目的：研究经鼻内镜低位泪囊鼻腔吻合术联合RT新型人工泪管置入手术的临床有效性和安全性。方法：采用前瞻性随机对照研究，将临床诊断为原发性鼻泪管阻塞继发的慢性泪囊炎患者随机分为两组。研究组(A组)43例(44眼)采用低位经鼻内镜泪囊鼻腔吻合联合新型RT人工泪管置入术。对照组(B组)39例(39眼)采用常规经鼻内镜泪囊鼻腔吻合联合双泪小管置入式人工泪管置入。术后3～6个月取出人工泪管，随访时间1～12个月，平均6个月。观察术中术后的并发症，评估其安全性。结果： A组治愈42眼(95.45%)，好转2眼(4.54%)；B组治愈38眼(97.43%)，好转1眼(2.56%)，两组比较差异无统计学意义(P＞0.05)。B组有12眼(30.77%)使用骨动力系统用于磨削骨质，A组未使用骨动力系统；A组手术时间为(31.88±1.64) min；B组手术时间为(48.54±4.40) min，两组比较差异有统计学意义(P <0.01)；B组术后人工泪管从内眦脱出2例，A组在人工泪管置入或取出时，均无管体被拉断裂的病例，无人工泪管从内眦侧脱出的病例。两组患者术后均无人工泪管导致的泪点撕裂，术后随访平均6个月，均无复发。结论：低位经鼻内镜泪囊鼻腔吻合术联合RT新型人工泪管置入可以作为一种新的治疗慢性泪囊炎手术有效、安全的方法。

Objective: To study the efficacy and safety of endonasal endoscopic lower position dacryocystorhinostomy(En-LPDCR) combined with new RT lacrimal stent intubation for treating chronic dacryocystitis. Methods: In A prospective randomized controlled study, patients with chronic dacryocystitis secondary to primary nasolacrimal duct obstruction who met the inclusion criteria were randomly divided into two groups. In study group (Group A), 43 cases (44 eyes) were treated with the En-LP-DCR combined with new RT lacrimal stent intubation. Control group (Group B), 39 cases (39 eyes): conventional endoscopic dacryocystorhinostomy combined with bicanalicular intubation. The stent was removed from 3 to 6 months after surgery and followed up 6 to 12 months. Results: There was no recurrence of chronic dacryocystitis in both groups. In group A, 42 eyes (95.45%) were cured and 2 eyes (4.54%) were improved. In group B, 38 eyes were cured (97.43%) and 1 eye was improved (2.56%), there was no significant difference between the two groups (P > 0.05). In group B, 12 eyes (30.77%) With the incorporation of powered instrumentation to make bony ostium with full exposure of the lacrimal sac., while group A did not use powered dynamic system. Operation time of group A was (31.88±1.64) min; The operation time of group B was (48.54±4.40) min. The difference between the two groups was significant (P < 0.01). In group B, the stent dislocated from the medial canthus in 2 cases, while in group A, there were no cases of the stent dislocated. No patient with dislocation, displacement of stent and punctum erosion founded in both groups, and no recurrence of chronic dacryocystitis was observed during the average follow-up of 6 months. Conclusion: Endonasal endoscopic lower position dacryocystorhinostomy combined with new RT lacrimal stent intubation is a new and effective method for the treatment of chronic dacryocystitis, with minimally surgical injury and faster postoperative recovery.

二氧化碳(carbon dioxide, CO₂)激光通过气体混合物激发产生红外光，组织水分高度吸收后引发汽化和局部热效应，能够精确封闭小血管和淋巴管。这些特性使得CO₂激光在组织切割过程中能够最大限度地减少出血，提高术中视野的清晰度，缩短手术时间，并减轻术后肿胀、瘀斑及疼痛。在眼整形外科，特别是处理眼周复杂病例方面，CO₂激光展现了显著的优势。文章对CO₂激光在眼整形外科中的应用进行综述，包括眼睑肿物切除、泪小管炎治疗、瘢痕治疗、皮肤松弛治疗以及眼袋去除等，旨在为临床医生和研究人员提供关于CO₂激光在眼整形外科中的全面参考，帮助其了解该项技术的优势、效果及术后并发症，以更有效地应用于实践并探索未来发展。

The carbon dioxide (CO₂) laser generates infrared light through the excitation of a gaseous mixture. When this infrared light is highly absorbed by tissue water, it triggers vaporization and localized thermal effects, enabling precise sealing of small blood vessels and lymphatic vessels. These properties allow the CO₂ laser to minimize bleeding during tissue dissection, enhance intraoperative visual field clarity, reduce operative time, and alleviate postoperative swelling, ecchymosis, and pain. The CO₂ laser has demonstrated significant advantages in oculoplastic surgery, particularly in the management of complex periorbital cases. This article reviews the applications of the CO₂ laser in oculoplastic surgery, including eyelid tumor excision, treatment of canaliculitis, scar management, skin laxity treatment, and removal of eye bags. It aims to provide clinicians and researchers with a comprehensive reference on the use of the CO₂ laser in oculoplastic surgery, helping them understand the advantages, effects, and postoperative complications of this technology, in order to more effectively apply it in practice and explore future developments.

目的：分析鼻内镜下泪囊鼻腔吻合术手术疗效的影响因素。方法：纳入2021年1月—2023年7月在成都中医药大学附属医院眼科行鼻内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗的单眼慢性泪囊炎患者90例(90只眼)。所有患者均进行泪道CT造影检查及鼻内镜下泪囊鼻腔吻合术，术后随访6个月，评估手术疗效，分析手术疗效的影响因素。结果：本研究显示，慢性泪囊炎患者中女性占比为90%，平均年龄为(49.97±13.10)岁。单因素分析结果显示，术中是否置入引流管、下鼻甲肥厚与EnDCR手术疗效有关(P < 0.05)。Logistic多因素回归分析结果显示，下鼻甲肥厚为En-DCR手术疗效的危险因素(P < 0.05)。结论：慢性泪囊炎多发生于中老年女性。下鼻甲肥厚为En-DCR手术疗效的危险因素。

Objective: To analyze the influencing factors for effect of endoscopic dacryocystorhinostomy. Methods: A total of 90 patients (90 eyes) diagnosed with unilateral chronic dacryocystitis undergoing endoscopic dacryocystorhinostomy in the Department of ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine from January 2021 to July 2023 were included. All patients underwent lacrimal duct CT imaging and endoscopic dacryocystorhinostomy, and were followed up for 6 months to evaluate the efficacy of surgery. Results: This study showed that 90% of patients with chronic dacryocystitis were female, and the average age of patients was (49.97±13.096) years. The results of univariate analysis showed that there was a correlation between intraoperative drainage tube placement and inferior turbinate hypertrophy and the efficacy of En-DCR (P < 0.05). The results of Logistic regression analysis showed that inferior turbinate hypertrophy was a risk factor for the efficacy of En-DCR (P < 0.05). Conclusions: Dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy are the influencing factors of surgical effect. Chronic dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy is a risk factor affecting the curative effect of En-DCR surgery.

目的：比较中国南方地区与西北地区慢性泪囊炎患者的菌群分布，明确细菌谱的地理差异性，对不同地区抗生素使用因地制宜提供依据。方法：本研究为回顾性横断面研究。纳入2022年3月—2024年4月在中国西北地区三甲医院眼科诊断为慢性泪囊炎，拟行泪囊鼻腔吻合术的患者，并选取同时期在中国南方地区诊断为慢性泪囊炎的患者，所有患者在行经鼻镜泪囊鼻腔吻合术时切开泪囊取泪囊分泌物。两组标本均行一般细菌及真菌培养，比较两组细菌培养阳性率和构成比。结果：南方地区和西北地区泪囊分泌物细菌培养阳性率分别为26.0%和50.7%，差异有统计学意义(P < 0.001)。南方地区细菌分布中革兰阳性球菌、革兰阴性杆菌的构成比分别为 45.9%、37.6%，西北地区两种菌构成比为 71.4%、19.0%，差异有统计学意义(分别为P = 0.007，P = 0.003)。两地区检出率最高的菌均为凝固酶阴性葡萄球菌，链球菌属占比在两地区间比较差异有统计学意义(P = 0.004)。结论：中国南方地区比西北地区泪囊分泌物培养阳性率低，慢性泪囊炎细菌谱均以革兰阳性菌为主，南方地区革兰阴性菌占比较西北地区更高，链球菌属检出率较西北地区明显更低。这可能是不同地理环境、不同气候、不同生活习惯等共同因素的结果。

Objective: To compare the bacterial distribution of patients with chronic dacryocystitis from southern China and northwest China and to elucidate the geographical differences in the bacterial spectrum. Methods: This retrospective cross-sectional study included patients diagnosed with chronic dacryocystitis at the ophthalmology departments of tertiary hospitals in southern and northwest China between March 2022 and April 2024. Endoscopic dacryocystorhinostomy was performed on all patients to collect lacrimal sac secretions. The specimens were cultured for bacteria and fungi, and the positive rates and composition ratios of bacterial culture were compared between the two groups. Results: The positive rates of bacterial cultures from lacrimal sac secretions were 26.0% in southern China and 50.7% in northwest China (P < 0.001). The proportions of Gram-positive cocci and Gram-negative bacilli were 45.9% and 37.6%, respectively, in southern China, compared to 71.4% and 19.0%, respectively, in northwest China (P = 0.007 and P = 0.003, respectively). Coagulase-negative staphylococci were the most frequently detected bacteria in both regions. However, the proportion of Streptococcus species was significantly higher in northwest China compared to southern China (P = 0.004). Conclusions: The positive rate of lacrimal sac secretion cultures was lower in southern China compared to northwest China. The bacterial spectrum of chronic dacryocystitis in both regions was predominantly composed of Gram-positive bacteria. However, the proportion of Gram-negative bacteria was higher in southern China, while the detection rate of Streptococcus species was significantly higher in northwest China. These differences may be attributed to variations in climate, geographical features, and lifestyle habits.

血泪是指因各种原因导致眼部流出血性泪液的症状，其病因和临床表现复杂多样，往往涉及多学科多专业。不同病因引起的血泪，无论是临床表现，还是诊治方法均差异很大。为了向临床医生提供可参考的血泪临床诊疗流程，中国医师协会眼科医师分会泪器病专业委员会及中国中西医结合学会眼科专业委员会泪器病学组组织有关专家以临床实践经验为基础，经过认真讨论建立本共识，对血泪的病因、临床特征及诊疗流程提出指导性意见。

Bloody tears refers to the symptoms of blooding tears flowing from the eye due to various reasons. Its etiology and clinical manifestations are complex and diverse, often involving multiple disciplines and specialties. In order to provide clinicians with a reference for the clinical diagnosis and treatment process of bloody tears, Lacrimal Diseases Professional Committee of Ophthalmologist Branch of Chinese Medical Doctor Association and Lacrimal Diseases Group of Ophthalmic Professional Committee of Chinese Association of Integrated Medicine organized relevant experts to establish this consensus based on clinical practice after serious discussion, and put forward guiding opinions on the etiology, clinical characteristics, and diagnosis and treatment process of bloody tears.

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.

目的：探讨非超声乳化白内障手术两种不同的娩核方式对角膜内皮细胞数量和形态的影响，以及对术后视力恢复情况的影响。

方法：选择在本院手术治疗的40例白内障患者娩核方式分为直接娩出组和半娩出组，并根据 Emery－ little晶状体核硬度分级标准分为软核和硬核，手术方式为白内障非超声乳化手术，术后第3天用角膜内皮镜检查并记录角膜内皮细胞数量和形态。术后随访3个月，比较并观察4组患者术前和术后角膜内皮细胞丢失率、形态变化和视力恢复情况。

结果：术前和术后3个月角膜内皮细胞丢失率比较，硬核直接娩出组与另外三组比较差异有统计学意义(P＜0.01)，而软核直接娩出组、硬核半娩出组与软核半娩出组比较差异无统计学意义(P＞0.05)。术前和术后第二天视力比较硬核半娩出组和软核直接娩出组之间无统计学意义(P＝0.49)，软核半娩出组与这两组比较有统计学意义(P＝0.030)，硬核直接娩出组与这两组之间比较也有统计学意义(P＝0.14)，术后三个月视力比较4组之间均无统计学意义(P＝0.067)。术后 3 个月角膜内皮细胞形态变化不明显。

结论：白内障非超声乳化手术时，硬核直接娩核法对角膜内皮细胞损伤最大，软核半娩核法对角膜内皮损伤最小。若内皮细胞损伤较轻，对手术3个月后视力和角膜内皮细胞形态无明显影响。 

Purpose: To investigate the effect of non-phacoemulsification cataract operation in two different patterns of nucleus delivery on the quantity and morphology of corneal endothelial cells and postoperative visual acuity．

Methods: Forty patients diagnosed with cataract underwent cataract surgery and were assigned into the direct nuclear delivery and semi-nuclear delivery groups. Lens density was measured and divided into the hard and soft lenses according to Emery-little lens nucleus grading system. Non-phacoemulsification cataract operation was performed. At 3 d after surgery, the quantity and morphology of corneal endothelium were counted and observed under corneal endothelial microscope. During 3-month postoperative follow-up, the endothelial cell loss rate, morphological changes and visual acuity were compared among four groups．

Results: Corneal endothelial cell loss rate in the direct delivery of hard nucleus group significantly differed from those in the other three groups before and 3 months after operation (P＜0.01),  whereas no statistical significance was found among the direct delivery of soft nucleus,  semi-delivery of hard nucleus and semi-delivery soft nucleus groups (all P＞0.05).  Preoperative and postoperative 2-d visual acuity did not differ between the semi-delivery of hard nucleus and direct delivery of soft nucleus groups (P＝0.49)，significantly differed from those in the semi-delivery of soft nucleus (P＝0.03) and direct delivery of hard nucleus groups (P＝0.14). Visual acuity at postoperative four months did not differ among four groups (P＝0.067). 
Conclusion: During non-phacoemulsification cataract surgery, direct delivery of hard nucleus caused severe injury to corneal endothelium and semi-delivery of soft nucleus yielded mild corneal endothelial injury. Slight corneal endothelial injury exerted no apparent effect upon visual acuity and corneal endothelial morphology at three months after surgery．

Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.

Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.

Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).

Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.

Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.

Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.

Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).

Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.