目的：评估超脉冲二氧化碳(CO₂)激光治疗不同类型眼睑肿物的疗效和安全性。方法：纳入50例眼睑肿物患者，其中男12例、女38例。患者年龄4~84岁。肿物类型包括眼睑色素痣、睑黄瘤、分裂痣、眼睑疣等，其中25例累及眼睑灰线，10例肿物直径>10 mm。所有患者接受超脉冲CO₂激光治疗，并进行术后随访。治疗效果通过术后数码照片评估，同时记录术后1个月并发症发生情况。结果：50例眼睑肿物总体治愈率为92%，有效率达到100%。4例眼睑色素痣在治疗后1个月内复发。术后并发症主要包括轻微倒睫(5例)、睫毛稀疏部分缺失(4例)和瘢痕增生及色素沉着(4例)，未出现其他严重并发症。结论：对于眼睑肿物，特别是睑缘肿物及大肿物，超脉冲CO₂激光是一种更为精确、微创、安全有效的治疗方法，可作为眼睑肿物治疗的优选方案。

Objective: To evaluate the efficacy and safety of ultrapulse carbon dioxide (CO₂) laser in the treatment for various types of eyelid tumors. Methods: A total of 50 patients, including 12 males and 38 females,with eyelid tumors were included in the study The age range is  from 4 to 84 years, with an average age of 37.9±20.0 years. The tumors found in our study include eyelid pigmented nevus, xanthelasma, divided nevus, and molluscum. Among them, 25 cases involved the gray line of the eyelid,and 10 cases had a tumor diameter greater than 10 mm. All patients underwent ultrapulse CO₂ laser treatment and postoperative follow-up. The treatment outcomes were assessed through digital photos, and complications were recorded one month after surgery. Results: The total cure rate of the 50 cases of eyelid tumors in our study was 92%, with the effective rate reaching 100%. 4 cases of eyelid pigmented nevi recurred within one month after treatment, while all other patients were cured. Postoperative complications mainly included minor trichiasis (5 cases), partial sparse to absent eyelashes (4 cases), and hypertrophic scar with hyperpigmentation (4 cases). No other serious complications were reported in our study. Conclusions: For eyelid tumors, especially eyelid margin and larger tumors, the ultrapulse CO₂ laser is a more precise, minimally invasive, safe and effective treatment method. It can be used as a preferred treatment option for eyelid tumors, and should be promoted widely in clinical practice.

目的：探讨小剂量利妥昔单抗(rituximab, RTX)预防视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder, NMOSD)复发的有效性和安全性。方法：采用前瞻性自身对照试验，选取2020年7月至2021年4月临床确诊为NMOSD的38例患者进行研究，给予小剂量RTX治疗。所有患者均进行病史采集、眼科检查和血清学指标检测，记录NMOSD年复发率(ARR)、最佳矫正视力(BCVA)、合并自身抗体情况和追加治疗的情况。视力检查采用Snellen视力表进行，并将结果转换为最小分辨角对数(logMAR)视力记录。随访至少12个月（17.29±2.2）个月，以末次随访为疗效判定时间点，比较治疗前后ARR、BCVA；分析复发与发病年龄、是否合并自身免疫抗体阳性和患自身免疫性疾病的关系。记录不良反应的发生率和追加治疗的时间。结果：共38例患者61眼纳入研究。其中男性4例，女性34例。发病年龄12~60岁，中位发病年龄23 (18~29.3)岁。病程10.0~265个月，中位病程65 (48.3~101.0)个月。治疗前logMAR矫正视力(1.15±0.13)，治疗后logMAR矫正视力(1.54±0.39)，比较差异无统计学意义(t=1.120，P=0.267)。治疗前ARR(1.50±0.86)次/年，治疗后ARR降低为(0.12±0.07)次/年，比较差异有统计学意义(t=8.304，P<0.001)。追加治疗时间为(6.4±2.3)月。随访期间3例患者复发，复发次数为 5次。 复发者与未复发者的发病年龄、合并免疫抗体阳性比例、合并自身免疫性疾病比例比较，差异均无统计学意义(均P>0.05)。38例患者中，出现输注不良反应7例，给予减慢RTX滴速及加用地塞米松5 mg治疗后均缓解，随访期间未见其他明显不良反应。结论：小剂量RTX可以有效清除B淋巴细胞，预防NMOSD复发，且安全性较好。

Objective: To evaluate the efficacy and safety of long-term treatment with low-dose rituximab for neuromyelitis optica spectrum disorders (NMOSD). Methods: A prospective self-control study. A total of 38 patients who were diagnosed with NMOSD from July 2020 to April 2021 were recruited for rituximab treatment. All patients collected medical history, ophthalmic examination and serological test. Recorded the annual recurrence rate (ARR), best corrected visual acuity (BCVA), combined autoantibodies and therapy times after the first treatment. The BCVA was examined using Snellen chart, and converted to logMAR. The patients were followed up at least 12(17.29±2.2) months, and the last follow-up was taken as the time point of efficacy evaluation. ARR and BCVA before and after treatment were compared. To analyze the relationship between relapse and age of onset, combination of autoimmune antibodies and autoimmune diseases. The incidence of side effects and duration of additional therapy were recorded. Results: A total of 38 NMOSD patients (4 male/34 female, 61 involved eyes) were included in this study. The ages of onset age were 12-60 years, the median onset age was 23 (18~29.3) years. Duration of disease was 10.0~265 months, the median duration was 65 (48.3~101.0) months. Before treatment, the mean BCVA was 1.15 ± 0.13 , the mean BCVA at last follow-up was 1.54 ± 0.39, which was no significant difference (t=1.120, P=0.267). The mean ARR before and after treatment were 1.50±0.86 and 0.12 ± 0.07, respectively, with significant difference (t=8.304, P<0.001). The mean reinfusion period was 6. 4±2.3 months. Five relapses in 3 patients were observed. There were no significant difference between relapsed patients and non-relapsed patients on onset age, with/without auto-immune antibody ratio, with/without auto-immune diseases ratio (all P>0.05). Of 38 patients, 7 patients had side effects, all patients who had side effects, slowing down the infusion speed of RTX or infusing 5 mg of dexamethasone could relieve the discomfort. Conclusions: Low-dose RTX can effectively clear B lymphocytes, prevent NMOSD recurrence and with good safety.

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：评估显微射频消融术治疗异位睫毛的临床疗效和安全性。方法：回顾性分析接受显微射频消融术治疗的18例异位睫毛患者资料，均采用美国Ellman公司Surgitron射频刀进行治疗，术后随访至少3个月。观察指标包括异位睫毛清除率、达到治愈所需治疗次数、并发症、患者满意度。采用Spearman等级相关分析评估患者基线特征与治疗次数的相关性。结果：共纳入18例患者30眼。显微射频消融术的术后即刻异位睫毛清除率达100%。5眼（16.7%）经单次治疗后达到治愈，11眼（36.7%）需要2次治疗达到治愈，13眼（43.3%）需要3次治疗达到治愈，1眼（3.3%）需要3次以上治疗达到治愈。主要并发症包括干眼13眼（43.3%）、睑缘炎症1眼（3.3%），未发现睑缘畸形、瘢痕等严重并发症。患者满意度调查显示非常满意16例（88.9%），基本满意2例（11.1%），总体满意度（非常满意+基本满意）达100%。相关性分析提示倒睫数量与达到治愈的治疗次数呈显著正相关（r_s=0.672, P=0.002）。结论：显微射频消融术治疗异位睫毛具有精确定位、有效破坏毛囊、治疗时间短、创伤小、恢复快、安全性高等优点，患者满意度高，是治疗异位睫毛的有效方法。

Objective: To evaluate the clinical efficacy and safety of microscopic radiofrequency ablation in treating of distichiasis and aberrant lashes. Methods: We performed a retrospective analysis on 18 patients with trichiasis (distichiasis and aberrant lashes) who underwent microscopic radiofrequency ablation treatment. All patients were followed up for a minimum of 3 months after the operation. The outcome measures included trichiasis clearance rate, the number of treatment sessions  needed to achieve success, complications, and patient satisfaction. Spearman rank correlation analysis was used to evaluate the correlation between the baseline characteristics of patients and the number of treatment sessions. Results: The study included 18 patients with a total of 30 eyes. Immediately after the operation,  the trichiasis clearance rate achieved through microscopic radiofrequency ablation was 100%. Among the eyes, 5 eyes (16.7%) were  successful treatment after just one session, 11 eyes (36.7%) required 2 treatment sessions, 13 eyes (43.3%) needed 3 treatment sessions, and 1 eye (3.3%) required more than 3 treatment sessions to achieve success. The major complications included dry eye in 13 cases (43.3%) and eyelid margin inflammation in 1 case (3.3%). Notably, no severe complications such as eyelid deformity or scarring were observed. According to the patient satisfaction survey, 16 cases (88.9%) reported being very satisfied, and 2 cases (11.1%) were basically satisfied, resulting in an overall satisfaction rate of 100%. The correlation analysis indicated that the number of trichiatic eyelashes was significantly positively correlated with the number of treatment sessions (r_s=0.672, P=0.002). Conclusions: Microscopic radiofrequency ablation for distichiasis and aberrant lashes treatment boasts serveral advantages, including precise localization, effective destruction of hair follicle, short treatment duration, minimal trauma, rapid recovery, and high safety. With a high level of  patient satisfaction, it serves as an effective treatment method for distichiasis and aberrant lashes.

目的：评估EYESi手术模拟器在眼科医师专科培训玻璃体手术中的教学效果。方法：招募中山大学中山眼科中心进行专科医师规范化培训的15名学员，开展眼底手术培训课程，随机分为A组、B组、C组，每组各5名学员。以培训开始前进行初次视网膜脱离手术作为基础分数，除玻璃体后脱离项目、视网膜前膜及内界膜项目等基础练习内容外，A组仅接受双手剪刀训练，B组仅接受激光训练，C组同时接受双手剪刀训练及激光训练。最后所有学员再进行视网膜脱离手术项目作为最终考核成绩。记录下学员的每次得分和操作时间。结果：培训后学员视网膜脱离手术得分较培训前提高（P<0.001）。C组与A组学员最终视网膜脱离手术得分高于B组学员（P<0.05）。有内眼手术经验的学员初次视网膜脱离手术得分高于无内眼手术经验的学员，且手术时长低于无内眼手术经验的学员（P<0.05）。结论：EYESi手术模拟器能有效提高眼科医师的手术操作信心及玻璃体视网膜手术操作技能，双手剪刀训练模块是玻璃体视网膜手术培训中的重要模块。

Objective: To assess the instructional efficacy of the EYESi surgical simulator in training ophthalmology residents on vitreoretinal surgical procedures. Methods: Fifteen ophthalmology residents participating in standardized specialist training program at Zhongshan Ophthalmic Center, Sun Yat-sen University, were randomly assigned to three groups (A, B, C; n=5 per group). All participants underwent an initial baseline assessment through simulated retinal detachment surgery. In addition to standard training modules covering posterior vitreous detachment, anterior retinal membrane peeling, and inner limiting membrane manipulation, Group A received supplementary bimanual scissors training, Group B underwent laser training, and Group C received both types of advanced training. The final assessments were carried out using the same retinal detachment simulation, with performance scores and operation times carefully recorded. Results: Post-training surveys revealed significant increases in both trainees’ self-confidence and their self-assessed surgical proficiency. Objective performance scores for retinal detachment surgery showed marked improvement after training (P < 0.001). Groups C and A achieved significantly higher final scores compared to Group B (P < 0.05). Participants with prior intraocular surgical experience scored higher and completed procedures more quickly in the baseline assessment than those without such experience (P < 0.05). Conclusions: The EYESi simulator proves to be an effective tool for enhancing surgical skills and boosting operational confidence in vitreoretinal surgery training. In particular, bimanual instrumentation training offers significant educational value in the development of advanced microsurgical techniques.

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

目的：评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法：回顾性分析中山眼科中心2016—2019年入院，因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼，术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率，比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA)，通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果：在总的71只眼中，有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升（P＜0.001），黄斑平均光敏度增加（P＜0.000 1）、黄斑完整指数降低（P＜0.000 1）、固视稳定性P1（P＜0.000 1）及P2（P＜0.001）均提升。结论：内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式，空气填充可有效地辅助黄斑裂孔愈合，可作为优先考虑的术中填充物，减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。

Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P < 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.

目的：探讨内镜下泪囊鼻腔吻合(endoscopic dacryocystorhinostomy, En-DCR)联合双管人工泪管植入(bicanalicular silicone tube intubation, BSTI)术治疗小泪囊型慢性泪囊炎的疗效。方法：回顾2020年7月—2023年3月在温州医科大学附属眼视光医院通过CT泪囊造影术(CT dacryocystography, CT-DCG)确诊的单眼小泪囊型慢性泪囊炎并接受手术的患者69例(69眼)，手术采取术中开放泪总管平面的En-DCR并联合BSTI术治疗。术后3个月取出人工泪管，通过术前和术后9个月随访资料，记录和分析了纳入患者的基本资料、手术治疗、治疗效果(包括解剖成功率和功能成功率)和并发症情况。结果：本研究最终纳入61例(61眼)患者，其中男21例、女40例，右眼33眼、左眼28眼。平均年龄为(55.31±12.28)岁(范围为27~75岁)。所有患者均顺利完成术中开放泪总管平面的En-DCR并联合BSTI术治疗。随访9个月，En-DCR的解剖成功率为80.33%(49/61)，功能成功率为75.41%(46/61)，在随访过程中未出现视力下降、眶内出血、感染扩散等并发症。结论：En-DCR联合BSTI术治疗小泪囊型慢性泪囊炎可取得较为满意疗效。

Objective: To evaluate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) Combined with bicanalicular silicone tube intubation (BSTI) for the Management of Chronic dacryocystitis with Small Lacrimal sac. Methods: A total of 69 patients (69 eyes) with chronic dacryocystitis with small lacrimal sac diagnosed by CT dacryocystography (CT-DCG) treated with En-DCR combined with BSTI at the Eye Hospital of Wenzhou Medical University from July 2020 to March 2023 were reviewed. The surgery procedure exposed the plane of common canalicular, and followed by BSTI. The tube was removed 3 months after surgery. The basic data, surgical treatment, therapeutic effect (including anatomical and functional success rates) and complications of the included patients were recorded and analyzed through the follow-up data before and 9 months after surgery. Results: Ultimately, 61 patients (61 eyes) were included in this study—21 males and 40 females—with a distribution of 33 right eyes and 28 left eyes. The mean age was calculated at 55.31±12.28 years (range: 27 to 75 years). All patients underwent a successful En-DCR with exposed the plane of common canalicular and BSTI. At the nine-month follow-up, the anatomical success rate of En-DCR was 80.33%(49/61), the functional success rate was 75.41%(46/61). No complications such as visual impairment, intraorbital hemorrhage, or spread of infection occurred during the follow-up period. Conclusions: The combination of En-DCR and BSTI surgery for chronic dacryocystitis with small lacrimal sac can achieve a satisfactory therapeutic effect.

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：探讨胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果。

方法：2003年12月－2008年12月在我院就诊的原发性翼状胬肉患者55例57眼，均采用胬肉切除联合自体角膜缘干细胞移植治疗，术后随访2～8年，平均5.3年。观察创面愈合情况、治疗效果和并发症情况。

结果：术后早期患者均有不同程度的充血、水肿和异物感，3～5d 后症状逐渐减轻，一周左右完全消失。角膜创面完全上皮化时间为4～7d，平均4.83d。术后有持续性眼表刺激症状者7例，术后残留纤维组织者1例，角膜浅层瘢痕者4例。术后随访2～8年，平均5.3年，复发8例8眼 (复发率13.11％)。术后1年时复查OSDI 评分，所有患者较术前评分均有不同程度的降低，与术前相比，两组评分和构成比差异有统计学意义(P＜0.05)。术后5年时复查OSDI评分较1年前稍有降低，但差异没有统计学意义(P＞0.05)。术后1、5年时泪液基础分泌[(12.95±4.03) mm，(12.68±4.77) mm]和泪膜破裂时间 [(10.55±4.13)s, (10.03±4.64) s] 较术前[(9.48±3.34)mm，(8.14±3.57)s] 明显改善，差异有统计学意义(P＜0.05)。

结论：应用胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉，术后早期症状轻、消失快，远期复发少，效果良好。

Purpose: To evaluate the long-term efficacy of pterygium excision combined with autologous corneal limbal stem cell transplantation in the treatment of pterygium．

Methods: Fifty five patients (57 eyes) diagnosed with primary pterygium undergoing pterygium excision combined with autologous corneal limbal stem cell transplantation between December 2003 and December 2008 were enrolled in this study. Postoperative follow-up endured for 2-8 years, 5.3 years on average. The wound healing, clinical efficacy and postoperative complications were observed．

Results: During early stage after surgery, all patients presented with varying degree of hyperemia, edema and sense of foreign body, which were gradually mitigated 3-5 d later and completely recovered in approximately 1 week. The corneal wound was completely epithelized within 4-7 d, 4.83 d on average. Seven patients had persistent ocular surface irritation symptoms after surgery, one case had residual fibrous tissues and four patients developed superficial corneal scars. Postoperative follow-up endured for 2-8 years, 5.3 years on average. Eight patients (8 eyes) recurred with a recurrence rate of 13.11％. In all patients,  postoperative OSDI score was significantly decreased at 1-year reexamination. OSDI score and constitution ratio significantly differed between two groups (both P＜0.05)．At postoperative 5 years, OSDI score was slightly lower compared with that in last year with no statistical significance(P＞0.05)．At post operative 1- and 5-year, basic tear secretion was (12.95 ±4.03) mm and (12.68 ±4.77) mm, tear film break-up time was (10.55±4.13)s and (10.03±4.64)s. Both indexes were significantly improved compared with (9.48±3.34) mm and (8.14±3.57)s before surgery (all P＜0.05)．

Conclusion: Pterygium excision combined with autologous corneal limbal stem cell transplantation is an efficacious treatment of pterygium with mild postoperative symptoms, rapid recovery, low long-term recurrence rate and high efficacy．