明显异常，因其脱镜意愿强烈，植入双焦点散光矫正型IOL(德国Zeiss公司AT LISA toric 909M)。根据Barrett True-K Toric公式测量的后表面散光计算结果进行手术规划，选择+17 D球镜1.5 D柱镜Zeiss 909M IOL，植入轴位55 °。术后1个月患者裸眼远视力0.8，35 cm裸眼近视力1.0，最佳矫正远视力–0.25 DS/–0.5 DC×120 °至1.0，患者满意。提示经过详细的术前评估及规划，并与患者充分沟通，多焦点散光矫正型人工晶状体可以在部分适合的LASIK术后患者中取得良好效果。

It is reported a case of cataract phacoemulsification combined with toric multifocal intraocular lens (IOL) implantation after LASIK surgery in this article. A 42 year-old female patient who underwent bilateral LASIK surgery in other hospital 20 years ago. She visited our hospital due to blurred vision in her right eye for one year. The preoperative IOL Master examination results showed an axial length of 29.66 mm, anterior chamber depth of 3.18 mm, lens thickness of 4.75 mm, white to white distance of 11.6 mm, and anterior surface and total corneal astigmatism of 1.01 D @ 67 ° and 0.91 D @ 56 °, respectively in right eye. The corneal astigmatism measured by Pentacam using 15°range simulated keratometry is 1.2 D@ 58.1 °, which is a regular bow tie shape.No obvious abnormalities was found in the patient's fundus examination. Due to her strong desire to get rid of the glassesa toric bifocal IOL (AT LISA Toric 909M, Zeiss, Germany) was implanted.Based onthe IOL power calculation results of Barrett True-K Toric formula with measured posterior corneal astigmatism, an IOL with Sph 17.0 D/Cyl1.5 D/A 55°was chosen. One month after surgery, the patient's uncorrected distance visual acuity was 20/25, 35 cm uncorrected near visual acuity was 20/20, and the best corrected distance visual acuity was 20/20 with a prescription of –0.25 DS/–0.5 DC × 120 °. The patient was satisfied with the outcome. After detailed preoperative evaluation and design, and sufficient communication with patients, toric multifocal IOL implantation can achieve good results in some apropriated for the patients after LASIK surgery.

肥厚型脉络膜谱系疾病(pachychoroid disease spectrum,PCD)包括肥厚型脉络膜色素上皮病变(pachychoroid pigment epitheliopathy,PPE)、中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)、肥厚型脉络膜新生血管病变(pachychoroid neovasculopathy,PNV)、息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)、局灶性脉络膜凹陷(focal choroidal excavation,FCE)和盘周肥厚型脉络膜综合征(peripapillary pachychoroid syndrome,PPS)。有学者将PCD看作脉络膜功能障碍引发的一系列连续疾病过程，但关于PCD的发病机制、形态改变尚未明确。该文对PCD的脉络膜、涡静脉及巩膜相关改变做一综述。

Pachychoroid disease spectrum include pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, focal choroidal excavation, and peripapillary pachychoroid syndrome. Currently, some scholars regard pachychoroid disease spectrum as a series of continuous disease processes caused by choroidal dysfunction, but the pathogenesis and morphological changes of pachychoroid disease spectrum are not yet clear. This paper reviews the changes of choroid, vortex veins and sclera in pachychoroid disease spectrum.

朗格汉斯细胞组织细胞增生症 (Langerhans cell histiocytosis,LCH) 是一种由骨髓细胞肿瘤性增殖引起的罕见疾病，多见于儿童。LCH临床表现多样，以骨骼受累最常见。该文报道了一例儿童颅眶沟通LCH，影像学检查结果提示患儿右侧眉弓处类圆形穿凿样骨质破坏，通过手术切除病灶，送组织病理学检查明确诊断，同时选择通过3D打印聚醚醚酮(polyetheretherketone,PEEK)材料修补颅眶缺损部位，PEEK材料匹配度高、安全性好，改善患儿预后，提升患儿生存质量。

Langerhans cell histiocyte (LCH) is a rare disease caused by the tumor-like proliferation of bone marrow cells, which is mostly seen in children. Its clinical manifestations can be diverse, in which the skeletal system is most involved. This paper reports a case of LCH in cranio-orbital communication of a child. The imaging results suggest that there is a round chisel damage at the patient’s right brow ridge. In terms of definitive diagnosis and treatment, this patient underwent surgical resection and histopathological examination. 3D-printed polyether-ether-ketone (PEEK) material was selected to repair the cranio-orbital defect. The material can achieve better biocompatibility, while 3D-printing technique allows higher matching degree, both help to improve the prognosis and quality of life of the patient.

Blindness prevention has been an important national policy in China. Previous strategies, such as deploying experienced cataract surgeons to rural areas and assisting in building local ophthalmology centers, had successfully decreased the prevalence of visual impairment and blindness. However, new challenges arise with the aging population and the shift of the disease spectrum towards age-related eye diseases and myopia. With the constant technological boom, digital healthcare innovations in ophthalmology could immensely enhance screening and diagnosing capabilities. Artifcial intelligence (AI) and telemedicine have been proven valuable in clinical ophthalmology settings. Moreover, the integration of cutting-edge communication technology and AI in mobile clinics and remote surgeries is on the horizon, potentially revolutionizing blindness prevention and ophthalmic healthcare. The future of blindness prevention in China is poised to undergo signifcant transformation, driven by emerging challenges and new opportunities.

Blindness prevention has been an important national policy in China. Previous strategies, such as deploying experienced cataract surgeons to rural areas and assisting in building local ophthalmology centers, had successfully decreased the prevalence of visual impairment and blindness. However, new challenges arise with the aging population and the shift of the disease spectrum towards age-related eye diseases and myopia. With the constant technological boom, digital healthcare innovations in ophthalmology could immensely enhance screening and diagnosing capabilities. Artifcial intelligence (AI) and telemedicine have been proven valuable in clinical ophthalmology settings. Moreover, the integration of cutting-edge communication technology and AI in mobile clinics and remote surgeries is on the horizon, potentially revolutionizing blindness prevention and ophthalmic healthcare. The future of blindness prevention in China is poised to undergo signifcant transformation, driven by emerging challenges and new opportunities.

目的：构建眼科日间病房护理质量指标，为眼科日间病房的护理质量管理提供理论依据。方法：以Donabedian三维质量结构模式为理论框架，通过查阅文献、小组讨论，初步拟定眼科专科护理质量评价指标。通过专家函询，对指标进行筛选和修订，确定了眼科日间病房护理质量指标。结果：经过2轮函询，专家意见趋向一致，2轮问卷回收率均为100%，协调系数分别为0.129、0.342(P＜0.01)。构建的眼科专科护理质量指标包括3项一级指标，分别为结构指标(二级指标2项)、过程指标(二级指标8项)和结果指标(二级指标3项)。结论：该指标具有较高的科学性、可靠性、可行性以及专科特色，可为眼科日间病房护理质量的评价提供良好的方法。

Objective: To set up nursing quality indicators for ophthalmic intra-day ward, providing theoretical basis for nursing quality management in ophthalmic intra-day ward. Methods: Based on the "Donabedian three dimensional quality structure model" as the theoretical framework, the preliminary ophthalmic specialized nursing quality assessment indicators were designed by literature review and group discussion. The ophthalmic nursing quality indicators for intraday ward were finalized by expers consultated, indicators screened and revised. Results: After two rounds of inquration by letters, the opinions from the experts were consistent. Questionnaire response rates were both 100% in two rounds, with coordination coefficients of 0.129 and 0.342 respectively (P< 0.01). The nursing quality indicators for ophthalmic intra-day ward were established, including 3 primary indicators, which are structual indicators (2 secondary indicators), process indicators (8 secondary indicators) and outcome indicatiors(3 secondary indicators). Conclusion: The indicators are scientific, reliable, feasible with specialized characteristics, which can provide a good reference for evaluating the nursing quality in ophthalmic intra-day wards.

Background and Objective: Limbal stem cell deficiency (LSCD) is characterized by the insufficiency of limbal stem cells to maintain the corneal epithelium. Severe cases of LSCD may be treated with limbal transplantation from healthy autologous or allogeneic limbal tissue. Multiple cell-based therapies have been studied as alternative treatments to improve success rates and minimize immunosuppressive regimens after allogeneic transplants. In this review, we describe the success rates, and complications of different cell-based therapies for LSCD. We also discuss each therapy’s relative strengths and weaknesses, their history in animal and human studies, and their effectiveness compared to traditional transplants.

Methods: PubMed was searched for publications using the terms LSCD, cell-based therapy, cultivated limbal epithelial transplantation (CLET), cultivated oral mucosal epithelial transplantation (COMET),and mesenchymal stem cells from 1989 to August 2022. Inclusion criteria were English language articles.Exclusion criteria were non-English language articles.

Key Content and Findings: current cell-based therapies for LSCD are CLET and non-limbal epithelial cells. Non-limbal epithelial cell methods include COMET, conjunctival epithelial autografts, and mesenchymal stem/stromal cells (MSCs). Moreover, several alternative potential sources of non-limbal cells have described, including induced pluripotent stem cells (iPSCs), human embryonic stem cells (hESCs),human dental pulp stem cells, hair follicle bulge-derived epithelial stem cells, amniotic membrane epithelial cells, and human umbilical cord lining epithelial cells.

Conclusions: Cell-based therapies are a promising treatment modality for LSCD. While CLET is currently the only approved cell-based therapy and is only approved in the European Union, more novel methods have also been shown to be effective in human or animal studies thus far. Non-limbal epithelial cells such as COMET are also an alternative treatment to allogeneic transplants especially as a surface stabilizing procedure. iPSCs are currently being studied in early phase trials and have the potential to revolutionize the way LSCD is treated. Lastly, cell-based therapies for restoring the limbal niche such as mesenchymal stem cells have also shown promising results in the first human proof-of-concept study. Several potential sources of non-limbal cells are under investigation.

Background and Objective: Limbal stem cell deficiency (LSCD) is characterized by the insufficiency of limbal stem cells to maintain the corneal epithelium. Severe cases of LSCD may be treated with limbal transplantation from healthy autologous or allogeneic limbal tissue. Multiple cell-based therapies have been studied as alternative treatments to improve success rates and minimize immunosuppressive regimens after allogeneic transplants. In this review, we describe the success rates, and complications of different cell-based therapies for LSCD. We also discuss each therapy’s relative strengths and weaknesses, their history in animal and human studies, and their effectiveness compared to traditional transplants.

Methods: PubMed was searched for publications using the terms LSCD, cell-based therapy, cultivated limbal epithelial transplantation (CLET), cultivated oral mucosal epithelial transplantation (COMET),and mesenchymal stem cells from 1989 to August 2022. Inclusion criteria were English language articles.Exclusion criteria were non-English language articles.

Key Content and Findings: current cell-based therapies for LSCD are CLET and non-limbal epithelial cells. Non-limbal epithelial cell methods include COMET, conjunctival epithelial autografts, and mesenchymal stem/stromal cells (MSCs). Moreover, several alternative potential sources of non-limbal cells have described, including induced pluripotent stem cells (iPSCs), human embryonic stem cells (hESCs),human dental pulp stem cells, hair follicle bulge-derived epithelial stem cells, amniotic membrane epithelial cells, and human umbilical cord lining epithelial cells.

Conclusions: Cell-based therapies are a promising treatment modality for LSCD. While CLET is currently the only approved cell-based therapy and is only approved in the European Union, more novel methods have also been shown to be effective in human or animal studies thus far. Non-limbal epithelial cells such as COMET are also an alternative treatment to allogeneic transplants especially as a surface stabilizing procedure. iPSCs are currently being studied in early phase trials and have the potential to revolutionize the way LSCD is treated. Lastly, cell-based therapies for restoring the limbal niche such as mesenchymal stem cells have also shown promising results in the first human proof-of-concept study. Several potential sources of non-limbal cells are under investigation.

玻璃体切割术是目前临床上常见的眼科手术之一，其应用广泛，且具有良好的治疗效果，但术后仍会出现各种并发症，眼压升高便是其中常见的一种。玻璃体切割术后眼压升高的病因复杂多样，术前原发病的不同、术中处理方式的差异以及术后并发症均可引起眼压升高，根据不同的病因可以选用更合适的治疗方法。早期的眼压升高较易控制，主要采用药物及激光治疗，晚期眼压升高导致继发性青光眼则相对复杂，以手术治疗为主。该文主要对玻璃体切割术后高眼压的原因分析及治疗进展进行综述。

Pars plana vitrectomy is one of the common ophthalmic surgeries in clinic practice currently, which is widely used with good therapeutic effect. However, various complications may still occur after operation. Elevated intraocular pressure is one of common complications. The causes of postoperative ocular hypertension are complex and diverse. Elevated intraocular pressure could be caused by different preoperative primary diseases, intraoperative management methods,and postoperative complication. More appropriate treatment methods can be selected based on different causes. Early elevated intraocular pressure iseasier to control and is mainly treated with medicine and laser. Late elevated intraocular pressure leads to secondary glaucoma, which is relatively complex and mainly treated with surgery. This review mainly states causes and treatment progress of high intraocular pressure after vitrectomy.