目的：分析慢性泪囊炎患者鼻内镜下泪囊鼻腔造瘘口术后的远期肉芽增生情况，评价物理清除联合曲安奈德（triamcinolone acetonide，TA）局部注射治疗慢性泪囊炎鼻内镜术后造瘘口肉芽组织增生的效果。方法：回顾性分析接受鼻内镜手术的慢性泪囊炎患者98例115眼。随访收集术后造瘘口肉芽组织增生发生情况，分析肉芽增生与无肉芽增生患者的临床特征。对有肉芽增生的患者26例31眼，根据治疗方式分为物理清除联合TA局部注射组13例16眼和单纯物理清除组13例15眼，比较2组间治疗有效率。结果：鼻内镜术后造瘘口肉芽增生病例共31眼（26.96%）。物理清除联合TA组的治愈率、好转率分别为93.75%、6.25%，物理清除组相应为60%、33.33%。组间比较差异有统计学意义（P < 0.05）。结论：物理清除联合TA局部注射治疗泪囊炎鼻内镜术后造瘘口肉芽组织增生安全、有效。

Objective: This study aimed to analyze the formation of ostium granulomas following endonasal endoscopic dacryocytostomy (DCR) in patients with chronic dacryocystitis and to evaluate the efficacy of excision combined with triamcinolone (TA) injection for treating ostium granulosis after endoscopic dacryocystorhinostomy. Methods: A restrospective analysis was conducted on 98 patients (115 eyes) with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy.  Postoperative growth of the ostium granulomas was monitored, and clinical characteristics were compared between patients with and without ostium granulomas. Among these, 26 cases (31 eyes) of ostium granuloma were identified and randomly assigned to either an excision combined with triamcinolone injection group (13 cases with 16 eyes) or excision-only group (13 cases with 15eyes) based on the treatment method. The effective rates between two groups was compared. Results: Ostium granulomas occurred in 31 eyes (26.96%). The cure rate and improvement rate in the excision combined with TA group were 93.75% and 6.25%, respectively, whereas in the excision-only group, they were 60% and 33.33%. These differences were statistically significant (P < 0.05).  Conclusions: Excision combined with intralesional triamcinolone acetonide injections proved effective in promoting the regression of ostium granuloma after DCR.

目的：探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法：采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象，所有对象培训周期均为3个月，分为乳化劈核教学组和压核进钩劈核教学组，统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数，培训结束时对学员进行猪眼手术操作考核并记录评分，采用问卷调查对两种教学方式进行评价。结果：压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69（19，50）个，低于乳化劈核教学组的49.86（29，66）个（U=-3.08，P<0.05）；压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13（31，79）个，低于乳化劈核教学组73.14（50，90）个（U=-2.66，P<0.05）；压核进钩劈核教学组一次性完整完成二分核的次数为14.75（9，22）次，高于乳化劈核教学组6.79（3，14）（U=4.02，P<0.05）；压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50（3，5），高于乳化劈核教学组的3.71（2，5）次（U=2.23，P<0.05）；完整手术考核总分平均分为29.00（23，33）分，高于乳化劈核教学组的23.07（19，28）分（U=3.98，P<0.05）。培训结束时，压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31（15，20）分，高于乳化劈核教学组15.07（12，18）（U=3.69，P<0.05）。结论：核进钩劈核技术有助于学员更快地掌握碎核技术，缩短白内障超声乳化摘除手术的学习曲线，增强学习白内障手术的信心，提高超声乳化白内障吸除术的教学效果和满意度。

Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery．

音乐作为一种非侵入性的感官刺激，凭借其独特的治疗价值在医疗领域的应用日益广泛。文章综述了音乐在眼底诊疗领域的应用现状及研究进展。大量临床研究表明，音乐干预可以显著降低患者在眼科诊疗过程中的焦虑水平，改善医疗体验。在玻璃体腔注射、早产儿视网膜病变筛查、视野检查等不同临床场景中，音乐的应用均显示出积极效果。此外，在眼科模拟手术操作研究中，背景音乐的存在不仅没有对医生的手术操作造成干扰，反而可能通过调节术者的心理状态，优化手术环境。虽然音乐干预效果存在个体差异，不同患者对音乐类型、节奏和音量的偏好各异，但总体而言，作为一种安全、经济且易于实施的辅助手段，音乐疗法在眼底临床实践中展现出良好的应用前景。目前已有初步研究表明，音乐在糖尿病视网膜病变合并抑郁症的大鼠实验模型中可减少细胞凋亡并改善抑郁。未来需要开展更多严谨的随机对照试验，建立标准化的音乐干预方案，以充分发挥音乐在眼科诊疗中的积极作用。同时，也应该重视个体化治疗原则，根据患者的个人喜好和具体临床情况，制定合适的音乐干预策略。

Music, as a non-invasive sensory stimulus, has been increasingly applied in medical fields due to its unique therapeutic value. This article reviews the current applications and research progress of music in fundus examination and treatment. Extensive clinical studies have demonstrated that music intervention can significantly reduce patients' anxiety levels during ophthalmic procedures and improve their medical experience. Positive effects have been observed across various clinical scenarios, including intravitreal injections, retinopathy of prematurity screening, and visual field examinations. Furthermore, studies on simulated ophthalmic surgical procedures have shown that background music not only does not interfere with surgeons' operational performance but may actually optimize the surgical environment by regulating the operator's psychological state. Although the effectiveness of music intervention varies among individuals, with patients showing different preferences for music types, rhythms, and volumes, music therapy generally demonstrates promising potential in fundus clinical practice as a safe, economical, and easily implemented auxiliary measure. Preliminary studies have demonstrated that music can reduce cell apoptosis and improve depression in rat models of diabetic retinopathy complicated with depression. Looking forward, more rigorous randomized controlled trials are needed to establish standardized music intervention protocols to maximize the positive effects of music in ophthalmic treatment. Meanwhile, emphasis should be placed on the principle of individualized treatment, developing appropriate music intervention strategies based on patients' personal preferences and specific clinical conditions.

大型语言模型（large language models, LLMs）在眼科的应用为医疗领域带来了巨大的潜力，尤其是在提升诊断效率、优化医患沟通和促进个性化医疗方面。通过自然语言处理技术，LLMs可以协助医生进行临床数据的归纳和分析，可以结合患者的病史、影像资料和症状描述，提供精准的辅助诊断，并在复杂病例中提供参考。LLMs还可以帮助医生快速撰写病历报告，改善医疗记录管理效率。在医患沟通中，LLMs能够通过生成通俗易懂的解释，帮助患者理解疾病状况及治疗方案，缩短医生与患者之间的沟通障碍。在远程医疗场景下，LLMs可通过实时分析患者上传的图像文本信息，提供初步诊断建议，助力医生远程诊疗。个性化医疗也是LLMs的重要应用方向，借助患者的遗传数据和生活习惯，可以帮助医生制定更为精准的个性化治疗方案，并预测手术后的恢复情况。此外，LLMs可以通过与临床数据的不断交互进行自我优化，提升其在眼科诊疗中的智能化程度。尽管LLMs在眼科领域的应用前景广阔，但仍面临数据隐私、模型解释性、语言理解等方面的挑战。未来LLMs将继续作为医生的辅助工具，形成“人机协同”的诊疗新模式，为患者提供更好、更精准的医疗服务。

The application of Large Language Models (LLMs) in ophthalmology presents tremendous potential for the healthcare field, particularly in enhancing diagnostic efficiency, optimizing doctor-patient communication, and promoting personalized medicine. Through natural language processing technology, LLMs can assist doctors in summarizing and analyzing clinical data. They can integrate a patient's medical history, imaging data, and symptom descriptions to provide precise diagnostic support and reference for complex cases. LLMs can also help physicians quickly draft case reports, improving the management efficiency of medical records. In doctor-patient communication, LLMs can generate easy-to-understand explanations that help patients comprehend their conditions and treatment plans, thereby reducing communication barriers between doctors and patients. In telemedicine scenarios, LLMs can provide preliminary diagnostic suggestions by real-time analyzing images and textual information uploaded by patients, aiding doctors in remote diagnosis and treatment.

Personalized medicine is another significant application direction for LLMs. By utilizing patients' genetic data and lifestyle habits, LLMs can assist physicians in formulating more precise personalized treatment plans and predicting postoperative recovery outcomes. Additionally, LLMs can self-optimize through continuous interaction with clinical data, enhancing their intelligence in ophthalmic diagnosis and treatment. Despite the broad application prospects of LLMs in the field of ophthalmology, challenges remain, including data privacy, model interpretability, and language understanding. In the future,  LLMs will continue to serve as auxiliary tools for physicians, forming a new model of "human-machine collaboration" in diagnosis and treatment, ultimately providing better and more precise medical services to patients.

泪器疾病是一类常见的眼科疾病，其诊疗过程复杂，治疗方法精细，涉及多种临床数据及影像资料。现有研究表明，随着人工智能（artificial intelligence，AI）技术，尤其是机器学习和深度学习的发展，AI在泪器疾病的早期筛查、精确诊断和个性化治疗中展现了巨大的应用潜力。AI能够通过高效的图像分析、多模态数据融合及深度学习算法，提供更加精确的疾病识别和治疗方案，并且能够对患者的病情进行定期监测和动态调整，提升治疗效果。然而，其仍面临诸多挑战，如多模态数据融合的复杂性、模型泛化能力的局限以及实时预测和动态调整的需求等，需要通过持续的技术创新、算法优化和跨学科合作来实现。文章对当前AI在泪器疾病诊疗中的应用现状进行了全面梳理和总结，深入分析了AI技术在诊断与治疗中的优势与局限，特别强调了AI与新兴技术的结合在优化临床决策支持系统方面的重要性。通过分析现有的挑战与技术融合策略，文章提出了AI在泪器疾病诊疗中的发展方向，旨在为未来的研究者提供创新性的思路，为眼科领域的临床实践提供有价值的参考，助力泪器疾病的精准医疗和个性化治疗的发展。

Lacrimal disorders are common ophthalmic conditions characterized by complex diagnostic and treatment processes, involving intricate therapeutic approaches and diverse clinical and imaging data. Recent studies have indicated that with the advancements in artificial intelligence (AI) technologies, particularly in machine learning and deep learning, AI demonstrates significant potential in the early screening, accurate diagnosis, and personalized treatment of lacrimal disorders. AI has the ability to provide more precise disease identification and treatment strategies through efficient image analysis, multimodal data fusion, and deep learning algorithms. Additionally, it enables regular monitoring and dynamic adjustment of patients' conditions, improving treatment outcomes. However, several challenges persist, such as the complexity of multimodal data integration, limitations in model generalization capabilities, and the need for real-time prediction and dynamic adjustments, all of which necessitate continuous technological innovations, algorithm optimization, and interdisciplinary collaborations. This paper provides a comprehensive review of the current status of AI applications in the diagnosis and treatment of lacrimal disorders, analyzing the advantages and limitations of AI in clinical practice. It especially emphasizes the importance of integrating AI with emerging technologies to optimize clinical decision support systems. By addressing the existing challenges and exploring strategies for technological integration, this paper proposes future directions for the development of AI in lacrimal disorder diagnosis and treatment, aiming to offer innovative perspectives for future researchers and valuable references for clinical practice in the field of ophthalmology, ultimately contributing to the advancement of precision medicine and personalized treatment for lacrimal disorders.

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.

Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。

Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。

目的：像差和对比敏感度检查结果数据繁多复杂。为了高效准确地完成检查数据提取工作，自主开发一款像差和对比敏感度数据提取处理软件(Aberrations and Contrast Sensitivity Helper，ACSH)。方法：参考其他同类软件的设计模式，结合我院科研实际，采用开发工具VB6.0编程实现。结果：ACSH在Windows的运行环境下，能够准确地在局域网环境下实现对iTrace，Zywave像差仪和Optec_6500对比敏感度测试仪的检查数据进行提取。像差仪信息包括病人基本信息、屈光度、眼别、瞳孔直径，各项像差Zernike系数，高阶像差和总高阶像差均方根RMS(Root Mean Square)。对比敏感度仪数据包括：病人基本信息、检查时间、检查时的模拟光照度和眩光强度、 各空间频率的对比敏感度数值。同时软件支持对已提取的数据进行浏览、查询及导出EXCEL等功能，并开放数据接口供电子病历等其他系统对接。结论：ACSH是一款能够有效辅助视光专科科研和临床工作的应用软件。

Objective: Aberration and contrast sensitivity test results data is various and complex. In order to complete efficiently and accurately the data extraction work, we developed an aberration and contrast sensitivity data extraction software Aberrations and Contrast Sensitivity Helper (ACSH). Methods: VB6.0 was used as a development tool after we referred to other similar software design pattern and combined the reality of our scientific research. Results: The ACSH under the Windows environment can accurately extract the results’ data of iTrace and Zywave aberration meter and Optec 6500 contrast sensitivity tester in local area network. Aberration instrument information include patients’ basic information, refraction, which eye, pupil diameter, the aberration  Zernike coefficients, the high-order aberration and total aberration Root Mean Square (RMS). Contrast sensitivity tester data included: patients’ basic information, time, the intensity of analog light and the glare ,the contrast sensitivity values of every spatial frequency. ACSH is able to browse and query extracted data and export to EXCEL, and open data interface for electronic medical records and other system. Conclusion: ACSH is an effective software which assists optical specialized scientific research and clinical work.

目的：探讨爱先蓝(Alcian Blue，AB)和细胞角蛋白(cytokeratin，CK)双重染色技术在泪腺腺样囊性癌组织中的应用, 提高泪腺腺样囊性癌染色效率。方法：选取中山大学中山眼科中心临床病理科2015年1月至2017年1月期间诊断为泪腺腺样囊性癌病例标本23例，在同一张切片上先进行AB染色，再进行CK染色，观察染色效果。结果：23例泪腺腺样囊性癌标本组织中黏液物质全部呈蓝色；癌细胞胞质CK阳性，呈棕黄色。结论：AB和CK双重染色方法稳定，颜色对比鲜明，能够良好显示癌细胞及黏液的关系，并且比分开的两次单种染色省时、经济。

Objective: To investigate the application of Alcian Blue (AB) and cytokeratin (CK) double staining technique in adenoid cystic carcinoma to improve the staining efficiency. Methods: Twenty-three specimens of adenoid cystic carcinoma from January 2015 to January 2017 in the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University were stained with AB first and CK then on the same slide. Results: Mucinous substance showed blue. And the cytoplasm of the cancer cells presented with brown yellow in all the specimens.Conclusion: The method of double staining with AB and CK is stable and displays bright color contrast. It can effectively reveal the relationship between the mucus and cancer cells. It proves to be more time-saving and economical than the individual staining of AB and CK respectively.

目的：探讨基于问题式教学法(problem-based learning，PBL)联合基于案例教学法(case-based learning，CBL)的模式在留学生眼科学教学中的效果。方法：将教学对象分为两组，其中传统教学组30人，联合教学组35人。传统教学组采用传统授课方法，联合教学组采用PBL联合CBL的教学方法。对其效果进行评估，评估指标包括发言次数、临床思维能力、学习兴趣、教学质量评分、教学满意度、理论分数、病例分析分数等。结果：与传统教学组相比，联合教学组学生在各项评估 指标上均明显优于传统教学组，且各项指标之间的差异均具有统计学意义。结论：PBL与CBL相结合的教学模式能有效提高眼科学教学质量，值得在临床教学中进一步推广应用。

Objective: To investigate the effect of problem-based learning (PBL) and case-based learning teaching (CBL) teaching approaches in the ophthalmology teaching of foreign students. Methods: The subjects were divided into a control group (30 students) and an experimental group (35 students). In the control group, the students were taught via traditional teaching methods. The PBL and CBL teaching approaches were applied in the experimental group. Then, the number of statements, clinical thinking ability, learning interest, teaching quality scores, teaching satisfaction, theoretical scores, and case analysis scores were assessed in these two groups. Results: Compared with the control group, the assessments in the experimental group were significantly better (P<0.05). Conclusion: The PBL and CBL teaching approaches can effectively improve the teaching quality of ophthalmology of foreign students. It is worth to popularize this method in clinical teaching.