目的：设计一套瞳孔动、静态信息提取方案，尝试初步建立正常人群瞳孔动、静态信息数据库。方法：于2023年1月—7月，从中山大学眼科中心眼科门诊招募无眼部疾病、全身疾病的参与者。使用工业级红外相机搭配850 nm红外光源录制参与者瞳孔区域20 s视频，提取瞳孔横径数据并输出为txt文件。使用R语言分析数据，构建瞳孔舒缩过程中的波峰、波谷拟合线，并估算瞳孔舒缩频率。结果：共收集32位参与者的瞳孔动态数据，右眼数据纳入主要结果的分析。参与者年龄范围为7~61岁，男性占50%，等效球镜度范围为-5.630~+5.00 D。测量过程中的瞳孔横径平均值与年龄呈负相关，与等效球镜度、性别无关。在20 s的记录中，瞳孔舒缩次数为(15±7)次。基于波峰与波谷拟合线的趋势，瞳孔舒缩动态分为3种类型：舒缩扩张型、舒缩稳定型和舒缩缩小型。舒缩稳定型进一步分为稳定扩张型、稳定恒定型和稳定缩小型3个亚型，其中25人为舒缩缩小型。双眼的过滤后波峰、波谷拟合线的斜率和截距与过滤前比较差异无统计学意义(P>0.05)。结论：低成本、简易的设备配以算法可以便捷、快速地提取瞳孔动、静态信息。

Objective: To design a method for extracting dynamic and static information of the pupil and to establish a database of pupil dynamic and static information in a healthy population. Methods: From January to July 2023, subjects without any ocular or systemic diseases were recruited from the ophthalmology outpatient department. An industrial-grade infrared camera, paired with an 850nm infrared light source, was used to record 20-second videos of the pupil area of each subject. Horizontal pupil diameter data was extracted and saved as txt files. The data was analyzed using R software to construct fitted lines of peaks and troughs during the pupil constriction and dilation process, and the frequency of pupil contraction and dilation was estimated. Results: Pupil dynamic data was collected from 32 subjects with an age range of 7 to 61 years, of whom 50% were male. The spherical equivalent range was from +5.00 D to -5.625 D. The average number of pupil contractions and dilations within the 20-second recordings was (15 ± 7) cycles. Based on the trend of fitted lines for peaks and troughs, pupil dynamic types were categorized into three types: dilation type, stable type, and contraction type. The stable type was further divided into stable dilation, stable constant, and stable contraction subtypes. 25 subjects exhibiting the constriction type. A paired t-test showed no significant difference in the slope and intercept of the fitted lines for peaks and troughs between both eyes. Conclusion: Low-cost and simple equipment combined with algorithms can efficiently and quickly extract dynamic and static pupil information.

      迟发性眼前节毒性综合征（toxic anterior segment syndrome，TASS）是 TASS 的一种特殊类型，两者既有共同点又有区别，随着人们认识的深入，越来越多的迟发性 TASS 被报道。迟发性 TASS 较典型性 TASS 少见，流行病学特征因人工晶体不同而有差异。几乎所有可引起典型性 TASS 的因素都可以引起迟发性 TASS，此外铝元素在迟发性 TASS 的发生中可能有关键作用。迟发性 TASS 临床表现与典型性 TASS 类似，累及后段更为常见，激素治疗有效。

Late-onset toxic anterior segment syndrome (TASS) is a special type of TASS, which has both similarities and differences. With the deepening understanding, more and more late-onset TASS is reported. Late-onset TASS is less common than typical TASS, and the epidemiological characteristics are vary with intraocular lenses. Almost all the factors that can cause typical TASS can cause late-onset TASS, in addition, aluminum element may play a key role in the occurrence of delayed TASS. The clinical manifestations of late-onset TASS are similar to those of typical TASS, with the involvement of the posterior segment more common and hormone therapy effective.

      干眼是指以泪膜稳态失衡为主要特征并伴有眼部不适症状的多因素眼表疾病。目前干眼的主要治疗手段包括药物治疗（人工泪液替代疗法、抗炎治疗、免疫抑制治疗）和必要时的手术干预治疗。地夸磷索四钠属于 P2Y₂ 受体激动剂，是一种治疗干眼的新型药物。它通过刺激位于眼表组织的 P2Y₂ 受体，促进泪液、黏液、脂质分泌，增强泪膜稳定性，从而改善干眼的症状和体征。

Dry eye refers to a series of chronic and progressive ocular surface diseases characterized by imbalanced tear film accompanied with ocular discomfort symptoms. The available methods mainly include pharmacotherapy (artificial tears replacement, anti-inflammatory, immunosuppressive therapy) and ophthalmic surgery. P2Y₂ receptor agonist is a novel pharmaceutical agent for dry eye treatment, which could stimulate tear fluid secretion and mucin secretion through binding with P2Y₂ receptors on the ocular surface, so that improve tear film stability and alleviate symptoms of dry eye. 3% diquafosol ophthalmic solution is the only P2Y₂ receptor agonist available for dry eye.

目的：总结全身麻醉斜视矫正日间手术服务模式的创建与安全管理方法。方法：回顾 2015 年 10 月至 2018 年 10 月期间全身麻醉下行斜视矫正日间手术患者共 9 570 例。改革护理管理模式，实施医护一体化，在实施过程中对患者进行严密的术前、术后护理管理：术前评估，健康教育前移、加强核查制度、严格监测患者生命体征；术后病情严格交接，家属及患者同步术后指导、离院后回访。结果：全身麻醉斜视矫正日间手术的 9 570 例患者，均未发生手术并发症，术后不适 34 例，占 0.36%，其中 2 例患者离院时出现头晕，2 例发生尿储留，30 例出现恶心、呕吐。护理人力由开展前 16 人减少到 12 人，节约 25%；患者等候手术时间缩短了 8 d，满意度由 70% 提高到 90%，平均住院时间由 3.2 d 减少为 1 d。结论：全身麻醉斜视矫正日间手术模式是一种新的医疗模式，开展全身麻醉日间手术不但可以节省医疗资源，还可提高患者满意度。

Objective: To summarize the establishment and safety management methods of ambulatory strabismus surgery that can provide the basis for carrying out ambulatory surgery nursing under general anesthesia. Methods:We carried out ambulatory surgery management that reformed nursing management model and delivered the integration of medical care in 9 570 patients undergoing strabismus surgery under general anesthesia from October 2015 to October 2018. In implementation process, we carefully managed the patients before and after operation including performing preoperative assessment and health education in advance, strengthening the verification system, strictly monitoring vital signs of the patients, strict shifting state of patients after operation, providing postoperative guidance to patients and their families, and performing follow-up clinic visits after leaving the hospital. Results: No surgical complications occurred in any of our cases. 34 patients had postoperative discomfort, accounting for 0.36%. Among these 34 patients, 2 had dizziness, 2 had urinary retention and 30 had nausea and vomiting. After treatments, all patients were discharged on schedule. The number of nurses reduced from 16 to 12 that fell by 25%. Wait times for operation reduced by 8 days. Patient satisfaction was improved from 70% to 90%. The mean length of hospital stay was reduced from 3 days to 1 day. Conclusion: The management of ambulatory surgery under general anesthesia is a new medical care service model. Careful planning and strict preoperative and postoperative safety management can ensure the safe implementation of strabismus surgery. Ambulatory surgery under general anesthesia has benefits to save medical resources and improve patient satisfaction.

目的：探讨先天性瞳孔残膜围手术期的护理方法。方法：对 13 例（15 眼）先天性瞳孔残膜患儿围手术期给予心理护理、安全护理、优先安排术前检查、术后严密观察病情变化、延续性护理并观察其效果。结果：13 例（15 眼）先天性瞳孔残膜的患儿手术均顺利完成，术后均无出现并发症，其中 6 例患者术后视力较术前视力有所提高，住院满意度为92.3%（12 / 13）。结论：对先天性瞳孔残膜患儿围手术期给予针对性的心理护理、安全护理、延续性护理是瞳孔残膜围手术期的有效护理方法。

Objective: To explore the perioperative nursing methods of persistent pupillary membrane. Methods: In the perioperative period, 13 cases (15 eyes) with persistent pupillary membrane were given preoperative nursing care, psychological nursing, careful observation of the change of condition, safety nursing, continuous nursing and observation of its effect. Results: A total of 13 cases (15 eyes) with persistent pupillary membrane were successfully operated, among which 6 cases had improved postoperative visual acuity compared with preoperative visual acuity, and no postoperative complications occurred. The satisfaction rate of hospitalization was 92.3% (12/13). Conclusion: It is an effective nursing method to give psychological nursing, safety nursing and continuous nursing to children with persistent pupillary membrane in perioperative period.

真菌性眼内炎是临床上少见的眼内感染疾病。因为其诊断延迟和抗真菌药物的有效性有限，因此真菌性眼内炎常常导致视力严重损害。按照感染性途径，真菌性眼内炎包括内源性和外源性，其中外源性眼内炎常见，进展较快，眼部手术术后感染是常见原因之一。小梁切除术是抗青光眼滤过性手术，是目前手术治疗青光眼的有效方法之一。滤过泡相关性眼内炎是其并发症之一，对患者视功能的损害尤为严重。本文通过回顾 1 例滤过泡相关性真菌性眼内炎患者的临床病例资料，讨论及分析滤过泡相关性的真菌性眼内炎的危险因素及诊治方法。

Fungal endophthalmitis is a disease which is a rare kind of interocular infection in clinic. Fungal endophthalmitis often results in severe visual impairment because of delayed diagnosis and limited effectiveness of antifungal drugs. Fungal endophthalmitis includes endogenous and exogenous endophthalmitis which is common and progresses rapidly. Postoperative infection is one of the common causes of fungal endophthalmitis. Trabeculectomy is an antiglaucoma filtering operation, and it is one of the effective methods for glaucoma surgery at present. Glaucomafiltering bleb infection is one of the complications of trabeculectomy, which can lead to severe visual impairment. In this article, we analyzed and discussed the risk factors, diagnosis and treatment methods about the filtering bleb-associated fungal endophthalmitis.

医师规范化培训面临的主要问题是缺少规范化的培训模式和统一的培训评估标准。本研究通过客观结构化临床考试（objective structured clinical examination，OSCE）教学评估及问卷调查，探讨基于问题的学习（problem-based learning，PBL）教学模式在医师规范化培训中的应用效果，结果表明 PBL 是适应医师规范化培训特点的一种教学模式，而 OSCE 是一种规范化培训行之有效的评估模式。

The main problems faced by the standardized training of physicians are the lacking of standardized training mode and unified training evaluation standard. This study was designed to evaluate the effectiveness of employing problem-based learning （PBL） on the standardized training of ophthalmologic residents by objective structured clinical examination （OSCE） and questionnaire survey. The result shows that PBL training mode is eligible for the characteristics of standardized training of ophthalmologic residents, and OSCE is an effective estimate model. 

囊袋缩窄综合征（capsule contraction syndrome CCS）是白内障超声乳化摘除人工晶体囊袋内植入术后少见的并发症。遵义医学院附属医院收治的 2 例植入蔡司 603P 人工晶体患者，均在术后 3 个月后自发出现非典型囊袋缩窄伴人工晶体偏斜移位，6 个月后行人工晶体置换术。本文通过回顾 2 例患者的病例资料，讨论及分析其囊袋缩窄的原因、危险因素及诊疗方法。

Capsule contraction syndrome （CCS） is a rare complication after cataract ultrasonic emulsification and implantation of intraocular lens. Two patients with implanted Zeiss 603p intraocular lens were treated in Zunyi Medical College Affiliated Hospital, they presented with spontaneous dislocation of intraocular lens by atypical CCS after 3 months. After 6 months, they received artificial lens replacement. By reviewing the clinical data of two patients, the causes, risk factors and diagnosis and treatment of the narrowing of the pouch were discussed and analyzed.

患者，男，54 岁，因“双眼异物感伴眼痒 2 周”在北京怀柔医院眼科就诊。自诉 1 d 前自行从眼内取出白色虫体 1 条。裂隙灯检查发现左眼结膜囊内可见白色虫体 2 条，用眼科镊子将其取出，并送病理科检查。就诊结束后嘱患者左氧氟沙星眼液滴左眼，4次/d 。后病理科证实虫体为结膜吮吸线虫。5 d 后患者复诊，诉左眼仍眼痒伴异物感，再次行裂隙灯检查检深部穹隆白色虫体 1 条，取出虫体，并使用生理盐水加压冲洗结膜囊，嘱患者局部抗生素点眼，门诊随访 3 周未见复发。

A 54-year-old patient was admitted to the Department of Ophthalmology in Beijing Huairou Hospital due to the itch of eyes for 2 weeks. He said that a white worm was removed from the eye the day before the visit. Two white worms were found in the conjunctival sac from the left eye and we removed them with the tweezers and then sent to pathology department for further examination. The patient was told to use the levofloxacin eye drop 4 times a day. After 2 days, it was confirmed that the worms were Thelazia callipaeda; after 5 days, the patient came back for further consultation and complained that the itching and foreign body sensation didn’t disappear. And then a white worm was found in the deep conjunctival sac from the left eye. The worm was removed, and the conjunctival sac was flushed with saline. The patient was told to continue using the levofloxacin eye drop. During 3-week followup, no recurrence was found.

目的：评估 2.2 mm微切口白内障超声乳化摘除（phacoemulsification，Phaco）联合多焦点人工晶状体 （multifocal intraocular lens，MIOLs）植入术治疗老年性白内障的临床安全性及疗效。方法：选取于 2018 年 1 月 1 日至 2018 年 6 月 31 日于佛山市第二人民医院行白内障Phaco联合人工晶状体植入的老年白内障患者。将其分为 2 组：A组 31 例 35 眼行 2.2 mm微切口Phaco联合MIOLs植入术，B组 31 例 38 眼行 3.0 mm标准切口Phaco联合单焦点IOLs植入术。2 组患者均完善术前、术后的裸眼视力、角膜曲率、眼压、角膜内皮细胞数、离焦曲线等检查，同时记录其手术过程中的参数，进行比较。结果：A组与B组在手术过程中，总超乳时间、总超乳能量、超声乳化累积能量复合参数、有效超乳时间、平均超乳能量、总手术时间对比，差异均无统计学意义（均P>0.05）。2组患者术后较术前比较，角膜内皮细胞数均有所下降，差异有统计学意义（P<0.05）；2 组患者间在各时间点的比较，差异均无统计学意义（均P>0.05）。2 组患者手术中均未出现后囊膜破裂等并发症。2.2 mm切口与 3.0 mm切口术后均增加了角膜散光，与术前比较差异均有统计学意义（均P<0.01）；2 组间比较，差异无统计学意义（均P>0.05）。术后 3 个月，2 组间裸眼远视力（uncorrected distance visual acuity，UCDVA）对比差异无统计学意义（t=−1.794，P=0.07）；裸眼近视力（uncorrected near visual acuity，UCNVA）对比差异有统计学意义（t=−25.147，P<0.01）。A组的离焦曲线有 2 个峰值，分别位于 0 D和−3.5 D附近，两峰值间形成一个下降平缓的平台；B组的离焦曲线只有1个峰值，位于0~0.5 D之间，峰值两端下降趋势明显。A组的脱镜率为 77.42%（24/31），B组的脱镜率为12.90%（4/31），差异有统计学意义（χ² =26.050，P<0.01）；2 组的总体满意度差异无统计学意义（χ² =1.615，P=0.204）。结论：2.2 mm同轴微切口白内障手术在临床上安全性良好，联合植入MIOLs有较好的疗效，可于临床上广泛推广。 

Abstract Objective: To evaluate the clinical safety and curative effect of phacoemulsification （Phaco） combined withmultifocal intraocular lens （MIOLs） implantation in the treatment of senile cataract with 2.2 mm microincision cataract. Methods: The cataract patients who underwent phacoemulsification and intraocular lens implantation in our hospital were selected from January 1, 2018 to June 31, 2018. They were divided into two groups: group A with 31 patients （35 eyes） undergoing 2.2 mm micro-incision Phaco combined with MIOLs, while group B with 31 patients （38 eyes） undergoing 3.0 mm standard incision Phaco combined with single focus IOLs.The preoperative and postoperative uncorrected visual acuity, corneal curvature, intraocular pressure, corneal endothelium number, and defocus curve were recorded in both groups. The parameters during the operation were also recorded and compared. Results: There was no statistically significant difference in the parameters including total phacoemulsification time, total phacoemulsification energy,phacoemulsification cumulative energy compound parameters, effective phacoemulsification time, average phacoemulsification energy, total surgery time between group A and group B during the operation （all P>0.05）. Compared with preoperative, the number of corneal endothelial cells decreased both in the two groups after surgery. The difference was statistically significant （P<0.05）. There was no significant difference between the two groups at any time （all P>0.05）. There were no complications such as posterior capsule rupture during operation in both groups. The corneal astigmatism was increased after operation both in the 2.2 mm incision and 3.0 mm incision, and the difference was statistically significant compared with pre-operation （both P<0.01）. There was no significant difference between the two groups （all P>0.05）. At 3 months postoperatively, there was no significant difference in uncorrected distance visual acuity （UCDVA） between the two groups （t=−1.794, P=0.07）, and the difference was statistically significant in the uncorrected near visual acuity （UCNVA） （t=−25.147, P<0.01）. Defocus curve: The defocus curve of group A had two peaks, which are located near 0 D and −3.5 D, forming a flat platform with a descent between the two peaks. The defocus curve of group B had only one peak, located at 0–0.5 D, and the downward trend at both ends of the peak was obvious. The rate of off-glasses and satisfaction: the rate of off-glasses in group A was 77.42% （24/31）, and the rate of dislocation in group B was 12.90% （4/31）. The difference was statistically significant （χ² =26.050, P<0.01）. There was no significant difference in overall satisfaction between the two groups （χ² =1.615, P=0.204）. Conclusion: The 2.2 mm coaxial microincision cataract surgery yields high clinical safety, and the combined implantation of multi-focal intraocular lens has good curative effect and can be widely promoted in clinical practice.