目的: 探讨白内障手术患者围手术期非甾体抗炎药（non-steroidal anti-inflammatory drugs, NSAIDs）滴眼液应用的合理性，为优化临床用药方案提供依据。方法：采用回顾性研究方法，分析郑州市第二人民医院2024年100例（100眼）行白内障超声乳化并人工晶状体植入手术患者的临床数据，依据药品说明书、《我国白内障围手术期非感染性炎症反应防治专家共识(2015年)》《中国成人白内障摘除手术指南（2023年）》《中国激光角膜屈光手术围手术期用药专家共识（2024年）》等指南/共识制定评价标准，评价NSAIDs滴眼液的用药频次、疗程及术前预防性抗炎处理的规范性。结果：35%的病例存在用药不合理，共发现88项问题，包括用药频次错误（7.96%）、超疗程（22.72%）及术前用药不当（69.32%）。其中，65%糖尿病患者术前未启动NSAIDs预处理，41%非糖尿病患者术前1 d使用NSAIDs；溴芬酸钠滴眼液疗程超过10天者占20.45%，可能增加肝损伤风险。结论：医疗机构应采取积极有效措施，如制定个体化用药方案、加强合理用药培训、开展专项处方点评等，切实促进NSAIDs滴眼液在白内障手术患者围手术期的合理使用，保障患者的用药安全与治疗效果，提高医疗服务质量和患者满意度。

Objective: To investigate the rationality of perioperative application of non-steroidal anti-inflammatory drugs (NSAIDs) eye drops in patients undergoing cataract surgery, thereby providing evidence for optimizing clinical medication protocols. Methods: A retrospective study method was used to analyse the clinical data of 100 patients (100 eyes) who underwent cataract ultrasonoemulsification with IOL implantation in 2024 at the Second People's Hospital of Zhengzhou City, and the evaluation criteria were developed based on the instructions of the medication, the Chinese expert consensus on prevention and management of non-infectious inflammatory responses in the perioperative period of cataract surgery (2015), the Chinese guideline for cataract surgery in adults (2023), and the Chinese expert consensus on the perioperative medication in laser corneal refractive surgery(2024)" and other guidelines/consensus to develop evaluation criteria to evaluate the standardisation of NSAIDs eye drops in terms of frequency of dosing, duration of treatment, and preoperative prophylactic anti-inflammatory treatment. Results: Irrational medication use was identified in 35% of cases, with a total of 88 issues categorized as follows: incorrect dosage frequency (7.96%), prolonged treatment duration (22.72%), and inappropriate preoperative medication (69.32%). Notably, 65% of diabetic patients failed to initiate NSAIDs pretreatment preoperatively as recommended by guidelines, while 41% of non-diabetic patients received NSAIDs one day before surgery. Prolonged use of bromfenac eye drops (>10 days) was observed in 20.45% of cases, potentially increasing the risk of liver injury. Conclusions: Medical institutions should take active and effective measures, such as formulating individualised medication plans, strengthening training on rational use of medication, and carrying out special prescription reviews, etc., to effectively promote the rational use of NSAIDs eye drops in the perioperative period of patients undergoing cataract surgery, to safeguard the safety of patients' use of medication and therapeutic efficacy, and to improve the quality of healthcare services and patients' satisfaction.

目的：分析喉罩在肥胖患者眼科日间手术中的应用特点。方法：选择 2021 年 1 月— 2024 年 3 月在中山大学中山眼科中心行日间眼科手术 且体质量指数（body mass index，BMI）≥25 kg/m²的男性患者进行分析，将患者分为2组：超重组（BMI 25~<30 kg/m2）及肥胖组（BMI≥30 kg/m²）。比较两组患者入室时（T₁）、诱导后（T₂）、喉罩置入后（T₃）、手术开始时（T₄）、手术开始10 min（T₅）、手术结束时（T₆）、入麻醉恢复室（post-anesthesia care unit，PACU）（T₇）、喉罩拔除时（T₈）的血流动力学和血氧饱和度变化情况；并分析喉罩置入后（T₃）、手术开始时（T₄）、手术开始10 min（T₅）、手术结束时（T₆）和喉罩拔除时（T₈）患者的呼吸参数变化情况，记录两组患者的喉罩通气成功率及复苏室的停留时间。结果：纳入 118 例患者，其中超重组 57 例、肥胖组 61 例。两组均未出现喉罩通气失败病例，肥胖组在T₃、T₄、T₅、T₆以及T₈等时点气道峰压均高于超重组（P < 0.05）；肥胖组的呼吸道不良事件发生率高于超重组（P < 0.05）。两组患者围术期生命体征平稳（P > 0.05），复苏室停留时间在组间比较差异无统计学意义（P > 0.05）且均顺利日间手术离院。结论：喉罩通气下全身麻醉能安全应用在肥胖患者眼科日间手术中，高BMI与高气道峰压相关。

Objective: General anesthesia using laryngeal mask airway (LMA) ventilation can facilitate ambulatory ophthalmic surgery, however, there remains debates about the use of LMA for obese patients. This study retrospectively analyzed the application of LMA in obese patients for ambulatory ophthalmic surgery. Methods: In this retrospective study, we analyzed all patients with a BMI≥25 kg/m2 who underwent ambulatory ophthalmic surgery under general anesthesia at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2021 to March 2024.  The patients were divided into two groups: overweight group (BMI 25~<30 kg/m2) and obese group (BMI ≥30 kg/m2) . We compared the changes in hemodynamics and oxygen saturation at the several time points, baseline after entering operating room (T₁), anesthesia induction (T₂), LMA insertion (T₃), start of surgery (T₄), 10 minutes after surgery (T₅), surgery completion (T₆), transfer to PACU (T₇), and LMA removal (T₈);and analyzed the changes in respiratory parameters of the patient at T₃, T₄, T₅, T₆, and T₈ time points between both groups. We also observed the differences in success rate of LMA insertion and ventilation and PACU stay time as well as time to discharge home between two groups. Results: 118 cases were found suitable for the final analysis and divided into overweight group (n=57) and obese group (n=61). All patients in the two groups uneventfully completed the ophthalmic ambulatory surgery and discharged home under the laryngeal mask airway ventilation, none of patients in both group displayed LMA ventilation failure. The hemodynamics and oxygen saturation in both groups were stable during perioperative period(P > 0.05). The peak airway pressures in obese group were dramatically increased than in overweight group at T₃, T₄, T₅, T₆ and T8 time points (P < 0.05), and the incidences of adverse respiratory events in obese group were significant higher than in overweight group （P < 0.05）. The PACU stay time was comparable in both groups (P > 0.05). Conclusion: LMA can be safely used for obese patients undergoing ophthalmic surgery, high BMI is related to high peak airway pressures.

人工智能(artificial intelligence，AI)在白内障手术中的应用越来越广泛，二者结合对于白内障手术的术前诊断和分级管理、术中人工晶状体选择、位置预测及术后管理(视力预测、并发症预测及随访)、手术培训和教学方面均起到巨大的促进作用。诚然，AI在与白内障手术相关的管理、分析和研究中还面临着许多问题，但其广泛的应用前景不可忽视。现对AI在白内障手术治疗和教学中的应用做以总结，并对其未来的发展做出展望。

Artificial intelligence (AI) has been widely used in cataract surgery. The combination of the two can play a great role in improving preoperative diagnosis, grading management of cataract surgery, intraoperative intraocular lens selection and location prediction, postoperative management (vision prediction, complication prediction and follow-up), surgical training and teaching. It is true that AI still faces many problems in the management, analysis and research related to cataract surgery, but its broad application prospects cannot be ignored. This review summarizes the application of AI in cataract surgery and teaching, and the future prospects of AI.

目的：分析全身麻醉在青光眼日间手术中的应用特点。方法：回顾性收集2023年1月—6月于中山大学中山眼科中心在全身麻醉下接受青光眼日间手术患者71例(全麻组)，并选择同时期在局部麻醉下接受青光眼手术患者154例(局麻组)，同时以年龄为配对因素行倾向评分匹配分析。主要观察指标为患者术后离院时间，并对患者的手术时间、手术前后眼压、视力、中央前房深度、周边前房深度、甘露醇使用情况以及术后较术前眼压降低差值进行分析。结果：与局麻组比较，全麻组患者术后离院时间未有延长(P>0.05)；全麻组患者术前眼压较高(P<0.001)、中央前房深度浅(P=0.018)、周边前房深度浅(P<0.001)；且全麻组患者在术后较术前眼压降低差值更大(P=0.002)。组间术后中央前房深度、术后使用甘露醇者比例及术后视力提高者比例比较差异均无统计学意义(P>0.05)。结论：术前眼部条件较差的青光眼患者能在全身麻醉下完成日间手术，且不延长术后离院时间。

Objective: To analyze the application of general anesthesia in the ambulatory glaucoma surgery. Methods: This retrospective study collected 71 patients who underwent ambulatory glaucoma surgery with general anesthesia at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2023 to June 2023, and 154 patients who underwent similar glaucoma surgery with local anesthesia during the same period. Age differences between the two groups were balanced by propensity score-matched analysis. The main outcome measures were the patients' post-operative discharge time, and the secondary end points included the duration of surgery, the patients' preoperative and postoperative intraocular pressure (IOP), visual acuity status, central anterior chamber depth, peripheral anterior chamber depth, mannitol use, the difference in IOP reduction after surgery compared to preoperative. Results: After propensity score-matched analysis, as compared with group L, general anesthesia did not prolong the patients' post-operative discharge time(P>0.05).Patients in the group G displayed significant higher IOP (P<0.001), shallower central anterior chamber depth (P=0.018), and shallower peripheral anterior depth (P<0.001). The dramatic reductions in IOP after surgery were exhibited in group G as compared with group L(P=0.002). There were no statistically significant differences in postoperative central anterior chamber depth, incidences in postoperative mannitol use, as well as incidences in visual acuity improvement on the first day after surgery. Conclusion: Glaucoma patients with poor preoperative ocular conditions were able to complete the complex glaucoma surgery under general anesthesia without prolonging their post-operative discharge time.

传统的眼底手术要求眼科医生具备精细的操作技术，但即便拥有再精湛的操作技术，眼底手术还是存在很大的风险性。因此，为了减少手术风险，提高手术质量，对传统眼底手术进行改进是十分必要的。近年来，在我国对于人工智能产业的大力支持之下，应用于各类行业的机器人随之诞生。机器人辅助系统(robot auxiliary system，RAS)在医学领域，特别是眼科学中应用广泛。对近几年RAS应用于眼底手术的案例进行整理总结，并将RAS参与的眼底手术以及传统的眼底手术进行对比，可以发现RAS在眼底手术中的应用可以显著提高手术效率，并降低手术风险。未来RAS的发展趋势可能着重聚焦于与深度学习算法的紧密结合。通过算法对手术中的视野图像进行预测、优化，从而让高精度的眼底手术更加高效、安全。

Traditional fundus surgery requires ophthalmologists to be equipped with sophisticated operating techniques, but even with the most sophisticated operating techniques, fundus surgery still has great risks. Therefore, in order to reduce the risk of surgery and improve the quality of surgery, it is very necessary to improve the traditional fundus surgery. In recent years, with China’s strong support for the artificial intelligence industry, robots used in various industries have been born. Robot auxiliary system (RAS) is widely used in the medical field, especially in ophthalmology. By summarizing the cases of fundus surgery with RAS in recent years and comparing the fundus surgery involving RAS with traditional fundus surgery, it can be found that the application of RAS in fundus surgery can significantly improve the efficiency of surgery and reduce the risk of surgery. The future development trend of RAS may focus on the close integration with deep learning algorithms, which can predict and optimize the field of view images during surgery so that high-precision fundus surgery can be more efficient and safer.

目的：探究可弯曲喉罩在经鼻内镜眼科日间手术中应用的安全性。方法：收集2023年1月—2024年1月在全身麻醉(全麻)下行经鼻内镜眼科日间手术成年患者资料，分析可弯曲喉罩使用的成功率，观察患者入室时、插管后、手术开始时、手术结束时的血流动力学变化情况；并记录喉罩置入后、手术开始5 min、手术开始30 min和手术结束时的呼吸参数及患者在麻醉恢复室（post-anesthesia care unit，PACU的停留期间的并发症。结果：共635例患者纳入分析，其中619例患者选用喉罩，607例患者喉罩置入成功，成功率98.1%，喉罩置入失败12例，均为诱导期间置入失败，占1.9%，无术中发生喉罩通气失败改气管插管病例。喉罩通气能满足经鼻内镜手术需求，表现为各时点通气量无显著变化及平稳的心率和平均动脉压。患者均顺利复苏，PACU停留时间为(34.6±11.2) min，喉罩拔除时间为(14.3±4.3) min，无二次气管内插管事件发生。结论：置入成功的可弯曲喉罩可安全应用在经鼻内镜眼科日间全麻手术中。

Objective: To investigate the safety of flexible laryngeal masks in the application of endoscopic ophthalmic ambulatory surgery. Methods: Data of adult patients undergoing endoscopic day ophthalmic surgery under general anesthesia from January 2023 to January 2024 were collected; the changes in hemodynamics at T1 (entry into the operating room), T2 (after intubation), T3 (before surgery), and T6 (after surgery) time points and the respiratory parameters at T2 (after intubation), T4 (5 minutes after surgery), T5 (30 minutes after surgery), and T6 (after surgery) time points were analyzed; meanwhile, the complications during the PACU stay were also analyzed. Results: A total of 635 patients were included in the retrospective analysis, of whom 619 patients were initially used FLMA, FLMA were successfully inserted in 607 patients with a rate of 98.1% while 12 patients suffered insertion failure during the period of anesthesia induction. Importantly, none of patients displayed FLMA ventilation failure and required tracheal intubation during the period of surgery. General anesthesia via FLMA ventilation can provide high quality of surgical field for endoscopic ophthalmic surgery, as evidenced by stable heart rates and mean arterial pressure and no significant change in minute ventilation at each time points. All patients recovered uneventfully with a PACU stay time of 34.6±11.2 min and FLMA removal time of (14.3±4.3) min. None of patients exhibited subsequently endotracheal intubation after FLMA removal. Conclusion: FLMA with successful placement can be safely used for endoscopic ophthalmic ambulatory surgery under general anesthesia.

先天性晶状体不全脱位是一种较为罕见的晶状体悬韧带异常的疾病，其手术治疗极具挑战性。以人工晶状体悬吊为代表的传统手术方式易出现囊袋破裂、玻璃体疝、人工晶状体脱位和继发性青光眼等严重并发症。近年来，以重建囊袋悬韧带隔为目标，新型囊袋辅助装置的应用极大程度提高了先天性晶状体不全脱位的手术成功率。然而，以改良式张力环为代表的囊袋辅助装置在我国仍难以得到普及且操作繁琐。因此，如何最大程度利用普通张力环等最常见的装备，设计出一种安全可靠手治疗先天性晶状体不全脱位的手术方式是眼科界亟待解决的问题。本文将介绍一种二期张力环缝合固定治疗先天性晶状体不全脱位手术技术。该技术仅需使用普通张力环，具有操作简单安全、术后效果稳定和易于技术推广的优点。

Congenital ectopia lentis is a relatively rare zonular disorder of the lens, and its surgical treatment is extremely challenging. The traditional surgical procedures represented by intraocular lens suspension are prone to result in serious complications such as capsular bag rupture, vitreous hernia, intraocular lens dislocation and secondary glaucoma. In recent years, with the goal of reconstructing the capsular bag–zonules diaphragm, the application of new capsular bag-assisted devices has greatly improved the surgical success rate of congenital ectopia lentis. However, the capsular-assisted devices, such as modified capsular tension ring, are still difficult to be popularized in China and the surgical procedures are complicated. Therefore, how to maximize the use of common equipment such as normal capsular tension rings and design a safe and reliable surgical method for the treatment of congenital ectopia lentis is an urgent issue for ophthalmologists. This article aims to introduce a two-stage capsular tension ring fixation for the treatment of congenital ectopia lentis, which has many advantages such as simple and safe operation, stable postoperative effect and less requirements for special equipment, and is worth promoting in clinical practice.

目的：探讨提高眼科喉罩全身麻醉患儿在麻醉恢复室(post-anesthesia care unit, PACU)复苏质量与效率的整体护理策略。方法：选取2020年1月—2023年12月在中山大学中山眼科中心行眼科全身麻醉并保留喉罩进入PACU复苏的24 180例患儿，总结患儿在PACU复苏的护理措施及复苏质量。结果：所有患儿经复苏期综合护理后均顺利拔除喉罩完成麻醉复苏，未发生苏醒期二次插管或非计划转院治疗。采取个性化的整体护理策略后，喉罩全身麻醉患儿PACU平均复苏时间明显缩短。部分术后常见并发症(术后躁动，低氧血症和呼吸道梗阻)和护理不良事件(留置针脱落和眼包脱落)发生率逐年降低，经治疗和护理后均获得改善。结论：针对眼科全身麻醉的患儿特点，在麻醉复苏期采取个性化的整体护理策略，有利于顺利完成麻醉复苏，降低麻醉并发症和护理不良事件的发生率，提高复苏质量效率，满足眼科日间手术快速康复的需求。

Objective: To explore holistic nursing strategies to improve the quality and efficiency of post-anesthesia care unit (PACU) resuscitation in childrenpatients undergoing ophthalmic laryngeal mask anesthesia. Methods: A total of 24,180 children patients who underwent general anesthesia and retained laryngeal mask airway for PACU resuscitation at Sun Yat-sen Ophthalmic Center of Sun Yat sen University from January 2020 to December 2023 was reviewed and summarized the nursing measures and resuscitation quality of children patients undergoing PACU resuscitation. Results: All patients underwent comprehensive care during the recovery period and successfully removed the laryngeal mask to complete anesthesia recovery. There were no cases of secondary intubation or unplanned transfer for treatment during the recovery period. After adopting personalized holistic nursing strategies, the average recovery time of PACU in children under laryngeal mask anesthesia was significantly shortened.The incidence of common postoperative complications(postoperative agitation, hypoxemia and respiratory obstruction)and adverse nursing events (indwelling needle falls off, eye bandage fall off)had been decreasing year by year. These complications had been improved after treatment and care. Conclusions: Based on the characteristics of children patients undergoing general anesthesia in ophthalmology, adopting personalized holistic nursing strategies during the anesthesia recovery period is beneficial for successfully completing anesthesia recovery, reducing the incidence of anesthesia complications and adverse nursing events, improving the quality and efficiency of recovery, and meeting the needs of rapid recovery in ophthalmic day surgery.

目的：探讨青光眼日间手术患者的自我管理行为现状及影响因素分析。方法：采用便利抽样法选取2021年9月—2022年5月于广州市某三级甲等眼科专科医院就诊的223例青光眼日间手术患者。采用一般资料调查表、青光眼自我管理行为量表、慢性疾病自我效能量表和青光眼知识学习问卷进行问卷调查。结果：青光眼日间手术患者的自我管理行为得分为(54.03±6.95)分，其中生活调整维度得分最低。慢性病自我效能与自我管理行为呈正相关(r=0.368, P<0.001)。疾病知识与自我管理行为无显著相关性(r=0.077, P=0.252)。多因素线性回归分析结果显示，患者的文化程度(P<0.001)和自我效能(P=0.028)是自我管理行为的影响因素，可解释自我管理行为总变异的12.4%。结论：青光眼日间手术患者具有良好的自我管理行为，较低的自我效能和文化程度是自我管理行为的危险因素，因此应优先提高患者的自我效能，并提供个性化教育。

Objective: To determine self-management and its association with self-efficacy and knowledge among glaucoma patients undergoing day surgery. Methods: A total of 223 glaucoma patients were recruited from September 2021 to May 2022and they were investigated with the Glaucoma Self Management Questionnaire (GSMQ), The Self- Efficacy in Chronic Disease Scale (SECD-6), and the glaucoma knowledge questionnaire. Results: Of the 223 study participants, the study population had a total GSMQ score of 54.03±6.95 with the lowest score found in the life adjustment dimension. The total SECD-6 score was showing a significantly positive correlation with the total GSMQ score(r =0.368, P <0.001). The total score of disease knowledge was without significant correlation with the total GSMQ score (r =0.077, P =0.252). Multivariate linear regression analysis showed that self-efficacy (P <0.001) and education level was independently associated with self-management(P =0.028). Conclusions: Glaucoma patients undergoing daytime surgery demonstrated good overall self-management, yet further improvement was required in terms of life adjustment. Low self-efficacy and educational level were identified as risk factors for self-management. Therefore, self-management programs should prioritize enhancing patients' self-efficacy and delivering individualized education.

前段巨眼(anterior megalophthalmos, AM)是一种罕见的双侧非进展性先天性眼前段增大疾病，表现为大角膜(直径≥ 12.5 mm)、前房极深、角膜厚度正常或轻中度变薄和睫状环扩大等。并发性白内障以及晶状体脱位是导致AM视力下降的主要原因。然而，解剖结构的异常使AM白内障手术具有很大的挑战性。文章报道了一例AM合并白内障的48岁男性患者，成功为其行手法小切口白内障摘除联合人工晶状体(intraocular lens, IOL)一期植入术，患者术后视力恢复良好，IOL位置居中，未出现较大的屈光误差。对该典型AM病例的临床特点以及手术难点的回顾总结，有助于加深广大眼科临床工作者对该疾病的认识。

Anterior megalophthalmos is a rare congenital enlargement of the anterior segment, characterized by bilateral nonprogressive megalocornea (diameter ≥12.5 mm), extremely deep anterior chamber, normal or moderate thinning of the cornea, and elongation of the ciliary ring. Cataract and lens dislocation are the main causes of decreased vision in patients with AM. However, cataract surgery on patients with AM are challenging due to the anatomical abnormalities. This case reports a 48-year-old male patient diagnosed with AM and cataract, who successfully underwent a manual small incision cataract extraction combined with intraocular lens implantation. Finally, our patient showed a good visual outcome with a well centered IOL and without obvious refractive error. In this typical AM case, we reviewed and summarized the clinical characteristics and the challenges of surgical treatment so that other ophthalmologists can learn about this disease.