神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病，表现为角膜神经的知觉和营养功能受损，导致角膜上皮缺损、角膜溃疡和角膜穿孔。目前对神经营养性角膜病变的主要治疗方式有药物治疗、非手术干预治疗和手术治疗，但是对于重度病变患者行药物治疗、非手术干预治疗通常效果不佳。对未恢复角膜神经营养功能的患者行角膜移植术，可能导致角膜移植术后上皮持续不愈合，因此恢复角膜神经营养功能是该类患者复明的重要前提。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能，提高角膜知觉，改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围，使神经末梢重新长入角膜基质，恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进，其良好的术后效果和优点已经渐渐凸显。文章基于作者结合团队在角膜神经移植术方面经验结合近年研究进展阐述了神经营养性角膜病变的治疗手段和不同术式在角膜神经移植术中的应用，并进行展望。

Neurotrophic keratopathy is a disease related to degenerative changes in corneal nerves, resulting in impaired sensory and nutritive functions of corneal nerves. This leads to corneal epithelial defects, corneal ulcers, and corneal perforation. Currently, the main treatment modalities include pharmacotherapy, non-surgical interventions, and surgical treatment. However, drug therapy and non-surgical interventions often yield unsatisfactory results for severe neurotrophic keratopathy patients. Performing corneal transplantation in patients with unrecovered corneal sensation may result in persistent epithelial defect. Therefore, the restoration of corneal sensation is a crucial prerequisite for visual rehabilitation. Corneal neurotization emerges as an important and effective therapeutic approach for severe cases of neurotrophic keratopathy, aiming to restore corneal sensation and enhance corneal transparency. The procedure involves transplanting nerves from a donor with normal sensory function to the paralyzed sub-Tenon perilimbal space, allowing nerve endings to regenerate into the corneal stroma and restoring corneal sensory function. With continuous improvements in the technique of corneal neurotization, its favorable postoperative outcomes and advantages are becoming increasingly evident. This article, based on the team's experience in corneal neurotization, elaborates on the treatment modalities for neurotrophic keratopathy and the application and prospects of various surgical techniques in corneal neurotization.

角膜是基因治疗的理想靶器官。角膜碱烧伤、角膜新生血管、角膜移植术后排斥反应因其病理机制复杂，所牵涉的致病因素众多而治疗困难，疗效不佳。本文就基因治疗在上述疾病中的应用加以综述，以了解基因治疗应用于角膜病变的新进展 。

Cornea is an ideal target organ for gene therapy. Corneal alkali burn, cornealneovascularization and corneal graft rejection tend to be with poor treatment elicacydue to its complex pathogenesis. This article aims to update the recent progress of genetherapy on corneal diseases.

神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病，角膜神经的知觉和营养功能受损，导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植，睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式，对于轻中度病变患者，具有较好的治疗效果，而对于重度病变患者，药物治疗及简单的手术干预治疗效果不佳，病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失，丧失角膜感觉，对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术，可能导致角膜移植术后上皮持续不愈合，因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能，提高角膜知觉，改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围，使神经末梢重新长入角膜基质，恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进，其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植，促使角膜神经重新生长，重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史，1981年Samii等首次报告了角膜神经移植术，2009年Terzis等成功地实施了第1例直接角膜神经移植术，2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变，角膜失去神经支配，继而出现角膜上皮缺损，角膜缘新生血管形成，经角膜神经移植后，角膜上皮愈合，角膜透明度改善，同时角膜缘新生血管消退。

神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病，角膜神经的知觉和营养功能受损，导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植，睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式，对于轻中度病变患者，具有较好的治疗效果，而对于重度病变患者，药物治疗及简单的手术干预治疗效果不佳，病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失，丧失角膜感觉，对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术，可能导致角膜移植术后上皮持续不愈合，因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能，提高角膜知觉，改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围，使神经末梢重新长入角膜基质，恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进，其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植，促使角膜神经重新生长，重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史，1981年Samii等首次报告了角膜神经移植术，2009年Terzis等成功地实施了第1例直接角膜神经移植术，2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变，角膜失去神经支配，继而出现角膜上皮缺损，角膜缘新生血管形成，经角膜神经移植后，角膜上皮愈合，角膜透明度改善，同时角膜缘新生血管消退。

目的：探讨大泡性角膜病变(bullous keratopathy，BK)患者行飞秒激光辅助的角膜内皮移植术(endothelium keratoplasty，EK)的围手术期护理。方法：回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的BK20例患者，分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果：患者得到及时、有效的护理，术后视力均有所提高，内皮贴伏好，无排斥反应及其他并发症的发生。结论：通过对患者围手术期的护理，可提高护理质量，缩短患者住院时间。

Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing.

圆锥角膜在眼科临床工作中是角膜疾病中较为熟知的病种。本文汇报1例角膜病变，女，33岁，无特殊诱因出现视物模糊，初步考虑圆锥角膜，但经过一系列检查后不能确诊该患者此次双眼角膜罹患何种眼疾，且该患者未行规律专科治疗，于家中全休2周后双眼不适症状消失，经甘肃省第三人民医院眼科检查角膜验光恢复正常，矫正视力均达正常。该患者自诉于2014年发作1次，且经过多院就诊，未能确诊，休息2~3周后症状消失。故整理此次就诊经过特汇报出来，供各位专家、同道参阅，以期得到明确诊断或者诊疗方向，为患者后续再次出现该类情况指导诊疗，缩短患者发病时长。

Keratoconus is a well-know disease in ophthalmology. This paper reports a case of keratopathy, female, 33 years old, had blurred vision without special inducement, and keratoconus was initially considered. However, after a series of examinations, diagnosis what kind of ocular disease the patient had in both eyes was not possible, and the patient had no regular specialist treatment, and the discomfort symptoms of both eyes disappeared after taking a full rest at home for 2 weeks, and the cornea was examined by Department of Optometry in Third People’s Hospital of Gansu Province returned to normal and corrected visual acuity was normal. The patient had a seizure in 2014, and after multiple hospital visits, the diagnosis could not be confirmed, after 2–3 weeks of rest, the symptoms disappeared. Therefore, after sorting out the special report of this visit, it is specially reported for the reference of all experts and colleagues to get a clear or direction of diagnosis and treatment, guide the diagnosis and treatment for patients who experience such similar situation in the future, and reduce the length of illness.

晚期糖尿病(diabetes mellitus，DM)患者常出现的糖尿病性视网膜病变能够被发现，而糖尿病性角膜病变(diabetic keratopathy，DK)却时常被人们忽略。近年来的许多研究表明，DK对角膜的结构、代谢、生理功能等多个方面均有重要影响。目前临床上尚无根治DK的有效疗法，现主流疗法多集中于对症治疗以维持光滑湿润的眼表，最大限度地减少视觉损失以及提高舒适度，如局部滴用人工泪液、使用角膜绷带镜及局部使用抗炎药物等，但这些现有的治疗方法对于角膜组织损伤的修复能力有限。近年来出现神经生长因子、胰岛素疗法等新兴的治疗方法，有望未来应用于临床。

The diabetic retinopathy which often occurs in patients with advanced diabetes mellitus (DM) can usually be realized, but diabetic keratopathy (DK) could sometimes be ignored. In recent years, many studies have found out that DK can cause significant abnormal changes in many ways, including structure, metabolism and physiological functions of the cornea. At present, there is no effective therapy to cure DK. The current mainstream therapy mostly focuses on symptomatic treatment to maintain a smooth and moist ocular surface, minimize visual loss and improve comfort, such as local drip of artificial tears, use of corneal bandage lens and local use of anti-inflammatory drugs. However, these existing treatment methods have limited repair ability for corneal tissue damage. In recent years, a number of new treatment methods have emerged, which are expected to be clinically used in the future, such as nerve growth factors and insulin therapy.