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.

眼睑基底细胞癌(basal cell carcinoma of eyelid, BCC)是眼附属器中最为常见的恶性肿瘤，近年来，其全球发病率呈持续上升趋势，且患者发病年龄有明显年轻化的倾向，这不仅增加了疾病的公共卫生负担，也对临床防治策略提出了更高要求。本文综述了眼睑BCC在诊疗领域的最新研究进展。在诊断方面，除传统组织病理学检查外，皮肤镜、反射共聚焦显微镜(reflectance confocal microscope, RCM)和光学相干断层扫描(optical coherence tomography, OCT)等新技术的应用不仅显著提升了诊断灵敏度与特异度，更在肿瘤亚型鉴别和边界描绘方面展现出独特优势。在分子机制研究方面，代谢组学揭示了眼睑BCC存在显著的代谢重编程，包括脂质代谢、烟酰胺腺嘌呤二核苷酸(nicotinamide adenine dinucleotide, NAD)代谢、多胺代谢以及葡萄糖代谢等多条代谢通路的异常活化。更为前沿的空间代谢组学技术则将代谢信息与组织空间位置相结合，进一步验证了磺酸、羟基吡啶硫酮等特异性代谢物在肿瘤发生发展中的潜在生物标志物价值。治疗方面，除了传统手术治疗之外，放射治疗的技术革新，以及针对Hedgehog信号通路的靶向药物及免疫抑制剂等免疫疗法的突破，为晚期/转移性患者带来了革命性的治疗转机。文章旨在为未来的眼睑BCC预防和治疗策略提供新的见解，并为临床医生提供新的诊疗思路。

Eyelid basal cell carcinoma (BCC), the most prevalent malignant tumor of the ocular adnexa, has seen a steady rise in global incidence, accompanied by a notable trend toward earlier onset. This trend not only exacerbates the public health burden but also imposes greater demands on clinical strategies for prevention and management. This article reviews the latest research progress in the diagnosis and treatment of eyelid BCC. In diagnostic practice, alongside conventional histopathological examination, the incorporation of novel technologies—such as dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT)—has markedly enhanced diagnostic sensitivity and specificity, while offering distinct advantages in tumor subtype differentiation and margin assessment. Metabolomic analyses reveal pronounced metabolic reprogramming in eyelid BCC, with aberrant activation of lipid, NAD, polyamine, and glucose metabolism. Spatial metabolomics further supports the biomarker potential of metabolites such as taurine and pyrithione in tumor initiation and progression. Beyond conventional surgery, advances in radiotherapy, targeted Hedgehog pathway inhibitors, and immunotherapies have created new opportunities for advanced or metastatic eyelid BCC. This review highlights emerging strategies for prevention, diagnosis, and treatment, offering clinicians fresh perspectives for patient management.

目的：评价上睑下垂矫正术后并发上睑内翻倒睫的手术治疗效果，并分析其发生原因。方法：回顾性分析2015年1月1日至2020年6月30日因上睑下垂矫正术后并发上睑内翻倒睫在中山大学中山眼科中心接受手术治疗，随访时间6个月以上的患者资料。患者的内翻倒睫矫正手术方案根据有无合并上睑下垂过矫或者欠矫，以及原上睑下垂矫正的矫正方式进行设计。评价术前、术后患者的睑裂高度、眼睑闭合不全程度、上睑睑缘弧度、内翻倒睫矫正状态和角膜荧光素染色评分。结果：本研究共收录上睑下垂术后并发上睑内翻倒睫患者19例(20眼)，其中额肌肌瓣悬吊术后17例(18眼：上睑过矫8眼，欠矫6眼，睑裂高度正常4眼)，提上睑肌缩短术后2例(2眼：上睑过矫1例，欠矫1例)。所有患者的上睑内翻倒睫经手术治疗均完全矫正，角膜上皮荧光素染色评分显著降低(P<0.05)。上睑下垂过矫或欠矫术后均矫正满意，术前睑裂高度正常的患者矫正内翻倒睫没有改变睑裂高度。总结术中探查所见，上睑下垂矫正术后发生上睑内翻倒睫可能与多个因素相关：上睑皮肤切口位置过低；睑缘眼轮匝肌去除过多；额肌肌瓣分离不佳；额肌肌瓣在睑板上的固定位置过高；术中对睑裂高度评估不准确引起上睑下垂过矫等。结论：上睑下垂矫正术后并发上睑内翻倒睫再次手术可以达到满意的治疗效果，但手术操作较为棘手。为降低此类并发症的发生和患者多次手术的风险，应规范上睑下垂矫正手术操作，总结教训。

Objective: To evaluate the surgical treatment outcome of upper eyelid entropion after ptosis correction and analyze the complicated causes. Methods: A retrospective analysis was performed on patients who underwent surgical treatment for complicated upper eyelid entropion after ptosis correction and were followed up for more than 6 months at Zhongshan Ophthalmic Center from January 1, 2015 to June 30, 2020. Pre- and postoperative lid height, lagophthalmos, upper lid margin curvature, eyelid entropion and corneal fluorescein staining scores

were evaluated. Results: A total of 18 cases (19 eyes) were included, among which 17 cases (18 eyes: 8 eyes of ptosis overcorrection, 6 eyes of ptosis undercorrection, and 4 eyes with normal eyelid height) were post-frontalis flap suspension, and 2 cases (2 eyes: 1 eye of ptosis undercorrection, 1 eye of ptosis overcorrection) post-levator resection. All patients had a complete correction of upper eyelid entropion and a significant reduction in corneal epithelial fluorescein staining score (P<0.05). Both the complicated ptosis undercorrection and overcorrection were treated with satisfactory outcome. Correction of entropion did not change the eyelid height in patients with preoperative normal height. The intraoperative findings showed that several factors related to original ptosis surgery may be involved in complicated upper eyelid entropion, including: the skin incision too close to the upper lid margin, excessive resection of the orbicularis oculi muscle along the eyelid margin, poor separation of the frontalis muscle flap, inappropriate eyelid plate fixation site of the frontalis muscle flap, and ptosis overcorrection caused by inaccurate evaluation of the intraoperative eyelid height, etc. Conclusion: Surgical treatment of the upper eyelid entropion secondary to ptosis correction is safe and effective, but is complicated and difficult. Skillful ptosis surgery and appropriate surgical techniques are crucial to reduce its occurrence.