目的：探讨超声乳化晶状体吸除联合囊袋上经巩膜缝线固定人工晶状体(intraocular lens,IOL)植入术治疗球形晶状体(microspherophakia,MSP)的有效性和安全性。方法：采用回顾性分析，选取2019年1月至 2020年6月期间在复旦大学附属眼耳鼻喉科医院进行治疗的MSP患者37例(37眼)，随机分为两组，纳入行超声乳化晶状体吸除联合囊袋上巩膜缝线固定IOL植入术(supra-capsular and scleral-fixated intraocular lens implantation,SCSF-IOL)的MSP患者20例(20眼)和行超声乳化晶状体吸除联合改良型囊袋张力环植入术(transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation,MCTR-IOL)的MSP患者17例(17眼)，观察两组术后最佳矫正视力及并发症等情况。结果：两组术后最佳矫正视力比术前均有改善(P<0.001)，而组间比较差异无统计学意义(P=0.326)。两组的IOL倾斜度相当(P=0.216)。预防性Nd:YAG激光后囊膜切开术在SCSFIOL术后1周至1个月进行。在SCSF-IOL组，2眼(10.00%)需要重复激光治疗，1眼(5.00%)出现囊口偏心。后囊膜混浊是MCTR组最常见并发症(6眼,35.29%)。随访期间两组均未出现IOL脱位、继发性青光眼和视网膜脱离。结论：SCSF-IOL是治疗球形晶状体的简单易行的手术方式，疗效与MCTR-IOL相当。Nd:YAG激光后囊膜切开术是预防SCSF-IOL术后囊袋并发症的必要手段。

Objective: To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens (IOL) implantation in the treatment of microspherophakia (MSP). Methods: by retrospective analysis, 37 MSP patients (37 eyes) who were treated in our hospital from January 2019 to June 2020 were randomly divided into two groups, including 20 MSP patients (20 eyes) who treated by SCSF-IOL and 17 MSP patients (17 eyes) who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL). The best corrected vision and complications were observed. Results: the best corrected vision was significantly improved in both groups (P < 0.001), but there was no remarkable difference between the two groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd: YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment, and one eye (5.00%) had a decentered capsule opening. Posterior capsular opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up. Conclusions: SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL. Nd: YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.

目的：比较重力液流与主控液流2种灌注方式下行白内障超声乳化手术对青光眼患者视盘血流的影响。方法：采用随机数字表法将患者分为2组，分别为重力液流灌注组和主控液流灌注组。记录术中超声乳化累积释放能量(cumulative dissipated energy，CDE)，术后1天、1周、1个月和3个月患者最佳矫正视力(best corrected visual acuity，BCVA)、眼压、视盘血流密度及视网膜神经纤维层厚度。结果：主控液流灌注组术中CDE小于重力液流灌注组(5.6±1.3 vs 6.3±1.2，P=0.034)。术后1天重力液流灌注组视盘周围血管密度(circumpapillary vascular density，cpVD)、整个图像血管密度(whole en face image vessel density，wiVD)和视盘内血管密度(inside disc vascular density，inside disc VD)均高于主控液流灌注组(P<0.05)，其余时间点差异无统计学意义(P>0.05)。术后1周和1个月重力液流灌注组视网膜神经纤维层厚度大于主控液流灌注组(P<0.05)，术后1天和3个月未见明显差异。结论：相较于传统的重力液流灌注，主控灌注能够在青光眼患者白内障超声乳化手术中减少超声能量的使用，术后早期可减轻由术中高眼压引起的视盘炎症性充血，可以减轻对视网膜神经纤维层的影响。

Objective: To compare the influence of active versus passive phacoemulsification fluidics systems on optic disc blood flow in patients with glaucoma. Methods: Patients were divided into 2 groups by a random number table method, namely the active fluidics system group and the passive fluidics system group. The intraoperative cumulative dissipated energy (CDE) was recorded, and the best corrected visual acuity (BCVA), intraocular pressure, optic disc blood flow density and retinal nerve fiber layer thickness were measured at the follow-up of 1 day, 1 week, 1 month and 3 months. Results: During phacoemulsification, CDE in the active fluidics system group was lower than that in the passive fluidics system group (5.6±1.3 vs. 6.3±1.2, P=0.034). One day after the surgery,the circumpapillary vessel density (cpVD), whole image vessel density (wiVD) and inside disc vascular density(inside disc VD) in the passive fluidics system group were higher than those in the active fluidics system group(P<0.05), and the differences were not statistically significant at the rest of the follow-ups (P>0.05).The retinal nerve fiber layer in passive fluidics system group was thicker than that in active fluidics system group at the follow-ups of 1 week and 1 month (P<0.05), and the difference was not statistically significant at the follow-up ofs 1 day and 3 months. Conclusion: Compared with the traditional passive fluidics system, the active fluidics system can reduce the CDE during phacoemulsification surgery. It can reduce the inflammatory congestion of the optic disc caused by intraoperative high intraocular pressure on the early postoperative stage. In addition, it can also protect retinal nerve fiber layer.

目的：评估白内障手术是否影响高度近视黄斑劈裂的进展，为高度近视黄斑劈裂合并白内障患者先行白内障手术改善视觉质量可行性提供依据。方法：选取2018年4月至2021年1月在上海市第十人民医院眼科确诊为高度近视黄斑劈裂患者共36例36眼纳入研究。根据是否行白内障手术分为实验组：男10例10眼，女8例8眼；对照组：男9例9眼，女9例9眼。比较两组初诊及1个月、3个月、6个月、12个月后黄斑中心区视网膜厚度(central subfield thickness，CST)、黄斑区视网膜容积(macular volume，MV)、视网膜平均厚度(average macular thickness，AMT)、最佳矫正视力(best corrected visual acuity，BCVA)、黄斑劈裂形态学进展率情况。结果：两组CST、MV、AMT时间和组别交互效应差异无统计学意义(F=0.825，P=0.370；F=1.266，P=0.268；F=0.612，P =0.657)，两组间差异无统计学意义(F =2.519，P =0.122；F =3.318，P =0.077；F =1.378，P=0.249)。两组BCVA时间和组别交互效应差异有统计学意义(P<0.001)；做简单效应分析实验组术后1、3、6及12个月BCVA较初诊差异均有统计学意义(均P<0.001)；两组1、3、6、12个月BCVA较初诊BCVA的增量差异均有统计学意义(均P<0.001)。两组黄斑劈裂形态进展率差异无统计学意义(P=1.0)。结论：白内障超声乳化吸除术在短期内不影响高度近视黄斑劈裂的进展，且可以提高高度近视黄斑劈裂合并白内障患者的视力。

Objective: To assess whether cataract surgery can affect the progression of myopic foveoschisis, so as to provide evidence for the feasibility of cataract surgery to improve visual quality in patients with myopia foveoschisis accompanied by cataract. Methods: A total of 36 patients (36 eyes) diagnosed with high myopia foveoschisis at the Department of Ophthalmology, Shanghai Tenth People’s Hospital from April 2018 to January 2021 were enrolled in the study. The patients were divided into an experimental group (10 males with 10 eyes, and 8 females with 8 eyes) and an observation group (9 males with 9 eyes, and 9 females with 9 eyes) according to whether cataract surgery was performed. The central subfield thickness (CST), macular volume (MV), average macular thickness (AMT), best corrected visual acuity (BCVA), and the progression rate of foveoschis morphology were compared between the two groups at the initial diagnosis and 1 month, 3 months, 6 months, and 12 months after the surgery. Results: In terms of CST, MV, and AMT in the central macular area, no significant difference was found between the two groups (F=2.519, P=0.122; F=3.318, P=0.077; F=1.378, P=0.249), and there was no significant difference in time and group interaction effects between the two groups (F=0.825, P=0.370; F=1.266, P=0.268; F=0.612, P=0.657). In terms of BCVA, there was significant difference in time and group interaction effects between the two groups (P<0.001). The simple effect analysis showed that, compared with initial diagnosis, the BCVA in the experimental group was statistically significant at 1, 3, 6 and 12 months after the surgery (all P<0.001). In addition, there was a significant difference in the increments of BCVA between the two groups at 1, 3, 6, and 12 months after the surgery when compared with the initial diagnosis (all P<0.001). However, there was no significant difference in the morphological progression between the two groups (P=1.0). Conclusion: Phacoemulsification will not affect the progression of myopic foveoschisis in a short period, and can improve the vision of patients with myopic foveoschisis accompanied by cataract.

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.