目的：分析23G/25G微创玻璃体切割术后发生眼内炎的危险因素。方法：回顾性分析2014年6月—2023年5月于中国人民解放军中部战区总医院行微创玻璃体切割术后，临床诊断为眼内炎患者(开放性眼外伤患者除外)的临床特征。结果：纳入8 955例行微创玻璃体切割术患者，其中11例微创玻璃体切割术后患眼发生眼内炎，发生率为0.12％。平均年龄(60.8±7.6)岁。11例其中，5例(45.4%)患者合并糖尿病；原发眼疾构成情况：黄斑疾病7例(63.6%)、增殖期糖尿病性视网膜病变继发玻璃体积血2例(18.2%)，视网膜裂孔继发玻璃体积血1例(9.1%)、视网膜脱离1例(9.1%)；术中联合行白内障手术3例(27.3 %)；术毕8例(72.7%)患眼玻璃体腔填充无菌空气，3例(27.3%)填充平衡盐溶液，术毕所有患者均未缝合巩膜穿刺切口；术后低眼压3例(27.3 %)。术后发生眼内炎的时间为(2.8±1.1)d。11例患者经过局部和全身抗感染治疗后炎症控制不佳，均再次行玻璃体切割术联合术中配置万古霉素液灌注，其中9例术毕玻璃体腔填充硅油，术后所有眼内炎得到控制，10例(91.0%)患者最终矫正视力有所提高。结论：微创玻璃体切割术后，免缝合的巩膜切口可能是病原微生物侵入眼内导致眼内炎的潜在途径。尤其要重视黄斑手术中玻璃体不全切除引起巩膜切口处发生玻璃体束综合征可能是术后发生眼内炎的危险因素之一。

Objective: To analyze risk factors for endophthalmitis occurred after 23G/25G minimally invasive vitrectomy. Methods: Retrospective analysis of the clinical characteristics of patients with endophthalmitis (except patients with open eye trauma) after minimally invasive vitrectomy in General Hospital of Central Theater Command(Wuhan,430064) from June 2014 to May 2023. Results: This study included 8,955 patients, of which 11 cases occurred endophthalmitis after minimally invasive vitrectomy, with an incidence rate of 0.12%. The average age was (60.8±7.6) years, and 5 patients (45.4%) were complicated with diabetes; The composition of primary eye diseases: 7 cases (63.6%) of macular disease, 2 cases (18.2%) of vitreous hemorrhage secondary to proliferative diabetic retinopathy and 1 case (9.1%) vitreous hemorrhage secondary to retinal fissure, 1 case (9.1%) of retinal detachment; During the operation, 3 cases (27.3%) underwent combined cataract surgery; After the operation, 8 cases (72.7%) were filled with sterile air in the vitreous cavity of affected eye, the other 3 cases (27.3%) were filled with equilibrium liquid,and sclera puncture incision was not sutured in all patients; 3 cases (27.3%) had low intraocular pressure after operation. The time for postoperative endophthalmitis to occur after operation was 2.8±1.1day. 11 patients had poor inflammation control after local and systemic anti-inflammatory treatments, and all underwent vitrectomy combined with intraoperative injection of vancomycin solution. Among them, 9 patients were filled with silicone oil in the vitreous cavity after the surgery. After the operation, all the endophthalmitis were controlled and final corrected visual acuity of 10 patients improved. Conclusions: Minimally invasive vitrectomy and suture-free scleral incision may be a potential way for pathogenic microorganisms to invade the eye and cause endophthalmitis. Particular attention should be paid to the ‘Vitreous Wick Syndrome’ at the scleral incision caused by incomplete vitrectomy in macular surgery, which may be one of the risk factors for postoperative endophthalmitis.

目的: 分析高度近视眼行白内障摘除及后房型人工晶状体植入术后并发裂孔源性视网膜脱离的发生率、相关危险因素及临床特点。

方法 : 回顾性分析高度近视眼行白内障摘除及后房型人工晶状体植入术患者 146 例(232 只眼) 。裂孔源性视网膜脱离在术后随访的3年时间发生。所有眼均进行了详细的眼科检查, 包括: 最佳矫正视力、眼底检查、A 超眼轴长度测量。

结果: 15 只眼发生裂孔源性视网膜脱离(6.4%) , 均需行玻璃体视网膜手术进行视网膜复位。从白内障手术到发生视网膜脱离的平均时间为10 ± 9 个月(0.5～32 个月) 。视网膜脱离经手术治疗后视力为手动 /10 cm～0.06, 12 只眼(80%) 最终视力低于白内障术前。术中后囊膜破裂与术后视网膜脱离的发生显著相关 (P < 0.01) , 60%(9/15) 的视网膜脱离患者术中发生了后囊膜破裂。

结论: 高度近视眼白内障术后并发裂孔源性视网膜脱离的发生率为 6.4%, 其预后差。术中发生后囊膜破裂患者术后发生视网膜脱离的危险性更高, 对术中后囊膜破裂患者需密切随访。

Aim: To analyze the clinical characteristics, incidence and risk of retinal detachment (RD) after cataract surgery and posterior chamber intraocular lens implantation in high myopic patients.

Methods:The medical records of 146 high myopic patients (232 eyes) who underwent cataract surgery and posterior chamber intraocular lens implantation were studied retrospectively. The development of RD was followed up over a 3-year period, and its characteristics were determined. All of the eyes received a comprehensive ophthal-mological examination, including best-corrected visual acuity measurements, a dilated fundus examination and axial length measured by A-scan ultrasonography.

Results: RD developed in 15 eyes of 15 patients. All the 15 eyes needed vitreo-retinal surgery. The mean interval between cataract surgery and the development of RD was 10 ± 9 months (range 0.5～32 months) . The visual results of the eyes after anatomical successful vitreo-retinal surgery ranged from finger count /10 cm to 0.06. 80% (12/15) of the eyes had a worse vision after the surgery than that before cataract surgery. Posterior capsular tear were associated significantly with RD (P < 0.01). Approximately 60%( 9/15) of retinal detachment was attributable to posterior capsule tear during cataract surgery.

Conclusion: Incidence of RD in high myopic patients after cataract surgery was 6.4%. RD was the potentially serious complication and tended to develop more frequently in eyes with posterior capsular rupture during cataract surgery. It is crucial to examine retinal status after cataract surgery and to have a close follow-up to prevent retinal complications, especially for patients with posterior capsular disruption. 

目的：分析玻璃体腔注射术后眼内炎的发生并总结原因，旨在进一步提高手术安全性。方法：回顾性分析中国人民解放军总医院第六医学中心2010年9月至2019年11月行玻璃体腔注射术的421例患者(973眼)的术后1 d、1周、1个月的随访资料。归纳注射药物种类、注射病因、患者全身病史，总结术后眼内炎的发生及治疗情况。结果：玻璃体腔注射术安全性高，但严重并发症眼内炎(0.41%)仍偶有发生。4例眼内炎患者中2例为Irvine-Gass综合征患者行曲安奈德玻璃体腔注射后，1例为视网膜中央静脉阻塞患者行曲安奈德玻璃体腔注射后，1例为中心性渗出性视网膜脉络膜病变患者行雷珠单抗玻璃体腔注射后。其中曲安奈德引起的眼内炎(1.99%)明显高于抗血管内皮生长因子(vascular endothelial growth factor，VEGF)药物引起的眼内炎(0.12%)。结论：严格按照操作指南操作，当针对高血压老年群体尤其是Irvine-Gass综合征患者玻璃体腔注射曲安奈德时尤其防范眼内炎的发生。

Objective: To analyze the incidence and causes of endophthalmitis after intravitreal injection and to further improve the safety of the surgery. Methods: The follow-up data of 973 eyes of 421 patients who received intravitreal injection in our hospital in the past 9 years at 1 day, 1 week and 1 month were retrospectively analyzed.The types of injected drugs, the cause of injection and systemic history were summarized, and the occurrence and treatment of postoperative endophthalmitis were summarized. Results: The intravitreal injections were safe.However, the severe complication of endophthalmitis (0.41%) occurred occasionally. Among these 4 patients with endophthalmitis, 2 patients were intravitreal injected triamcinolone acetonide because of Irvine-Gass syndrome;1 patient accepted intravitreal injection by Ranibizumab because of central retinal vein occlusion; 1 patient accepted intravitreal injection by Ranibizumab because of central exudative chorioretinopathy. The incidence of endophthalmitis (1.99%) after intravitreal injection of triamcinolone acetonide was higher than that of anti-vascular endothelial growth factor (VEGF) agents (0.12%). Conclusion: The clinical operating guideline of intravitreal injection should be followed strictly. Furthermore, the elderly people with hypertension diagnosed of Irvine-Gass syndrome have a higher risk of endophthalmitis after intravitreal injection of triamcinolone acetonide than others and should be paid more important attention.

木村病(Kimura disease，KD)是一种罕见的、病因不明的、可能由免疫介导的慢性进行性炎症性疾病。本文分析1例8岁的男性患者，因左眼无痛性上睑下垂、影像学提示双眼泪腺占位、血象提示嗜酸性粒细胞及免疫球蛋白E(immunoglobulinE，IgE)水平升高、病理提示大量嗜酸性粒细胞浸润，被最终诊断为累及双侧泪腺的KD。行左眼眶肿物切除术后，对患者随访6个月期间未见复发。

Kimura disease (KD) is a rare chronic progressive inflammatory disease of unknown etiology that may be immunemediated. Herein, we analyze an 8-year-old male patient who was diagnosed with painless ptosis in the left eye, double tear glands on imaging, elevated levels of eosinophils and immunoglobulin E (IgE) on blood, and massive eosinophil infiltration on pathology. The final diagnosis was Kimura disease involving bilateral lacrimal glands. After resection of the left orbital tumor, no recurrence was observed in the six months postoperation follow-up

目的：对儿童癔症性视力障碍的病因进行分析，比较试镜与人工泪液给药治疗的疗效。方法：纳入2013年10月至2020年10月以“癔症性突发视力下降”于深圳市儿童医院门诊就诊的36例患儿，其中男16例，女20例。按随机原则分为试镜组与人工泪液给药组。两组在治疗过程中都辅以语言暗示。两组治疗的首次有效率采用SPSS17.0软件Fisher精确概率检验。分析儿童癔症性视力障碍的发病原因，提出诊断要点和防治对策。结果：在辅以语言暗示的前提下，试镜组人工泪液给药组治疗方案的首次有效率分别为94.4%、83.3%，差异有统计学意义(P<0.05)。在相关病因分析中，学习压力相关的有20例，占55.6%，包括成绩下降、逃避考试、因成绩受到家长或老师的训斥，甚至体罚。家庭变故13例，占36.1%，父母离异为主要原因。留守儿童不愿返乡、同学纠纷、校园霸凌以及外伤等为其他原因。结论：试镜加语言暗示比人工泪液加语言暗示更能有效提高癔症性视力障碍的首次治疗有效率。学习压力、家庭变故相关因素为癔症性视力障碍的最常见原因

Objective: To analyze the causes of hysterical visual impairment in children, and to compare the efficacy of two treatments of trial frame and artificial tears administration. Methods: A total of 36 children with sudden hysterical visual impairment admitted to Shenzhen Children’s Hospital from October 2013 to October 2020 were enrolled in our study, including 16 males and 20 females. They were randomly divided into trial frame group and artificial tears group. Both groups were supplemented with verbal suggestion during the treatment. The primary effective rates of the two groups were compared by SPSS 17.0 Fisher’s exact test. The causes of hysterical visual impairment in children were analyzed, and the main points of specific diagnostic tests and treatments were summarized. Results: The primary effective rate of the trial frame group and the artificial tears group were 94.4% and 83.3% respectively.Thedifference was statistically significant (P<0.05). In this study, therewere 20 cases (55.6%) related to study pressure, including decline in academic performance, evasion of exams, reprimand by parents or teachers, and even corporal punishment. There were 13 cases (36.1%) caused by family accidents, and parents’ divorce was the main reason. Leftover children unwilling to return hometown, classmate disputes, campus bullying and trauma were other reasons. Conclusion: Trialframe is more effective than artificial tears therapy in improving primary effective rate of hysterical visual impairment. Study pressure, family accident are the most common causes of hysterical visual impairment