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.

睑缘炎是一种普遍存在的慢性眼部炎症，主要影响睑缘的皮肤和黏膜。患者常表现为眼部干痒、异物感等刺激症状，以及睑缘充血、肥厚和睫毛反复脱落等。睑缘清洁可以抑制部分眼表细菌生长，也可以去除睑缘油脂、分泌物、角化上皮细胞，清洁眼表环境，对治疗睑缘炎具有较好效果。为确保患者的治疗安全，并指导和规范临床眼科医护人员的操作，由中山大学中山眼科中心牵头，联合全国17所医疗机构进行反复修订，于2023年12月17日在全国团体标准信息平台发布《基于眼睑清洁仪的睑缘清洁操作流程》的团体标准。文章对该团体标准进行深度解读，详细解读睑缘清洁操作的适应证与禁忌证、具体操作的重点、难点与细节等内容，以更好地指导临床医护人员实施规范有效的治疗操作，保证患者治疗效果与确保患者治疗安全。旨在规范和推进基于眼睑清洁仪的睑缘清洁操作流程的精准化发展，更为促进我国眼前段疾病医学和护理精准应用的水平提供重要的标准依据。

Blepharitis is a common chronic eye inflammation that mainly affects the skin and mucosa of the eyelid margin. It is characterized by eye irritation symptoms such as dryness, itching, and foreign body sensation, accompanied by clinical manifestations such as eyelid congestion, thickening, and repeated eyelash loss. It can damage the conjunctival tissue even. Eyelid cleaning can inhibit the growth of some bacteria on the ocular surface, remove eyelid oil, secretions, and keratinized epithelial cells, clean the ocular environment, and have a good effect on treating blepharitis. In order to ensure the safety of patient treatment and guide and standardize the operation of clinical ophthalmic medical staff, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and jointly revised by 17 medical institutions across the country, the group standard " Operation procedure of eyelid margin cleaning based on eyelid cleaning device" was released on the National Group Standard Information Platform on December 17, 2023. This article provides an in-depth interpretation of the group's standards, detailing the indications and contraindications, key points, difficulties, and details of eyelid cleaning procedures, in order to better guide clinical medical staff in implementing standardized and effective treatment procedures, ensuring patient treatment effectiveness and safety. Aiming to standardize and promote the precise development of eyelid margin cleaning procedures based on eyelid cleaning devices, and provide important standard basis for promoting the level of medical and nursing precision application of anterior segment diseases in China.

报道一例发生在41岁中年女性左眼上睑的无色素性黑色素瘤，曾在当地医院误诊为霰粒肿。体检见左眼上睑结膜面一大小约2 cm × 2 cm红色肿物，手术切除肿物送病理检查，标本经10%福尔马林固定，常规石蜡包埋切片，HE染色及免疫组织化学染色。光镜下见肿瘤细胞呈片状及巢状排列，瘤细胞圆形及梭形，部分瘤细胞胞浆空泡状呈气球样形，部分细胞核仁明显。免疫组化显示肿瘤细胞S-100、HMB-45阳性，CK及EMA阴性，最终病理诊断为左眼上睑无色素性黑色素瘤。对于临床上患者年龄较大无典型霰粒肿特征的眼睑肿物，术后标本均应送病理检查以除外其它肿瘤的可能。

To report a case of amelanotic melanoma located in the leff upper eyelid misdiagnosed as chalazion in a 41-yearold woman. Examination showed a red 2 cm × 2 cm mass in the left upper palpebral conjunctiva. The tumor was excised and regular fixed in 10% formalin, embedded, sectioned, HE stained and immunohistochemistry stained. Histopathological examination revealed nests of round atypical tumor cells with vacuolated cytoplasm and sheets of spindle atypical tumor cells. Some tumor cells had conspicuous nucleoli. Immunohistochemistry some tumor cells were positive for melanocytic markers S-100, HMB-45 and negative for CK, EMA. So the pathological diagnosis was palpebral conjunctiva amelanotic melanoma in the leff upper eyelid. For the mass in palpebral conjunctiva of senile patients without typical characteristics of chalazion, the surgical specimen should be performed for pathologic examination to rule out other tumors.

目的：探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法：通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗，对其疗效进行回顾性分析。结果：术后修复皮瓣均成活，眼睑功能良好，随访 4 个月~10 年，期间无复发及转移病例。结论：对于眼睑部的基底细胞癌，采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率，同时最大限度地保留了眼睑的正常组织，达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

近5年来眼睑皮脂腺癌研究取得一系列成果。临床研究方面，明确了眼睑皮脂腺癌冰冻切缘控制显微手术的意义，提出了患者预后指标；在基础研究方面，描述了基因突变谱，揭示了3种相互独立的发病模式，以及提出了免疫及靶向治疗相关研究；我国眼肿瘤工作者也在眼睑皮脂腺癌研究方面树立了国际地位。本文对近5年国内外眼睑皮脂腺癌相关研究方面的主要成果进行总结分析，并展望治疗前景，为临床提供有益参考。

In recent 5 years, a series of studies have been made in the mechanism of onset of eyelid sebaceous carcinoma worldwide. In clinical research, the prognosis has made in predicting progression of patients with eyelid sebaceous carcinoma, and the significancy of frozen margin control in microsurgery was clarified. In field of basic research,from elucidation of mutational landscape to revelation of three independent pathogenesis patterns, from researches on immunotherapy to targeted therapy, efforts have been made to reveal the pathological mechanism to both aspect of its morbidity and development. This paper summarizes, analyzes and reviews the main achievements in recent 5 years on eyelid sebaceous carcinoma.

眼睑皮脂腺癌是起源于眼睑部位皮脂腺体的恶性上皮性肿瘤，易复发、转移，主要治疗方式仍以手术切除为主，但患者整体预后并不理想，早期正确诊断和靶向治疗是改善患者预后和改进治疗的关键。眼睑皮脂腺癌临床表现复杂，早期容易误诊或漏诊进而延误治疗，病理检查是其诊断的金标准。此外，目前关于眼睑皮脂腺癌发病机制未完全阐明，癌发生发展的分子生物学过程尚未明确。因此，多方面了解眼睑皮脂腺癌发病机制为靶向治疗提供理论基础是十分必要的。本文主要从眼睑皮脂腺癌发病机制包括遗传因素、表观遗传、外源病毒感染、免疫逃逸、端粒酶学说等方面对眼睑皮脂腺癌作一综述。

Eyelid sebaceous gland carcinoma is a malignant epithelial tumor originating from eyelid sebaceous glands, which is prone to relapse and metastasis. The treatment mainly depends on surgical excision, but the overall prognosis of patients is not ideal. Early diagnosis and targeted therapy are the keys to improve the prognosis of patients.Due to its complex clinical manifestations, early misdiagnosis or missed diagnosis is easy to delay treatment, and pathological examination is still the gold standard for its diagnosis. In addition, the pathogenesis of eyelid sebaceous gland carcinoma is still unclear, and the molecular biological process of the occurrence and development is less understood. Therefore, it is very necessary to understand the pathogenesis of eyelid sebaceous gland carcinoma in various aspects to provide a theoretical basis for targeted therapy. In this paper, the pathogenesis of eyelid sebaceous gland carcinoma was reviewed from the aspects of gene , epigenetic, viral infection, immune escape, , telomerase theory and so on.

Merkel细胞癌(Merkel cell carcinoma，MCC)是一种少见的高度恶性的皮肤原发性神经内分泌癌，发生于眼睑的MCC更加罕见。本文对2例眼睑MCC患者的临床病史和治疗过程进行回顾和总结。1例初发患者经手术彻底切除，效果良好，随访7年，未再复发；1例患者在外院切除术后2个月，于眼睑原位复发，再次行手术彻底切除，2个月后同侧腮腺淋巴结及颈前淋巴结扩散，目前仍在肿瘤科进一步放化疗中。复习相关文献并结合本组病例提示，MCC诊断主要依靠病理检查，彻底切除病灶并结合术后放化疗是其治疗的主要手段，免疫治疗是目前新的发展趋势。

The Merkel cell carcinoma (MCC) is a rare highly malignant primary neuroendocrine carcinoma of the skin,especially in the eyelids. In this report, the clinical history and treatment course of 2 patients with MCC of the eyelid were reviewed and summarized. Patient 1 with primary MCC of eyelid was treated with complete surgical excision, with good results. Follow-up for 7 years had shown no recurrence. Patient 2 with the eyelid relapse in situ two months after resection in another hospital, was treated with complete surgical excision again, but the tumor metastasized to the ipsilateral lymphonodi parotidici and cervical lymph nodes two months after the surgery. The patient is now going through radiotherapy and chemotherapy in oncology department. According to the review of literatures, the diagnosis was based on the pathologic evidence. Complete removal of lesion combined with postoperative radiotherapy and chemotherapy is a major means of treatment for MCC. Immunotherapy will play a more important role in the future.

目的：评价手术视频辅助Wetlab眼睑手术教学的效果。方法：回顾性分析2021年4月至2021年9月在中山大学中山眼科中心住院医师规范化培训学员中使用全眼模型开展Wetlab外眼手术教学的情况。对照组(12人)采用传统教学方法，实验组(15人)在传统教学方法的基础上引入手术视频辅助教学，对学员第3、6、9次练习视频进行评分，分析教学效果。结果：2组学员的基线水平与学习曲线相似，练习第3次到第6次之间评分提高快(对照组P3~6=0.001，实验组P3~6<0.001)，第6次到第9次之间提高速度放缓(对照组P6~9=0.007，实验组P6~9=0.012)。对照组学员在练习第3次用时更长[(80.3±16.1) min]，随着练习次数增多，用时逐渐缩短并保持稳定(P3~6=0.040，P6~9=0.886，P3~9=0.020)，而实验组学员在练习第3次用时更短[(71.7±15.0) min]，练习过程中保持稳定(P3~6=0.568，P3~9=0.519)。结论：手术视频辅助教学有助于学员熟悉手术操作，提高练习效率。

Objective: To assess the efficacy of video-assisted Wetlab eyelid surgery teaching. Methods: From April 2021 to September 2021, the porcine orbit model was used to conduct a Wetlab teaching course on eyelid surgeries among trainees of standardized training for residents in Zhongshan Ophthalmic Center, Sun Yat-sen University. The control group (12 trainees) used conventional teaching methods. Video-assisted teaching was offered to the test group (15 trainees) based on conventional teaching methods. The videos records of the 3rd, 6th, and 9th practices were scored to analyze the teaching efficiency. Results: Trainees from the 2 groups showed a simila baseline and learning curve. Rapid improvement was found between the 3rd and 6th practice (P3–6=0.001 in control group, P3–6<0.001 in test group). The increment was slower between the 6th and 9th practice (P6–9=0.007 from control group, P6–9=0.012 from test group). Longer time was required by trainees from the control group at the 3rd practice [(80.3±16.1) min]. As they practiced more, the time required gradually decreased and remained stable (P3–6=0.040, P6–9=0.886, P3–9=0.020 from control group). Trainees from the test group spent less time at the 3rd practice [(71.7±15.0) min]. The time remained stable during all practices (P3–6=0.568, P3–9=0.519 from test group). Conclusion: Video-assisted teaching can help trainees get familiar with surgical operations and improve the efficiency of practices.

患者，女，62岁，自觉右眼突出2年就诊，高血压3年。专科体格检查：右眼上睑退缩约1.5mm，左眼上睑下垂约2.5mm。提上睑肌肌力右眼13mm，左眼9mm。完善眼眶CT及头颅磁共振，未见异常。查阅文献，初步诊断为假性正负眼睑综合征。假性正负眼睑综合征符合赫林定律。通过左眼抬高试验发现右眼上睑退缩明显好转，安排左眼手术。术中发现左眼提上睑肌腱膜撕脱约7mm，故行左眼提上睑肌前徙复位术，术后双眼上睑均回归正常位置且两边对称。假性正负眼睑综合征最常见的病因是重症肌无力，其他原因还包括甲状腺相关眼病、先天性上睑下垂、动眼神经麻痹、老年性上睑下垂及上睑成形术并发症等。临床工作中需抓住疾病的蛛丝马迹，真正做到诊疗如棋、破局而立，使患者得到精准的治疗。

A 62-year-old female patient presented with right eye protrusion for 2 years and hypertension for 3 years. Physical examination showed that the upper eyelid retraction of the right eye was about 1.5 mm, and the ptosis of left eye was about 2.5 mm. The levator upper eyelid muscle strength was 13 mm in the right eye and 9 mm in the left eye. Orbital CT and cranial MRI were completed, and no abnormalities were found. A preliminary diagnosis of pseudo plus-minus lid syndrome was made by literature review. Pseudo plus-minus lid syndrome conforms to the Herring’s law. The upper eyelid retraction of the right eye was significantly improved by the left eye elevation test. During the left eye surgery, it was found that the left levator aponeurotic was avulsed about 7 mm. so the left levator aponeurosis was repositioned. After the operation, the upper eyelids of both eyes returned to the normal position and both sides were symmetrical. The most common cause of pseudo Plus—Minus Lid Syndrome is myasthenia gravis. Other causes include thyroid-associated ophthalmopathy, congenital ptosis, oculomotor nerve palsy, senile ptosis, and complications of blepharoplasty. In clinical work, we need to grasp the clues of the disease, truly achieve the diagnosis and treatment like chess, break the game and stand, so that patients can get accurate treatment.

临床上儿童外眦部肿物合并眼睑畸形及结膜肿物少见，需在切除眼睑、结膜肿物的同时，灵活处置眼睑整复。本文回顾2例就诊于北京儿童医院的先天性外眦肿物合并眼睑缺损的病例。术后病理示皮赘伴结膜皮样脂肪瘤。患儿眼睑肿物切除彻底，眼睑整复后外观满意。

Lateral canthus mass with eyelid deformity and conjunctival mass is rare in children. The eyelid reduction should be handled flexibly while the mass is removed. Two cases of congenital lateral canthus with eyelid coloboma were reviewed in Beijing Children’s Hospital. Postoperative pathology showed fibroepithelial polyp and conjunctival dermolipoma. The eyelid masses of the child were completely excised, and the appearance was satisfactory after eyelid reduction.