角膜异物是眼科急诊中常见病之一，不及时处置或处置不当会导致角膜不同程度的损伤，严重者可引起角膜感染、角膜穿孔等并发症，严重损害视功能。因此安全、高效地剔除角膜异物至关重要。本文从角膜异物的特点、伤后首诊时间、角膜合并感染以及角膜异物的剔除方法等方面对角膜异物剔除术预后的影响进行回顾总结，旨在为医护人员行角膜异物剔除时提供有用参考。

Corneal foreign body is one of common diseases in ophthalmic emergency. Improper handling can cause different degree of corneal injuries, even corneal infection, perforation and endophthalmitis. Therefore, it is essential to eliminate corneal foreign bodies safely and effectively. This article mainly summarizes the influence of the characteristics of the corneal foreign bodies, the first diagnosis time after injury, corneal co-infection and the methods of weeding out the corneal foreign bodies upon the clinical prognosis of corneal foreign body removal, aiming to provide useful reference for medical practitioners in removing corneal foreign bodies.

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.

目的：观察生物工程角膜应用于感染性角膜炎的治疗效果。方法：对成都爱迪眼科医院19例采用生物工程角膜治疗的感染性角膜病角膜植片存活状况、术后视力变化及并发症进行回顾性分析。与同期22例人来源供体角膜移植行术后排异对比。结果：在19例患者中，女9例(47.37%)，平均年龄53.32岁；病因中细菌性角膜炎7例(36.84%)，真菌性角膜炎8例(42.11%)，病毒性角膜炎4例(21.05%)。术前裸眼视力检查：光感3例(光定位准)，手动5例，眼前指数4例，3.0~3.9者7例。随访1~14个月未发生原发感染复发；植片成活18例(94.74%)，1例1月内植片溶解再手术(5.26%)。裸眼视力4.0~4.5者15例(78.95%)，3.0~4.0者3例(15.79%)，数指1例(5.26%)。远期(6~12个月以上)生物工程角膜移植术后角膜缘新生血管更易侵入，以植片缘环形浑浊为主。两组间排异差异无统计学意义(Mann-Whitney检验，P=0.736)。结论：生物工程角膜具有较好的人角膜结构替代功能，对未累及全层的感染性角膜疾病起到较好的结构和功能重建作用，恢复有用视力，缓解角膜供体来源不足，有一定推广意义。

Objective: To observe the outcomes of bioengineered cornea for lamellar keratoplasty in the infectious keratitis.Methods: A total of 19 cases with infectious keratitis treated by bioengineered cornea in Chengdu Aidi Eye Hospital were analyzed retrospectively. The results of graft survival, visual acuity and complications were collected.Rejection reaction was compared with 22 cases of human donor corneal lamellar keratoplasty during the same period. Results: In the 19 cases patients, 9 cases were women (47.37%) with the average age of 53.32 years. Among the pathogenic factors, 7 cases were bacterial keratitis (36.84%), 8 cases were fungal keratitis (42.11%) and 4 cases were viral (21.05%). The results of preoperative uncorrected visual acuity (UCVA) showed that 3 cases were light perception (accurate light positioning), 5 cases were hand moving, 4 cases were counting finger, and 7 cases were in the range of 3.0–3.9. In the follow-up, no case of primary infection recurrence occurred; 18 grafts survived except one case dissolved end with re-transplant by human donor. The postoperative UCVA of 15 cases (78.95%) were in the range of 4.0–4.5, 3 cases were in the range of 3.0–4.0 (15.79%), and 1 case of counting finger (5.26%). There was no significant difference in rejection action (P=0.736). In the follow-up more than 6–12 months, the limbal neovascularization of the biological engineering cornea is more likely to invade with the result of ring shape opacity at the graft edge. Conclusion: The biological engineering cornea can play a good role in the reconstruction for the cases with infectious keratitis. It provides another way to solve the shortage of corneal grafts.

真菌性角膜炎是我国导致角膜盲的重要原因之一。由于部分患者在感染早期缺乏合理治疗，导致病情迁延难治，最终行角膜移植是主要的治疗手段。然而真菌感染十分顽固，术后仍有一定概率复发。因此，了解真菌性角膜炎的最新研究进展以及不同类型抗真菌药物和角膜移植手术的优劣，根据适应证选择合理的治疗方案，才能最大程度控制感染，降低真菌复发率，挽救患者视力。与此同时，对角膜移植后真菌复发的相关文献进行研究，总结其复发规律、影响因素和临床特征以及治疗手段和预后。为制订合理的、符合国情的治疗策略提供参考依据。

Fungal keratitis is one of the important causes of corneal blindness in China. Due to the lack of reasonable treatment for some patients in the early stage of infection, the disease is protracted and refractory, and eventually, corneal transplantation is the main treatment. However, Fungal keratitis infection is very stubborn, and there is still a certain probability of recurrence after surgery. Therefore, understanding the latest research advances in fungal keratitis as well as the advantages and disadvantages of different types of antifungal drugs and corneal transplantation, and choosing a reasonable treatment plan according to the indications can maximize the control of the infection, reduce the recurrence rate of the fungus and save the vision of patients. In addition, the relevant literature on fungal recurrence after corneal transplantation was studied to summarize its recurrence pattern, influencing factors and clinical features, as well as treatment means and prognosis. The purpose of this study is to provide a reference basis for formulating a reasonable treatment strategy in line with China’s national conditions.

目的：探讨角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响。方法：选取中山大学中山眼科中心白内障科2020年12月至2021年7月收治的120例独眼白内障患者作为试验对象，采用便利抽样法分为实验组(佩戴角膜绷带镜)与对照组(未佩戴角膜绷带镜)。运用焦虑自评量表、视功能的生存质量量表来评估比较2组患者的焦虑程度、术后生存质量。结果：入院前2组患者的焦虑评分、生存质量评分差异无统计学意义(P>0.05)，术后第1天实验组患者的焦虑评分明显低于对照组、生存质量评分明显高于对照组，差异有统计学意义(P<0.05)。实验组患者的焦虑评分由入院前的55.35±7.09降低至43.77±5.56，焦虑程度比入院前减轻20%；对照组患者焦虑评分由入院前的54.27±5.93降低至47.92±7.02，焦虑程度较入院前减轻12%；实验组患者生存质量评分由入院前的55.32±25.57增至术后第1天的81.01±13.74，增长了46%；对照组患者生存质量评分由入院前的56.38±14.43降低至术后第1天的36.15±17.97，降低了35%。结论：角膜绷带镜可以减轻独眼白内障患者的焦虑情绪，提高术后生活质量。

Objective: To investigate the effect of corneal bandage lens on anxiety and quality of life in patients with monocular cataract. Methods: A total of 120 patients with monocular cataract treated in our department from December 2020 to July 2021 were selected as the subjects. They were divided into an experimental group (wearing corneal bandage lens) and a control group (without corneal bandage lens) by convenient sampling method. Self-rating Anxiety Scale and Visual Function Quality of Life Scale were used to evaluate and compare the degree of anxiety and postoperative quality of life between the 2 groups. Results: There was no significant difference in anxiety score and quality of life score between the 2 groups before admission (P>0.05). On the first day after operation, the anxiety score of the experimental group was significantly lower than that of the control group, and the quality of life score was significantly higher than that of the control group (P<0.05). The anxiety score of patients in the experimental group decreased from 55.35±7.09 to 43.77±5.56, and the degree of anxiety decreased by 20% compared with that before admission. The anxiety score of patients in the control group decreased from 54.27±5.93 to 47.92±7.02, and the degree of anxiety decreased by 12% compared with that before admission. The score of quality of life in the experimental group increased from 55.32±25.57 before admission to 81.01±13.74 on the first day after operation, an increase of 46%. The quality of life score of patients in the control group decreased from 56.38±14.43 before admission to 36.15±17.97 on the first day after operation, a decrease of 35%.Conclusion: Corneal bandage lens can reduce the anxiety of patients with monocular cataract and improve the quality of life after operation.

外伤、感染、先天性疾病等均可能破坏角膜的组织结构和细胞稳态，同时造成角膜干细胞缺损，进而导致组织无法正常愈合，引起角膜盲，是世界范围内致盲的重要原因之一。目前已有多种干细胞相关的技术方法应用于重建功能性角膜组织，取得了瞩目的治疗效果。本综述以角膜缘干细胞缺乏症为主，旨在介绍多种来源的干细胞在角膜重建中的研究现状和最新进展，同时对不同干细胞的特异性标志物的研究进展进行阐述。

Trauma, infection and congenital diseases may disrupt the tissue structure and cellular homeostasis of the cornea, while causing impaired function of corneal stem cell defects, which in turn may even lead to corneal blindness caused by the inability of the tissue to heal properly. Corneal blindness is one of the major causes of blindness worldwide. Several stem cell-related techniques have been applied to reconstruct functional corneal tissue with impressive therapeutic results. This review focuses on corneal limbal stem cell deficiency and aims to present the current status and recent progress of research on stem cells from multiple sources in corneal reconstruction, as well as to describe specific markers of corneal stem cells.

目的：探讨连续锁边缝合联合角膜绷带镜在翼状胬肉手术中应用的效果。方法：采用前瞻性随机对照临床研究。选取2018年1月到2021年6月期间在我院行翼状胬肉切除联合自体角膜缘结膜瓣移植术的患者132例180眼，按结膜瓣固定方式随机分为A、B两组，其中A组患者(64例90眼)行间断缝合固定法，B组患者(68例90眼)行连续锁边缝合法，术毕两组患者均给与配戴角膜绷带镜。比较两组患者的术后眼部疼痛程度评分、术后效果及并发症。结果：术后1、3 d，B组疼痛评分明显低于A组，差异有统计学意义(P<0.01)；术后1、3、7 d两组间角膜染色评分差异无统计学意义(P>0.05)；术前、术后3个月两组间泪膜破裂时间(breakup time of tear film，BUT)差异无统计学意义(P>0.05)，但术后3个月组内的BUT较手术前有明显改善(P<0.05)。术前、术后2周两组间视力差异均无统计学意义(P>0.05)，术后2周两组组内视力较手术前均有明显改善(P<0.05)。随访3个月，两组患者主要术后并发症包括胬肉撕除后浅层基质损伤延迟愈合、线结处结膜增生、结膜植片松脱等，并发症发生率两组相当。结论：采用连续锁边缝合联合配戴角膜绷带镜治疗翼状胬肉可以促进角膜创面的修复，减轻患者的术后刺激症状，提高患者术后舒适度；连续锁边缝合时需要适当增加缝线跨度，可减少术后结膜植片的松脱。

Objective: To investigate the effect of continuous locking suture combined with corneal bandage lens in the operation of pterygium. Methods: A prospective randomized controlled clinical trial was conducted. From January 2018 to June 2021, 132 patients (180 eyes) who underwent pterygium excision combined with autologous limbal conjunctival flap transplantation were randomly divided into group A and group B according to the fixation of conjunctival fla. The patients in group A (64 cases, 90 eyes) were treated with intermittent suture and fixation, and the patients in group B (68 cases, 90 eyes) were treated with continuous locking suture. Both groups were given corneal bandage lenses at the end of the operation. The postoperative ocular pain score, postoperative effect and complications were compared between the two groups. Results: The pain score in group B was significantly lower than that in group A at 1 and 3 d after operation (P<0.01), and there was no significant difference in corneal staining score between the two groups at 1, 3 and 7 d after operation (P>0.05). There was no significant difference in breakup time of tear film (BUT) between the two groups before and 3 months after operation (P>0.05), but the BUT at 3 months after operation in the group was significantly better than that before operation (P<0.05). There was no significant difference in visual acuity between the two groups before and 2 weeks after operation (P>0.05). The visual acuity of the two groups was significantly improved 2 weeks after operation (P<0.05). During the follow-up of 3 months, the main postoperative complications of the two groups included delayed healing of superficial matrix injury after pterygium avulsion, conjunctival hyperplasia, conjunctival graft loosening and so on. Conclusion: Continuous locking suture combined with corneal bandage lens in the treatment of pterygium can promote the repair of corneal wound, reduce the postoperative irritation symptoms and improve the postoperative comfort of patients. It is necessary to increase the suture span during continuous locking suture, which can reduce the loosening of conjunctival graft after operation.

目的：比较角膜生物力学分析仪(Corvis ST)、A型超声测厚仪(A超)、Lenstar LS 900(Lenstar)在测量近视眼角膜厚度的差异，为屈光术前筛查提供参考。方法：纳入2020年3至12月佛山市第二人民医院收治的屈光术前近视患者244例(244只右眼)，并按中央角膜厚度(central corneal thickness，CCT)将患者分为3组：薄角膜组(CCT≤520 μm)、正常角膜组(520 μm570 μm)，分别采用Corvis ST、A超、Lenstar三种仪器测量3组患者的中央角膜厚度，并纳入对比指标。结果：Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组的测量值对比差异均有统计学意义(均P<0.05)；在相关性方面，Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组呈正相关(r=0.841，P<0.001 vs r=0.832，P<0.001；r=0.866，P<0.001 vs r=0.918，P<0.001；r=0.497，P<0.001 vs r=0.801，P<0.001)；在一致性方面，Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组上一致性系数ICC及95%置信区间分别为0.602(0.091，0.857)，0.758(0.221，0.901)、0.741(0.207，0.890)，0.845(0.396，0.938)、0.417(0.005，0.679)，0.667(0.172，0.851)，95%一致性区间范围分别是(-2.2~24.2 μm，-6.7~19.5 μm；-8.4~24.6 μm，-6.8~19.4 μm；-8.7~23.8 μm，-7.0~18.3 μm)。结论：通过对3组数据统计分析得出，Corvis ST与A超、Lenstar的测量值相比，差异均有统计学意义，且Corvis ST的测量值均高于后两种仪器；Corvis ST与后两者均有着较高的相关性，且在正常角膜厚度测量上相关性最高；在一致性方面，从ICC点估计及95%置信区间数值分析，一致性较差；从Bland-Altman角度分析，Corvis ST与后两者的绝对值最大差值超过10 μm，一致性较差，但在与Lenstar的绝对值最大差值均在20 μm内。因此，在测量精度要求较高的屈光手术筛查方面，Corvis ST与A超、Lenstar之间不能相互替代，而对于大规模临床筛查，其角膜厚度测量值对眼压的影响有一定的临床参考意义。

Objective: To compare the differences of corneal thickness measured by corneal biomechanical analyzer (Corvis ST), A-mode ultrasonic thickness meter (A-ultrasound) and Lenstar LS 900 (Lenstar) in myopia, so as to provide reference for preoperative screening of refractive surgery. Methods: A total of 244 patients (244 right eyes) with myopia before refractive surgery in Foshan Second People’s Hospital from March to December 2020 were included in the study, and the patients were divided into three groups according to the central corneal thickness (CCT): the thin cornea group (CCT≤520 μm), the normal cornea group (520 μm570 μm). The central corneal thickness (CCT) of the three groups was measured by Corvis ST, A-type ultrasonic thickness gauge and Lenstar LS 900, respectively, and included in the comparison index. Results: The measured values of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were statistically significant (all P<0.05). Corvis ST was positively correlated with A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group (r=0.841, P<0.001 vs r=0.832, P<0.001; r=0.866, P<0.001 vs r=0.918, P<0.001; r=0.497, P<0.001 vs r=0.801, P<0.001). In terms of consistency, the consistency coefficients ICC of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were 0.602 (0.091, 0.857), 0.758 (0.221, 0.901); 0.741 (0.207, 0.890), 0.845 (0.396, 0.938); 0.417 (0.005, 0.679), 0.667 (0.172, 0.851), and the range of 95% consistency interval were -2.2–24.2 μm, -6.7–19.5 μm; -8.4–24.6 μm, -6.8–19.4 μm; -8.7–23.8 μm, -7.0–18.3 μm. Conclusion: Through the statistical analysis of the data from the three groups, it is concluded that the measured values of Corvis ST are statistically significant compared with those of A-ultrasound and Lenstar, and the measured values of Corvis ST are higher than those of the latter two instruments. Corvis ST has a high correlation with the latter two, and the correlation is the highest in the measurement of normal corneal thickness. In terms of consistency, from the ICC point estimation and 95% confidence interval numerical analysis, the consistency was poor. From the perspective of Bland Altman, the maximum absolute value difference between Corvis ST and Lenstar was more than 10 μm, indicating poor consistency, but the maximum absolute value difference between Corvis ST and Lenstar was within 20 μm. Therefore, in refractive surgery screening with high measurement accuracy, Corvis ST, A-ultrasound and Lenstar cannot replace each other. However, in large-scale clinical screening, the measured value of corneal thickness has a certain clinical reference significance on the impact of intraocular pressure.

单纯疱疹病毒基质型角膜炎是引起角膜盲的主要原因之一，目前以局部使用糖皮质激素联合口服抗病毒药物治疗为主。传统治疗存在生物利用度低、药物不良反应等缺点，因此亟需寻找替代药物、开发新剂型。环孢素A和他克莫司等免疫抑制剂疗效明显、不良反应少，可能是糖皮质激素的潜在替代品。α干扰素联合阿昔洛韦可缩短病程，而单独使用效果有限。基质再生剂具有新的抗病毒机制，值得进一步研究。此外，纳米载体递送系统，如脂质体、纳米胶束、立方液晶纳米粒，由于能够增强药物角膜穿透性和延长药物释放，在治疗基质型单纯疱疹性角膜炎方面具有巨大潜力。

Herpes simplex virus stromal keratitis is one of the leading causes of corneal blindness. A topical corticosteroid

agent in conjunction with an oral antiviral agent is the preferred treatment, which has the disadvantages of low bioavailability and drug side effects. Therefore, there is an urgent need to find alternative drugs and develop new dosage forms. Immunosuppressants such as cyclosporine A and tacrolimus have obvious curative effects and few side effects, and may be potential substitutes for glucocorticoids. Interferon-α combined with acyclovir can shorten the course of disease, but the effect is not obvious when used alone. Matrix regenerating agents have new antiviral mechanisms and deserve further study. In addition, nanocarriers delivery systems, such as liposomes, nanomicelles and cubosomes, have great potential in the treatment of herpes simplex virus stromal keratitis due to their ability to enhance drug corneal penetration and prolong drug release.

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.