马方综合征(Marfan syndrome,MFS)是与晶状体异位有关的常见的全身性疾病，约50%~80%的MFS患者存在晶状体异位。该文报道一例21岁的男性患者，因患有MFS致双眼晶状体半脱位伴双眼并发性白内障，先后实施白内障摘除人工晶状体植入合并囊袋张力环悬吊固定术，术后保留低度近视，随访期间未发现眼压升高、人工晶状体严重移位及囊袋皱缩等并发症。

Marfan syndrome (MFS) is a common systemic disease associated with lens heterotopia, and about 50%~80% of Marfan patients have lens heterotopia. This article reports a case of a 21-year-old male patient who suffered from bilateral lens subluxation and concurrent cataract due to MFS, who underwent cataract extraction and IOL implantation with CTR suspension fixation was performed to preserve low-grade myopia after surger y. No complications such as increased intraocular pressure, intraocular lens severely displacement and capsular bag shrinkage were found during follow-up.

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.

眼健康是国民健康的重要组成部分，包括盲在内的视觉损伤严重影响人民群众的身体健康和生活质量，加重家庭和社会负担，威胁社会经济生产活动，是涉及民生的重大公共卫生问题和社会问题。弱视作为幼儿期起病的主要视觉障碍性疾病之一，是致使青少年低视力的首要因素，影响青少年自身学业和心理健康，增加致盲风险，故做好弱视的预防及康复工作刻不容缓。通过梳理研究发现，国内外对弱视的传统治疗方法有遮盖疗法、屈光矫正、压抑疗法等，知觉学习、视功能训练、电子视频游戏、针灸等则是近年逐渐新兴起并被广泛运用的弱视康复治疗方法，近年来关于年龄对弱视康复治疗影响的相关研究也较多。通过整理前人研究成果，提出建立儿童青少年视力档案、建立五位一体弱视康复治疗布局模式、进行联合临床治疗青少年弱视的对策，以期为青少年弱视提供康复治疗手段参考和选择，促进青少年弱视康复治疗眼健康事业发展。

Eye health is an important part of national health. Visual impairment, including blindness, seriously affects people’s physical health and quality of life, increases the burden on families and society, threatens social and economic production activities, and is a major public health and social problem related to people’s livelihood. Amblyopia,as one of the main visual disorders in early childhood, is the primary factor causing low vision in adolescents, which affects their academic and mental health and increases the risk of blindness. Therefore, it is urgent to do a good job in the prevention and rehabilitation of amblyopia. By summarizing existing studies, it is found that traditional treatment methods for amblyopia at home and abroad include occlusion therapy, refractive correction, and depressive therapy, while perceptual learning, visual function training, electronic video games, acupuncture and so on are gradually emerging in recent years and widely used in recent years. There are numerous studies on the impact of age on the rehabilitation of amblyopia. By sorting out the previous research results, this paper puts forward the countermeasures of establishing visual acuity files for children and adolescents, establishing the five- in-one rehabilitation treatment layout model, and combining clinical treatment for adolescent amblyopia, in order to provide reference and choice for the rehabilitation treatment of adolescent amblyopia, and promote the development of the eye health cause of adolescent amblyopia rehabilitation.

       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。

真菌性角膜炎是我国常见的致盲性眼病，其中排前3位的致病病原菌分别为曲霉菌、镰刀菌以及念珠菌。念珠菌作为一种条件致病真菌，在宿主免疫功能低下或眼表微环境失衡时易引发机会性感染，其发病率因免疫抑制药物的滥用以及隐形眼镜佩戴的增加等因素逐年上升。在机会感染后，由于念珠菌本身以及生物膜形成的特殊作用，常导致其对现用系统性抗真菌药物，如伏立康唑、两性霉素B、伊曲康唑及氟康唑等耐药性增加。近年来，关于纳米材料介导的药物传递系统作用于治疗念珠菌角膜炎的研究日益增多，新型纳米材料通过作为抗真菌药物的载体，增加药物溶解度，延长眼表停留时间，加强生物膜、角膜穿透性，提高了抗真菌药物对念珠菌的抗菌作用，为解决念珠菌感染耐药性难题提供了新思路。文章综述了纳米聚合物、纳米颗粒、纳米凝胶、脂质体载体、纳米立方体、纳米微针和纳米胶束等新型纳米材料作为治疗念珠菌角膜炎的新型给药载体的研究现状与进展，突破传统疗法的局限，为改善目前临床存在抗真菌治疗药物有限的问题提供新的可行思路。

Fungal keratitis is a prevalent blinding ocular disease in China, with Aspergillus, Fusarium, and Candida ranking as the top three pathogenic fungi. As an opportunistic pathogenic fungus, Candida readily causes opportunistic infections when host immunity is compromised or the ocular surface microenvironment is imbalanced. The incidence of Candida keratitis has been rising annually due to factors such as the misuse of immunosuppressive drugs and increased contact lens wear. Following infection, Candida itself and the formation of biofilms contribute to enhanced resistance against currently used systemic antifungal agents, including voriconazole, amphotericin B, itraconazole, and fluconazole, posing significant challenges to clinical treatment.Recently, research on nanomaterials-mediated drug delivery systems for treating Candida keratitis has burgeoned. Novel nanomaterials, serving as carriers for antifungal drugs, enhance therapeutic efficacy by improving drug solubility, prolonging ocular surface retention time, penetrating biofilms, and enhancing corneal permeability. These advancements offer new strategies to address drug resistance in Candida infections. This article reviews the research status and progress of emerging nanomaterials—such as nanopolymers, nanoparticles, nanogels, liposomal carriers, nanocubes, nanoneedles, and nanomicelles—as innovative drug delivery vectors for Candida keratitis. By overcoming the limitations of conventional therapies, these nanomaterials provide feasible solutions to the clinical challenges of limited antifungal options and drug resistance. The integration of nanotechnology holds promise for revolutionizing the treatment of Candida keratitis and advancing precision medicine for ocular surface fungal infections.

目的：评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法：回顾性分析中山眼科中心2016—2019年入院，因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼，术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率，比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA)，通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果：在总的71只眼中，有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升（P＜0.001），黄斑平均光敏度增加（P＜0.000 1）、黄斑完整指数降低（P＜0.000 1）、固视稳定性P1（P＜0.000 1）及P2（P＜0.001）均提升。结论：内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式，空气填充可有效地辅助黄斑裂孔愈合，可作为优先考虑的术中填充物，减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。

Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P < 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.

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.

睑板腺功能障碍(meibomian gland dysfunction, MGD)是一种慢性弥漫性睑板腺疾病，可引起眼红、眼干、异物感等眼部不适，影响患者的眼健康及生活质量。强脉冲光(intense pulsed light, IPL)作为一种新兴有效的物理治疗方法，目前已广泛应用于治疗MGD及其他常见的眼表疾病，如蠕形螨性睑缘炎、睑缘炎相关角结膜病变、复发性睑板腺囊肿等。在IPL临床应用中，规范的操作是保障治疗有效性与安全性的关键。为更好指导和规范临床眼科医护人员的IPL治疗操作，由中山大学中山眼科中心牵头，联合全国19所医疗机构，经过多次修订，于2023年12月17日在全国团体标准信息平台发布了《强脉冲光治疗睑板腺功能障碍操作流程》的团体标准。文章旨在对该团体标准进行深度解读，详细阐述操作中的重点、难点与操作细节，以更好地指导临床工作。

Meibomian gland dysfunction is a chronic diffuse meibomian gland disease that can cause eye discomfort such as redness, dryness, and foreign body sensation in patients, and influence their eye health and quality of life. Intense pulsed light (IPL), as an effective physical therapy for meibomian gland dysfunction, is being used to treat meibomian gland dysfunction and related diseases widely, such as demodex blepharitis, keratoconjunctivitis, recurrent meibomian gland cysts and so on.. In the clinical application of IPL, standardized procedures are key to ensuring the effectiveness and safety of treatment. In order to better guide and standardize the IPL treatment operation of clinical ophthalmic medical workers, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and joined with 19 medical institutions across the country, after multiple revisions, the group standard " Operation Procedure of Intense Pulsed Light for Meibomian Gland Dysfunction" was released on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group's standards, detailing the key points, difficulties, and operational details of specific operations, in order to better guide clinical work.

目的：对比玻璃体切割术(pars plana vitrectomy, PPV)联合或不联合注射地塞米松玻璃体内植入剂(dexamethasone intraveal implant, DEX)治疗特发性黄斑前膜(idiopathic macular epiretinal membrane, IMEM)的临床疗效。
方法： 采用回顾性研究设计，收集2022年1月—2023年6月于惠州市中心人民医院就诊，被诊断为IMEM(Gass 2期)并行PPV联合phaco+IOL植入的患者49例(49只眼)。根据其治疗方案分为非联合注射DEX组(25例共25只眼)及联合注射DEX组(24例共24只眼)。记录所有患者术前术后的最佳矫正视力(best corrected visual acuity, BCVA)、黄斑中心凹视网膜厚度(central macular thickness, CMT)、平均神经节细胞层(ganglion cell layer, GCL)厚度，椭圆体带(ellipsoidal zone, EZ)完整性。使用OCTA测量视网膜浅层毛细血管层(superficial capillary plexus, SCP)、中心区域血管密度(vessel densities, VDs)及中心凹无血管区(foveal avascular zone, FAZ)面积。使用非接触性眼压计测量患者眼压。随访至术后6个月，记录上述指标，其中BCVA及CMT随访至1年。使用SPSS 29.0软件进行数据的统计分析(独立样本t检验、Mann-Whitney U检验、Pearson χ2检验等)。使用重复测量方差检验分析各项指标的时间差异及交互差异性。采用线性回归分析CMT、平均GCL厚度、EZ完整性、VDs、FAZ面积及联合注射DEX与BCVA的相关性。
结果：本研究两组间性别、年龄、眼压及术前各项指标差异均无统计学意义(P>0.05)。两种术式均能改善黄斑区结构、功能及微循环障碍，术后的BCVA在两组患者中均较术前有所改善，且持续至术后6个月，CMT的变化趋势同BCVA有高度一致性，而平均GCL厚度于术后3个月时开始恢复，而SCP中心凹VDs及FAZ面积于术后6个月时才有明显恢复，两种术式术后以上各指标均具有时间差异及交互差异性(P≤0.015)，且6个月内联合注射DEX组表现更佳(P=0.036)。相较于非联合注射DEX组，只有联合注射DEX组在术后6个月时，EZ完整性的改善具有统计学意义(P=0.009)。但随访至1年时，两组之间BCVA及CMT差异均无统计学意义(P=0.079)。术后6个月内BCVA的改善与术后6个月的CMT、平均GCL厚度、SCP中心凹VDs、FAZ面积的改善及EZ完整性及是否注射DEX与术后6个月内BCVA的改善均有相关性。随访期间两组患者均未发生眼内炎、玻璃体积血、视网膜脱离等眼部或全身严重并发症。
结论：微创玻璃体切割术联合玻璃体内注射DEX治疗相较于非联合注射DEX治疗组在6个月内疗效更佳。联合单次注射DEX治疗方案与非联合注射DEX治疗方案相比，在手术1年后对BCVA及CMT的改善无明显差异。

Objective: To analyze the efficacy and safety of minimally invasive vitrectomy (PPV) with or without intraoperative injection of dexamethasone intravitreal implant (DEX) for the treatment of Idiopathic Macular Epiretinal Membrane (IMEM), by comparing the relevant indicators.

Methods: A retrospective study design was used to collect 49 patients (49 eyes) who were diagnosed with IMEM (Gass2) and underwent surgical treatment(PPV+phaco+IOL implantation) at Huizhou Central People’s Hospital from January 2022 to June 2023. According to their treatment plan, they were divided into a non-combined injection DEX group (25 cases, 25 eyes) and a combined injection DEX group (24 cases,24 eyes). All patients underwent comprehensive optometry before and after surgery, and their best corrected visual acuity (BCVA) was recorded. Scan the central macular thickness (CMT) within 6x6mm of the macular area, while scanning the average ganglion cell layer (GCL) thickness. Record whether the elliptical zone (EZ) within 1x1mm of the macular area is complete and continuous. Use OCTA mode to scan the superficial capillary layer (SCP) of the retina within a range of 6x6mm, and record the measurements of vascular density (VDs) in the central area and the area of the foveal avascular zone (FAZ). Measure the patient's intraocular pressure using a non-contact tonometer. Follow up for 6 months and record the above indicators, with BCVA and CMT followed up for 1 year. Perform statistical analysis of data using SPSS 29.0 software (Independent sample t-test, Mann Whitney U-test and Pearson χ2-test). Use repeated measures ANOVA to analyze the time differences and interaction differences of various indicators. Linear regression analysis was used to examine the correlation between CMT, mean GCL thickness, EZ integrity, VDs, FAZ area, and combined injection of DEX with BCVA.

Results: There were no statistically significant differences in gender, age, intraocular pressure, and preoperative indicators between the two groups (P>0.05). Both surgical methods can improve the structure, function, and microcirculation disorders in the macular area. The postoperative BCVA in both groups of patients improved compared to before, and persisted until 6 months after surgery. The trend of CMT changes was highly consistent with BCVA, while the average GCL thickness began to recover at 3 months after surgery. The SCP fovea VDs and FAZ area did not show significant recovery until 6 months after surgery. Both surgical methods showed time differences and interaction differences in the above indicators after surgery (P=0.015), and the combined injection of DEX group performed better within 6 months (P=0.036). Compared to the non combined injection of DEX group, only the combined injection of DEX group showed statistically significant improvement in EZ integrity at 6 months after surgery (P=0.009). However, at 1 year of follow-up, there was no statistically significant difference in BCVA and CMT between the two groups (P≥0.079). The improvement of BCVA within 6 months after surgery is correlated with the improvement of CMT, average GCL thickness, SCP fovea VDs, FAZ area, EZ integrity, and injection of DEX within 6 months after surgery. During this study, no serious ocular or systemic complications such as endophthalmitis, vitreous hemorrhage, or retinal detachment occurred in either group of patients at each follow-up time point.
Conclusions: The efficacy of PPV combined with intravitreal injection of DEX is better within 6 months compared to the non-combined injection of DEX treatment group. There was no significant difference in the improvement of BCVA and CMT after one year of surgery between the combined single injection DEX treatment regimen and the non-combined injection DEX treatment regimen.

目的：研究经鼻内镜低位泪囊鼻腔吻合术联合RT新型人工泪管置入手术的临床有效性和安全性。方法：采用前瞻性随机对照研究，将临床诊断为原发性鼻泪管阻塞继发的慢性泪囊炎患者随机分为两组。研究组(A组)43例(44眼)采用低位经鼻内镜泪囊鼻腔吻合联合新型RT人工泪管置入术。对照组(B组)39例(39眼)采用常规经鼻内镜泪囊鼻腔吻合联合双泪小管置入式人工泪管置入。术后3～6个月取出人工泪管，随访时间1～12个月，平均6个月。观察术中术后的并发症，评估其安全性。结果： A组治愈42眼(95.45%)，好转2眼(4.54%)；B组治愈38眼(97.43%)，好转1眼(2.56%)，两组比较差异无统计学意义(P＞0.05)。B组有12眼(30.77%)使用骨动力系统用于磨削骨质，A组未使用骨动力系统；A组手术时间为(31.88±1.64) min；B组手术时间为(48.54±4.40) min，两组比较差异有统计学意义(P <0.01)；B组术后人工泪管从内眦脱出2例，A组在人工泪管置入或取出时，均无管体被拉断裂的病例，无人工泪管从内眦侧脱出的病例。两组患者术后均无人工泪管导致的泪点撕裂，术后随访平均6个月，均无复发。结论：低位经鼻内镜泪囊鼻腔吻合术联合RT新型人工泪管置入可以作为一种新的治疗慢性泪囊炎手术有效、安全的方法。

Objective: To study the efficacy and safety of endonasal endoscopic lower position dacryocystorhinostomy(En-LPDCR) combined with new RT lacrimal stent intubation for treating chronic dacryocystitis. Methods: In A prospective randomized controlled study, patients with chronic dacryocystitis secondary to primary nasolacrimal duct obstruction who met the inclusion criteria were randomly divided into two groups. In study group (Group A), 43 cases (44 eyes) were treated with the En-LP-DCR combined with new RT lacrimal stent intubation. Control group (Group B), 39 cases (39 eyes): conventional endoscopic dacryocystorhinostomy combined with bicanalicular intubation. The stent was removed from 3 to 6 months after surgery and followed up 6 to 12 months. Results: There was no recurrence of chronic dacryocystitis in both groups. In group A, 42 eyes (95.45%) were cured and 2 eyes (4.54%) were improved. In group B, 38 eyes were cured (97.43%) and 1 eye was improved (2.56%), there was no significant difference between the two groups (P > 0.05). In group B, 12 eyes (30.77%) With the incorporation of powered instrumentation to make bony ostium with full exposure of the lacrimal sac., while group A did not use powered dynamic system. Operation time of group A was (31.88±1.64) min; The operation time of group B was (48.54±4.40) min. The difference between the two groups was significant (P < 0.01). In group B, the stent dislocated from the medial canthus in 2 cases, while in group A, there were no cases of the stent dislocated. No patient with dislocation, displacement of stent and punctum erosion founded in both groups, and no recurrence of chronic dacryocystitis was observed during the average follow-up of 6 months. Conclusion: Endonasal endoscopic lower position dacryocystorhinostomy combined with new RT lacrimal stent intubation is a new and effective method for the treatment of chronic dacryocystitis, with minimally surgical injury and faster postoperative recovery.