该文报道一例激光原位角膜磨镶(laser-assisted in situ keratectomy,LASIK)术后行白内障超声乳化摘除联合多焦点散光矫正型人工晶状体植入术的病例。该患者为42岁女性患者，20年前外院行双眼LASIK手术，现因右眼视物模糊1年就诊。术前IOLMaster检查患者右眼眼轴长度29.66 mm，前房深度3.18 mm，晶状体厚度4.75 mm，白到白距离11.6 mm，前表面及全角膜散光分别为1.01 D@67 °及0.91 D@56 °。Pentacam角膜地形图15 °范围模拟角膜屈光力得到的角膜散光为1.2 D@58.1 °，为规则领结型。患者眼底检查未见明显异常，因其脱镜意愿强烈，植入双焦点散光矫正型IOL(德国Zeiss公司AT LISA toric 909M)。根据Barrett True-K Toric公式测量的后表面散光计算结果进行手术规划，选择+17 D球镜1.5 D柱镜Zeiss 909M IOL，植入轴位55 °。术后1个月患者裸眼远视力0.8，35 cm裸眼近视力1.0，最佳矫正远视力–0.25 DS/–0.5 DC×120 °至1.0，患者满意。提示经过详细的术前评估及规划，并与患者充分沟通，多焦点散光矫正型人工晶状体可以在部分适合的LASIK术后患者中取得良好效果。

It is reported a case of cataract phacoemulsification combined with toric multifocal intraocular lens (IOL) implantation after LASIK surgery in this article. A 42 year-old female patient who underwent bilateral LASIK surgery in other hospital 20 years ago. She visited our hospital due to blurred vision in her right eye for one year. The preoperative IOL Master examination results showed an axial length of 29.66 mm, anterior chamber depth of 3.18 mm, lens thickness of 4.75 mm, white to white distance of 11.6 mm, and anterior surface and total corneal astigmatism of 1.01 D @ 67 ° and 0.91 D @ 56 °, respectively in right eye. The corneal astigmatism measured by Pentacam using 15°range simulated keratometry is 1.2 D@ 58.1 °, which is a regular bow tie shape.No obvious abnormalities was found in the patient's fundus examination. Due to her strong desire to get rid of the glassesa toric bifocal IOL (AT LISA Toric 909M, Zeiss, Germany) was implanted.Based onthe IOL power calculation results of Barrett True-K Toric formula with measured posterior corneal astigmatism, an IOL with Sph 17.0 D/Cyl1.5 D/A 55°was chosen. One month after surgery, the patient's uncorrected distance visual acuity was 20/25, 35 cm uncorrected near visual acuity was 20/20, and the best corrected distance visual acuity was 20/20 with a prescription of –0.25 DS/–0.5 DC × 120 °. The patient was satisfied with the outcome. After detailed preoperative evaluation and design, and sufficient communication with patients, toric multifocal IOL implantation can achieve good results in some apropriated for the patients after LASIK surgery.

儿童白内障是全球范围内可治疗儿童盲症的主要原因之一。对于这些患儿而言，手术是恢复或保护视力的主要方法。然而，手术后的并发症，特别是青光眼相关不良事件(glaucoma-related adverse events, GRAEs)，常常成为导致儿童二次致盲的主要原因，这引起了眼科医疗领域的广泛关注。文章综述了儿童Ⅱ期人工晶状体植入术后GRAEs的影响因素，包括手术设计、眼部解剖特征、其他眼部发育异常和全身疾病等。手术设计中是否植入人工晶状体(intraocular lens，IOL)以及植入的时机和位置都对GRAEs的发生有显著影响。此外，眼部解剖特征如角膜直径、眼轴长度、前房深度、中央角膜厚度和术前晶状体厚度等，也是影响GRAEs发生的重要因素。同时，其他眼部发育异常和全身疾病，如先天性无虹膜、先天性风疹综合征等，也会增加儿童白内障术后青光眼的发生率。文章还总结了预测GRAEs的方法，并推荐使用Cox回归模型建立预测模型。这种模型可以有效地预测儿童Ⅱ期IOL植入术后在特定时间段内发展为GRAEs的概率，从而为早期识别GRAEs高危儿童提供了重要的借鉴。通过对GRAEs影响因素的深入分析和预测模型的建立，文章旨在帮助眼科医生更好地理解GRAEs的发生机制，并在手术前对患儿进行风险评估，从而选择最佳的手术方案和预防措施。这对于改善患儿的术后恢复、减少并发症、保护视功能具有重要的临床意义。

Pediatric cataract is one of the leading causes of treatable childhood blindness worldwide. For these children, surgery is the primary method to restore or preserve vision. However, postoperative complications, particularly glaucoma-related adverse events (GRAEs), often become the main reason for secondary blindness in children, attracting widespread concern in the field of ophthalmology. This study reviews the impact factors of glaucoma-related adverse events after secondary intraocular lens (IOL) implantation in children, including surgical design, ocular anatomical characteristics, other ocular developmental abnormalities, and systemic diseases. Whether to implant an IOL in the surgical design and the timing and positioning of the implantation have a significant impact on the occurrence of GRAEs. In addition, ocular anatomical characteristics, such as corneal diameter, axial length, anterior chamber depth, central corneal thickness, and preoperative lens thickness, are also important factors affecting the occurrence of GRAEs. At the same time, other ocular developmental abnormalities and systemic diseases, such as congenital aniridia and congenital rubella syndrome, also increase the incidence of glaucoma after pediatric cataract surgery. The article also summarizes methods for predicting GRAEs and recommends using the Cox regression model to establish a predictive model. This model can effectively predict the probability of children developing GRAEs after secondary IOL implantation within a specific time period, providing an important reference for the early identification of high-risk children for GRAEs. Through in-depth analysis of the impact factors of GRAEs and the establishment of predictive models, the article aims to help ophthalmologists better understand the mechanisms of GRAEs and assess the risks of children before surgery, thereby selecting the best surgical plan and preventive measures. This is of great clinical significance for improving postoperative recovery in children, reducing complications, and protecting visual function.

目的：探讨超声乳化晶状体吸除联合囊袋上经巩膜缝线固定人工晶状体(intraocular lens,IOL)植入术治疗球形晶状体(microspherophakia,MSP)的有效性和安全性。方法：采用回顾性分析，选取2019年1月至 2020年6月期间在复旦大学附属眼耳鼻喉科医院进行治疗的MSP患者37例(37眼)，随机分为两组，纳入行超声乳化晶状体吸除联合囊袋上巩膜缝线固定IOL植入术(supra-capsular and scleral-fixated intraocular lens implantation,SCSF-IOL)的MSP患者20例(20眼)和行超声乳化晶状体吸除联合改良型囊袋张力环植入术(transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation,MCTR-IOL)的MSP患者17例(17眼)，观察两组术后最佳矫正视力及并发症等情况。结果：两组术后最佳矫正视力比术前均有改善(P<0.001)，而组间比较差异无统计学意义(P=0.326)。两组的IOL倾斜度相当(P=0.216)。预防性Nd:YAG激光后囊膜切开术在SCSFIOL术后1周至1个月进行。在SCSF-IOL组，2眼(10.00%)需要重复激光治疗，1眼(5.00%)出现囊口偏心。后囊膜混浊是MCTR组最常见并发症(6眼,35.29%)。随访期间两组均未出现IOL脱位、继发性青光眼和视网膜脱离。结论：SCSF-IOL是治疗球形晶状体的简单易行的手术方式，疗效与MCTR-IOL相当。Nd:YAG激光后囊膜切开术是预防SCSF-IOL术后囊袋并发症的必要手段。

Objective: To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens (IOL) implantation in the treatment of microspherophakia (MSP). Methods: by retrospective analysis, 37 MSP patients (37 eyes) who were treated in our hospital from January 2019 to June 2020 were randomly divided into two groups, including 20 MSP patients (20 eyes) who treated by SCSF-IOL and 17 MSP patients (17 eyes) who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL). The best corrected vision and complications were observed. Results: the best corrected vision was significantly improved in both groups (P < 0.001), but there was no remarkable difference between the two groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd: YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment, and one eye (5.00%) had a decentered capsule opening. Posterior capsular opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up. Conclusions: SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL. Nd: YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

目的：探讨内镜下泪囊鼻腔吻合(endoscopic dacryocystorhinostomy, En-DCR)联合双管人工泪管植入(bicanalicular silicone tube intubation, BSTI)术治疗小泪囊型慢性泪囊炎的疗效。方法：回顾2020年7月—2023年3月在温州医科大学附属眼视光医院通过CT泪囊造影术(CT dacryocystography, CT-DCG)确诊的单眼小泪囊型慢性泪囊炎并接受手术的患者69例(69眼)，手术采取术中开放泪总管平面的En-DCR并联合BSTI术治疗。术后3个月取出人工泪管，通过术前和术后9个月随访资料，记录和分析了纳入患者的基本资料、手术治疗、治疗效果(包括解剖成功率和功能成功率)和并发症情况。结果：本研究最终纳入61例(61眼)患者，其中男21例、女40例，右眼33眼、左眼28眼。平均年龄为(55.31±12.28)岁(范围为27~75岁)。所有患者均顺利完成术中开放泪总管平面的En-DCR并联合BSTI术治疗。随访9个月，En-DCR的解剖成功率为80.33%(49/61)，功能成功率为75.41%(46/61)，在随访过程中未出现视力下降、眶内出血、感染扩散等并发症。结论：En-DCR联合BSTI术治疗小泪囊型慢性泪囊炎可取得较为满意疗效。

Objective: To evaluate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) Combined with bicanalicular silicone tube intubation (BSTI) for the Management of Chronic dacryocystitis with Small Lacrimal sac. Methods: A total of 69 patients (69 eyes) with chronic dacryocystitis with small lacrimal sac diagnosed by CT dacryocystography (CT-DCG) treated with En-DCR combined with BSTI at the Eye Hospital of Wenzhou Medical University from July 2020 to March 2023 were reviewed. The surgery procedure exposed the plane of common canalicular, and followed by BSTI. The tube was removed 3 months after surgery. The basic data, surgical treatment, therapeutic effect (including anatomical and functional success rates) and complications of the included patients were recorded and analyzed through the follow-up data before and 9 months after surgery. Results: Ultimately, 61 patients (61 eyes) were included in this study—21 males and 40 females—with a distribution of 33 right eyes and 28 left eyes. The mean age was calculated at 55.31±12.28 years (range: 27 to 75 years). All patients underwent a successful En-DCR with exposed the plane of common canalicular and BSTI. At the nine-month follow-up, the anatomical success rate of En-DCR was 80.33%(49/61), the functional success rate was 75.41%(46/61). No complications such as visual impairment, intraorbital hemorrhage, or spread of infection occurred during the follow-up period. Conclusions: The combination of En-DCR and BSTI surgery for chronic dacryocystitis with small lacrimal sac can achieve a satisfactory therapeutic effect.

本文总结了 15 例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查，给予患儿及其家属个性化的心理护理，进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理，饮食、疼痛、眼部用药以及弹力绷带包扎护理，关注有无并发症的发生及给予相应的护理，并对患儿及其家属做好出院指导。15 例患儿均顺利完成手术，术后均出现术眼疼痛，2 例出现眶压增高，1 例出现呕吐，均得到妥善处理。术后随访 3~18 个月，患儿均获得了较为满意的眼部外观，生活质量得到了提高。

This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye, and the life quality was improved. 

目的：观察后房型有晶体眼人工晶体(implantable collamer lens，ICL)V4c植入术后2年的有效性、安全性和稳定性，评估ICL V4c矫正屈光不正的中远期临床疗效。方法：回顾性病例研究。收集在河 北省沧州市中心医院眼一科行ICL V4c手术治疗的屈光不正患者，观察并记录术前至术后2年的裸眼视力、最佳矫正视力、屈光状态、对比敏感度、高阶像差、眼压、人工晶体拱高、角膜内皮细胞 计数、不良反应、主观视觉质量等临床资料，进行统计学分析。结果：完成随访的96例术眼，术后2年的平均裸眼视力(LogMAR)为0.021±0.065，平均最佳矫正视力(LogMAR)为0.002±0.041，优于术前最佳矫正视力，有效性指数为1.05，安全性指数为1.09，等效球镜数值稳定，对比敏感度提升，高阶像差有所增加，但主观视觉质量良好，眼压基本稳定，内皮细胞丢失率为1.6%，平均拱高为(549.6±50.0) μm，随访期间未发现眼内感染、继发性青光眼、晶状体混浊、黄斑水肿、视网膜脱离等并发症。结论：ICL V4c植入术矫正屈光不正具有良好的中远期临床效果。

Objective: To assess the medium-long term efffcacy, safety and stability of a newly developed posterior chamber phakic intraocular lens (model V4c Visian Implantable Collamer Lens) to correct refractive errors. Methods: Retrospective case series. This study evaluated eyes that had implantation of ICL V4c to correct ametropia for at least two years. Uncorrected and corrected distance visual acuities, refraction, contrast sensitivity, high-order aberration, quality of life, intraocular pressure, endothelial cell density, pIOL vault, and adverse events were evaluated to assess the efffcacy, safety and stability of V4c. Results: The study comprised 96 eyes of 50 patients. At 2 years postoperatively, the mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.021±0.065 logMAR and 0.002±0.041 logMAR, which were better than preoperative CDVA. The efffcacy and safety indices were 1.05 and 1.09, respectively. The spherical equivalent was stable with improved contrast sensitivity and increased high-order aberrations, but the subjective visual quality was well. The IOP remained stable over time. The mean vault was (549.6±50.0) μm and the mean endothelial cell loss was 1.6%. No eye developed intraocular infection, secondary glaucoma, lens opacity, macular edema or retinal detachment.Conclusion: The good medium-long term outcomes support the use of ICL V4c for the correction of myopia. 

目的：观察青光眼引流钉植入术治疗难治性青光眼的疗效。方法：对联合应用抗青光眼药物无法控制的难治性开角型青光眼19例19只眼行青光眼引流钉植入术，术中应用丝裂霉素(2 mg /6~8 mL，2.5~4 min)及可松解缝线。术后1天、2周和1、3、6、12个月进行随访，观察眼压、视力、滤过泡形态、前房深度、眼底C/D、降眼压药物使用情况、完全及部分成功率 及有无并发症等情况。结果：19例患者中，术后完全成功率78.9%(15例)，部分成功率10.5% (2例)，失败10.5%(2例)。术前用3~5种降眼压药，眼压控制于27.7±10.1 mmHg。术后随访仅三人需使用1~2种降压药物。眼压下降组间有显著性意义(P<0.001)。与术前相比，术后1天(11.8±7.7 mmHg，P<0.001)，术后2周(10.1±4.2 mmHg，P<0.05)，1个月(12.0±4.0 mmHg，P=0.001)，6个月(12.2±3.4 mmHg，P<0.001)，1年(13.1±3.3 mmHg，P=0.001)及2年随访(14.5±2.5 mmHg，P=0.001)，眼压下降均具有显著性意义。术后患者视力、前房深度及C/D改变差异无显著性意 义。末次随访滤过泡弥散隆起57.9%(11例)，微囊型15.8%(3例)，瘢痕型21.1%(4例)，包裹型5.3%(1例)。所有患者均未观察到明显的术后并发症的发生。结论：房水引流钉植入术治疗难治性开角型青光眼手术成功率高，并发症少，值得推广。

目的：观察青光眼引流钉植入术治疗难治性青光眼的疗效。方法：对联合应用抗青光眼药物无法控制的难治性开角型青光眼19例19只眼行青光眼引流钉植入术，术中应用丝裂霉素(2 mg /6~8 mL，2.5~4 min)及可松解缝线。术后1天、2周和1、3、6、12个月进行随访，观察眼压、视力、滤过泡形态、前房深度、眼底C/D、降眼压药物使用情况、完全及部分成功率 及有无并发症等情况。结果：19例患者中，术后完全成功率78.9%(15例)，部分成功率10.5% (2例)，失败10.5%(2例)。术前用3~5种降眼压药，眼压控制于27.7±10.1 mmHg。术后随访仅三人需使用1~2种降压药物。眼压下降组间有显著性意义(P<0.001)。与术前相比，术后1天(11.8±7.7 mmHg，P<0.001)，术后2周(10.1±4.2 mmHg，P<0.05)，1个月(12.0±4.0 mmHg，P=0.001)，6个月(12.2±3.4 mmHg，P<0.001)，1年(13.1±3.3 mmHg，P=0.001)及2年随访(14.5±2.5 mmHg，P=0.001)，眼压下降均具有显著性意义。术后患者视力、前房深度及C/D改变差异无显著性意 义。末次随访滤过泡弥散隆起57.9%(11例)，微囊型15.8%(3例)，瘢痕型21.1%(4例)，包裹型5.3%(1例)。所有患者均未观察到明显的术后并发症的发生。结论：房水引流钉植入术治疗难治性开角型青光眼手术成功率高，并发症少，值得推广。

目的：评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜 散光的早期临床效果、安全性，以及术后人工晶状体眼的视功能状态。方法：搜集自2013年至今 在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼) 进行分析，术前患者散光均大于1.0 D。术后随访3个月，分别观察术后1周、1个月以及3个月的裸眼远视力，最佳矫正远视力以及裸眼近视力，术前散光以及术后3个月时残余散光、等效球镜度数 和人工晶状体的旋转度。结果：术后3个月患者裸眼远视力0.89±0.21，最佳矫正远视力0.95±0.38， 等效球镜为?0.5~+0.25D，裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D，较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论：Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质 量，并校正了术前角膜散光，实现了患者高度满意率和脱镜率，可预测性好，并有良好的旋转稳定性。

目的：评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜 散光的早期临床效果、安全性，以及术后人工晶状体眼的视功能状态。方法：搜集自2013年至今 在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼) 进行分析，术前患者散光均大于1.0 D。术后随访3个月，分别观察术后1周、1个月以及3个月的裸眼远视力，最佳矫正远视力以及裸眼近视力，术前散光以及术后3个月时残余散光、等效球镜度数 和人工晶状体的旋转度。结果：术后3个月患者裸眼远视力0.89±0.21，最佳矫正远视力0.95±0.38， 等效球镜为?0.5~+0.25D，裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D，较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论：Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质 量，并校正了术前角膜散光，实现了患者高度满意率和脱镜率，可预测性好，并有良好的旋转稳定性。

目的：建立并评估儿童Ⅱ期人工晶状体(intraocular lens,IOL)植入术后青光眼相关不良事件(glaucoma-related adverse events,GRAEs)的预测模型。方法：选取于中山大学中山眼科中心行Ⅱ期IOL植入术的无晶状体眼患儿205例(356眼)，并在术后对其随访3年。采用Cox比例风险模型确定GRAEs的预测因子，并建立列线图预测模型。采用随时间变化的受试者工作特征(receiver operating characteristic,ROC)曲线、决策曲线分析、Kaplan-Meier曲线评估模型性能，并通过Bootstrapping的C指数和校准图进行内部验证。结果：行Ⅱ期IOL植入术时年龄较大(HR=1.50, 95% CI: 1.03 ~2.19)、术后一过性高眼压(HR=9.06, 95% CI: 2.97~27.67)和IOL睫状沟植入术(HR=14.55, 95% CI: 2.11~100.57)是GRAEs的危险因素(均P<0.05)，并据此建立了两个列线图预测模型。在术后1、2、3年，模型1的ROC曲线下面积(area under curve,AUC)分别为0.747(95% CI: 0.776 ~0.935)、0.765 (95% CI: 0.804 ~0.936)和0.748 (95% CI: 0.736~0.918)，模型2的AUC分别为0.881 (95% CI: 0.836 ~0.926)、0.895 (95% CI: 0.852 ~0.938)和0.848 (95% CI: 0.752~0.945)。在内部验证和评价中，两种模型均表现出良好的性能和临床净效益。Kaplan-Meier曲线显示两个不同的风险组在两个模型中都能被显著且稳健地区分。此外，本研究也构建了在线风险计算器。结论：两种列线图均能灵敏、准确地识别Ⅱ期IOL植入术后GRAEs的高危患儿，有助对其进行早期识别和及时干预。

Aims: To establish and evaluate predictive models for glaucoma-related adverse events (GRAEs) following secondary intraocular lens (IOL) implantation in paediatric eyes. Methods: 205 children (356 aphakic eyes) receiving secondary IOL implantation at Zhongshan Ophthalmic Center with a 3-year follow-up were enrolled. Cox proportional hazard model was used to identify predictors of GRAEs and developed nomograms. Model performance was evaluated with time-dependent receiver operating characteristic (ROC) curves, decision curve analysis, Kaplan-Meier curves and validated internally through C-statistics and calibration plot of the bootstrap samples. Results: Older age at secondary IOL implantation (HR=1.5, 95% CI: 1.03 to 2.19), transient intraocular hypertension (HR=9.06, 95% CI: 2.97 to  27.67) and ciliary sulcus implantation (HR=14.55, 95% CI: 2.11 to 100.57) were identified as risk factors for GRAEs (all p<0.05). Two nomograms were established. At postoperatively 1, 2 and 3 years, model 1 achieved area under the ROC curves (AUCs) of 0.747 (95% CI: 0.776 to 0.935), 0.765 (95% CI: 0.804 to 0.936) and 0.748 (95% CI: 0.736 to 0.918), and the AUCs of model 2 were 0.881 (95% CI: 0.836 to 0.926), 0.895 (95% CI: 0.852 to 0.938) and 0.848 (95% CI: 0.752 to 0.945). Both models demonstrated fine clinical net benefit and performance in the interval validation. The Kaplan-Meier curves showing two distinct risk groups were well discriminated and robust in both models. An online risk calculator was constructed. Conclusions: Two nomograms could sensitively and accurately identify children at high risk of GRAEs after secondary IOL implantation to help early identification and timely intervention.