目的：探讨对伴有角膜散光的单纯白内障患者行白内障超声乳化联合植入 Toric 人工晶状体后，患者的视力、残余散光、人工晶状体偏转度等情况。方法：采用回顾性分析研究方法。选取 2015 年 12 月至 2017 年 6 月于解放军南京总医院行白内障超声乳化联合散光纠正型人工晶状体植入术的 45 例患者，术眼 47 只。分别测量患者术前的裸眼视力、最佳矫正视力、角膜散光度数以及手术后 3 个月的裸眼视力、最佳矫正视力、残余散光度数、人工晶状体偏移度数等。结果：47 例眼均手术成功。术前患者的裸眼视力为 0.71±0.33 （logMAR），最佳矫正视力为 0.44±0.34 ；术后 3 个月，患者裸眼视力为 0.25±0.17 （logMAR），最佳矫正视力为 0.17±0.16 （logMAR），差异有统计学意义（P <0.01）。术前患者角膜散光为（2.82±0.73）D ；术后 3 个月，患者的残余散光度数为（0.41±0.26）D ，较术前明显降低，差异有统计学意义（P<0.05）。术后 3 个月，患者人工晶状体轴向的偏转度为（3.18±2.06）° 。结论：使用 Toric 人工晶状体治疗伴有角膜散光的白内障安全有效，术后可明显提高患者术后裸眼视力，术后残余散光度数小，可提高患者视觉质量。

Objective: To explore the vision, astigmatism, intraocular lens deflection and visual quality of cataract patients with corneal astigmatism after cataract phacoemulsification combined with Toric intraocular lens implantation. Methods: A retrospective systematic study method was used. From December 2015 to June 2017, a total of 45 patients （47 eyes） underwent cataract phacoemulsification combined with Toric intraocular lens implantation in Nanjing General Hospital. Uncorrected visual acuity （UCVA）, best corrected visual acuity （BCVA） and astigmatism were measured before and 3 months after the operation. The intraocular lens axial was measured at 3 months after operation. Results: The surgery was successfully performed in 47 patients. The UCVA before operation was 0.71±0.33 （logMAR）, the BCVA was 0.44±0.34 （logMAR）; at 3 months after the operation, the UCVA was 0.25±0.17 （logMAR）, the BCVA was 0.17±0.16 （logMAR）, and the difference was statistically significant （P<0.01）. The astigmatism before operation was （2.82±0.73） D. The residual astigmatism at 3 months after operation was （0.41±0.26） D, which was significantly lower than that before operation （P<0.05）; at 3 months after the operation, the axial deflection of the intraocular lens was （3.18±2.06）°. Conclusion: It is safe and effective to treat cataract patients with corneal astigmatism with Toric intraocular lens. After operation, it can significantly improve postoperative visual acuity and residual astigmatism of patients.

      飞秒激光是一种以脉冲形式转运的红外线激光，可穿透透明组织，在组织内完成高精度切削，制作出不同形状的角膜植片和植床，在角膜移植方面取得了良好的应用效果。近年来多项相关研究阐述了飞秒激光辅助角膜移植术的有效性、安全性、稳定性，并提出一些新的技术和观点。

      Femtosecond laser is a kind of infrared laser transported in pulse form, and it can penetrate transparent tissue and perform high precision cutting in tissues. It can make corneal implants and beds with different shapes, and has achieved good results in corneal transplantation. In recent years, a number of related studies have described the effectiveness, safety and stability of femtosecond laser assisted keratoplasty, and have put forward some new techniques and viewpoints. 

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. 

青光眼是全球第二大致盲眼病，第一大不可逆性致盲眼病，其中原发性闭角型青光眼（primary angle closure glaucoma，PACG）占 25%。激光周边虹膜切除术（laser peripheral iridotomy，LPI）已成为 PACG 和原发性房角关闭的一线治疗。LPI 机制为利用激光在周边虹膜上打孔，解除 PACG 的瞳孔阻滞，加深前房，扩大房角，恢复生理性房水排出途径，从而降低眼压。研究表明 LPI 在原发性房角关闭各个疾病进程中均能比较好的控制眼压，是相对安全的治疗方法。

Glaucoma is the second leading cause of blindness and the most common cause of irreversible blindness worldwide. Primary angle closure glaucoma (PACG) accounts for 25% of glaucoma. Laser peripheral iridotomy (LPI) has become the first line treatment for PACG and primary angle closure (PAC). The mechanism of LPI is to use laser to create a hole in peripheral iris to relieve pupil block, deepen anterior chamber, expand chamber angle, restore pathway of physiological aqueous discharge and reduce intraocular pressure. Studies have shown that LPI can control intraocular pressure well in all stages of PAC, which is safe for PAC.

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.

青光眼是全球第二大致盲眼病，第一大不可逆性致盲眼病，其中原发性闭角型青光眼(primary angle closure glaucoma，PACG)占25%。激光周边虹膜切除术(laser peripheral iridotomy，LPI)已成为PACG和原发性房角关闭的一线治疗。LPI机制为利用激光在周边虹膜上打孔，解除PACG的瞳孔阻滞，加深前房，扩大房角，恢复生理性房水排出途径，从而降低眼压。研究表明LPI在原发性房角关闭各个疾病进程中均能比较好的控制眼压，是相对安全的治疗方法。

Glaucoma is the second leading cause of blindness and the most common cause of irreversible blindness worldwide. Primary angle closure glaucoma (PACG) accounts for 25% of glaucoma. Laser peripheral iridotomy(LPI) has become the first line treatment for PACG and primary angle closure (PAC). The mechanism of LPI is to use laser to create a hole in peripheral iris to relieve pupil block, deepen anterior chamber, expand chamber angle,restore pathway of physiological aqueous discharge and reduce intraocular pressure. Studies have shown that LPI can control intraocular pressure well in all stages of PAC, which is safe for PAC.