Fuchs葡萄膜炎综合征是一种主要累及眼前节的慢性前葡萄膜炎。由于病因不明，诊断主要依赖于临床表现，因此眼部结构改变对该病的诊治极为关键。长期慢性炎症致使Fuchs葡萄膜炎综合征患眼从角膜、前房至视网膜及脉络膜，均存在或明显或隐匿的结构改变。本文综述了患眼眼前节的特征性改变：角膜存在特征性的角膜后沉着物以及内皮细胞密度降低、形态改变；前房出现闪辉和细胞，房水中可检测到炎症因子和病毒；虹膜可见特征性萎缩，表现为脱色素和自体荧光改变。三者的结构改变直接反应炎症状态，可为病因机制研究提供线索。白内障和飞蚊症作为常见并发症，与反复的炎症相关，亦伴随着晶状体和玻璃体的结构改变。晶状体-玻璃体界面结构的改变为理解并发症的进展机制与防治方案提供了新思路。Fuchs葡萄膜炎综合征的眼底结构改变隐匿。黄斑区视网膜厚度是否改变尚未定论，另有多项研究认为视网膜血流密度降低。视盘神经节细胞层厚度降低可能与并发性青光眼相关。脉络膜也存在血管层厚度和血流密度改变，也许是慢性炎症的表现。总而言之，关于Fuchs葡萄膜炎综合征的眼部结构改变，尚有诸多疑问有待深入探索。

Fuchs uveitis syndrome is a chronic anterior uveitis that predominantly impacts the anterior segment of the eye. Since its etiology remains unclear, diagnosis largely relies on clinical manifestations.  Consequently, alternations in ocular structure play a pivotal role in both the diagnosis and treatment of this disease. Due to the persistent nature of chronic inflammation, a range of structural changes occur, spanning from the cornea and anterior chamber to retina and choroid. This article provides a detailed account of the characteristic changes in the anterior segment. In the cornea, characteristic keratic precipitates are observable, accompanied by a reduction in endothelial cell density and morphological alterations. The anterior chamber exhibits aqueous flashes and cells, where inflammatory factors and viruses can be detected. Additionally, characteristic iris atrophy is visible, presenting  as depigmentation and altered autofluorescence. These three factors collectively reflect the inflammatory state and progress with the course, potentially offering insights into the etiological mechanism. Concurrent cataract and floates, which are common complications associated with recurrent inflammation, accompanied by structural changes in the lens and vitreous. Structural alterations at the vitreol enticular interface, located between the posterior lens capsule and anterior vitreous, provide valuable clues regarding the pathogenesis of complications and provide new perspectives for therapeutic strategies. The structural changes in the fundus of Fuchs syndrome are often insidious. While it remains undetermined whether the retinal thickness in the macular region undergoes changes, numerous studies suggest a decrease in retinal blood flow density. Thinning of the ganglion cell layer in the optic disc may be linked to concurrent glaucoma. The choroid also experiences changes in the thickness of vascular layer and blood flow density, which could be a manifestation of chronic inflammation. In conclusion, numerous questions regarding the ocular structural changes in Fuchs uveitis syndrome still await further exploration.

目的：观察超声乳化白内障吸除人工晶状体植入术（phacoemulsification with intraocular lens implantation, PEI）联合房角分离术（goniosynechialysis, GSL）及房角切开术（goniotomy, GT）治疗中晚期原发性慢性闭角型青光眼（chronic primary angle-closure glaucoma , CPACG）合并白内障的安全性和有效性。方法：采用回顾性病例研究。收集2020年6月至2024年1月在成都市中西医结合医院行PEI联合GSL及GT的中晚期CPACG合并白内障患者94例133眼，观察最佳矫正视力（best corrected visual acuity, BCVA）、眼压、抗青光眼药物使用数量及术后并发症等情况。采用重复测量方差分析、Wilcoxon秩检验进行统计学处理。结果：术后1天，1周，1、3、6个月94例患者133眼的BCVA（logMAR）均较术前有所提升（P＜0.05）；从术后1天到6个月的所有随访时间点眼压均较术前明显下降（F = 189.79，P＜0.001）；术后6个月，患者使用的降眼压药物数量明显低于术前 ( Z = -2.392，P＜0.001)。术后1周中31眼（23%）出现角膜水肿，15眼（11%）出现前房积血，均在1周内消退；术后1个月内1眼出现眼压反跳，予以前房穿刺放液等治疗后眼压恢复到正常范围。术后6个月，121眼（91%）手术完全成功，10眼（8%）手术条件成功。结论：PEI联合GSL及GT治疗中晚期CPACG合并白内障可有效地提高视力、降低眼压，且无严重并发症。

Objective: To observe the safety and efficacy of phacoemulsification with intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) and goniotomy (GT) in treating advanced chronic primary angle-closure glaucoma (CPACG) complicated by cataract. Methods: This was a retrospective case series study. We collected data from a total of 94 patients (133 eyes) who had advanced CPACG along with cataract and underwent PEI+GSL+GT at Chengdu Integrated TCM&Western Medicine Hospital between June 2020 and January 2024. We observed the best corrected visual acuity (BCVA), intraocular pressure (IOP), the number of anti-glaucoma drugs used, and postoperative complications. Repeated measures ANOVA and Wilcoxon rank test were used for statistical analysis. Results: The BCVA (logMAR) at 1 day, 1 week, 1, 3, and 6 months after surgery showed significant improvement compared to the pre-surgical values (F = 189.79，P < 0.001); The IOP at 1 day, 1 week, 1, 3, and 6 months post-surgery was significantly lower than that pre-surgical IOP (P < 0.001). The number of IOP-lowering drugs used at 6 months after surgery was also significantly reduced compared to the pre-surgical (Z = -2.392, P < 0.001). One week after surgery, corneal edema occurred in 31 eyes (23%) and hyphema in 15 eyes (11%) , both of which resolved spontaneously within 1 week. Within one month after surgery, 1 eye experienced an IOP spike, and the intraocular pressure returned to normal range after treatments such as anterior chamber puncture and drainage. Six months after surgery, the operation was completely successful in 121 eyes (91%), and conditionally successful in 10 eyes (8%), resulting in an overall surgical success rate of 99%. Conclusions: PEI combined with GSL and GT can effectively improve vision and reduce IOP in patients with advanced CPACG complicated by cataract, without causing serious complications.

目的：关于大气污染物是否与年龄相关性白内障有关联的研究有限，以往的研究结果也不一致。本研究旨在评估多种大气污染物与年龄相关性白内障之间的关系。方法：采用双样本孟德尔随机化（Mendelian Randomization, MR）设计，并使用了来自亚洲及欧洲两个人群的独立全基因组关联研究（Genome-Wide Association Study, GWAS）的汇总统计数据。大气污染物数据包括颗粒物2.5（particulate matter_2.5, PM_2.5）、PM_2.5-10、PM₁₀、二氧化氮和氮氧化物。主要分析方法是逆方差加权（inverse variance weighted, IVW）法，辅以多变量孟德尔随机化分析（multivariable Mendelian randomization, MVMR）校正污染物间混杂效应，并通过敏感性分析验证结果的稳健性。Cochran Q检验法被用来评估各个单核苷酸多态性（single nucleotide polymorphism, SNP）之间是否存在显著的异质性。并采用MR PRESSO方法来识别并排除SNP中的异常值，同时利用MR Egger回归模型评估SNP之间可能存在的多效性，并通过逐一排除每个SNP进行敏感性分析，以确保MR分析结果不受单一SNP的显著影响。结果：关于5种大气污染物特征，亚洲人群结果中，二氧化氮暴露与年龄相关性白内障存在正相关（OR=1.03, 95%CI 1.00~1.06，P=0.026），但在多变量分析中效应方向反转（OR=0.86, 95%CI 0.77~0.97, P=0.013）；在欧洲人群中，PM_2.5-10与年龄相关性白内障显著相关（OR=1.35, 95%CI 1.12~1.62，P=0.002），且在多变量分析中因果效应依然显著（OR=1.58, 95%CI 1.27~3.70, P=0.03）。敏感性分析支持结果的稳健性，未发现异质性或多效性偏倚。结论：环境中PM_2.5-10和二氧化氮与年龄相关性白内障存在复杂因果关系，且因人群而异。亚洲人群中，二氧化氮单变量分析呈正相关，多变量分析效应反转，倾向多变量分析结果，即其降低年龄相关性白内障风险；欧洲人群中，PM_2.5-10单、多变量分析均呈正相关，显示其会增加年龄相关性白内障风险。

Objective: Research exploring the association between atmospheric pollutants and age-related cataracts is scarce, and previous studies have yielded inconsistent findings. This study aims to assess the relationship between various atmospheric pollutants and age-related cataracts. Methods: We adopted a two-sample Mendelian randomization (MR) design, using summary statistics from independent genome-wide association studies (GWAS) conducted on Asian and European populations. The atmospheric pollutant considered in this study included PM_2.5, PM_2.5-10, PM₁₀, nitrogen dioxide, and nitrogen oxides. The primary analysis method was the inverse variance weighted (IVW) approach. Additionally, multivariable MR (MVMR) was used to adjust for confounding effects among pollutants. Sensitivity analyses were conducted to verify the robustness of the results. The Cochran Q test was employed to assess significant heterogeneity among SNPs. The MR PRESSO method was applied to identify and exclude outliers SNPs, while the MR Egger regression model was used to evaluate potential pleiotropy among SNPs. Furthermore, sensitivity analyses were performed by excluding each SNP one by one to ensure that the MR analysis results were not significantly influenced by a single SNP. Results: Among the five atmospheric pollutants studied, we discovered a significant positive correlation between nitrogen dioxide exposure and age-related cataracts in the Asian population (OR=1.03, 95%CI 1.00-1.06, P=0.026). However, the direction of the effect was reversed in the multivariable analysis (OR=0.86, 95%CI 0.77-0.97, P=0.013). In the European population, PM_2.5-10 was significantly associated with age-related cataracts (OR=1.35, 95%CI 1.12-1.62, P=0.002), and the causal effect remained significant in the multivariable analysis (OR=1.58, 95%CI 1.27-3.70, P=0.03). Sensitivity analyses supported the robustness of the results, with no evidence of heterogeneity or pleiotropy bias. Conclusions: This study revealed a complex causal relationship between environmental PM_2.5-10 and NO₂ and age-related cataracts, which varied across populations. In Asian populations, the univariate analysis of nitrogen dioxide showed a positive correlation, but the effect was reversed in multivariate analysis, leaning towards the multivariate results and indicating a reduced risk of age-related cataracts. In European populations, both univariate and multivariate analyses of PM_2.5-10 showed a positive correlation, increasing the risk of age-related cataracts. The study provides genetic evidence for the prevention and control of air pollution and highlights the importance of using multi-pollutant models to assess environmental health effects.

IgG4相关性眼病（immunoglobulin G4-related ophthalmic disease, IgG4-ROD）是一种与IgG4阳性浆细胞浸润和血清IgG4水平升高相关的系统性疾病。该病的眼部表现包括泪腺、眼眶脂肪、眶下神经、眼外肌和眼睑的受累，且常伴有炎症和纤维化过程。在分子水平上，IgG4-ROD涉及多种免疫细胞和细胞因子的相互作用，包括辅助性T细胞1（T helper cell 1, Th1）、辅助性T细胞2（T helper cell 2, Th2）、调节性T细胞 (regulatory T cells, Tregs）和滤泡辅助性T细胞（follicular helper T cell, Tfh），以及由它们分泌的白细胞介素4（interleukin 4, IL-4）、白细胞介素13（interleukin 13, IL-13）和转化生长因子β（transforming growth factor-β,  TGF-β）等。这些分子通过促进B细胞活化和IgG4的产生，以及纤维化过程的发生，共同参与了IgG4-ROD的发病机制。诊断依赖于组织病理学特征，治疗通常包括糖皮质激素和免疫抑制剂，旨在控制免疫介导的炎症和纤维化，减轻症状并防止器官损伤。随着对IgG4-ROD在分子层面发病机制认识的深入，治疗策略将不断优化，进而为患者提供更为精准和有效的治疗方案，从而改善患者预后，提高患者生活质量。本文基于现有研究，总结并阐述了与IgG4-ROD致病有关的关键分子及信号通路，从分子视角对IgG4-ROD的自身免疫、纤维化及二者之间的联系与转变进行综述。

Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) is a systemic disorder characterized by the infiltration of IgG4-positive plasma cells and elevated serum IgG4 levels. The ocular symptoms of this disease can affect multiple structures, including the lacrimal gland, orbital fat, infraorbital nerves, extraocular muscles, and eyelids.These manifestations are often accompanied by inflammatory and fibrotic processes. At the molecular level, IgG4-ROD is linked to the interaction of various immune cells and cytokines. These include T helper cell 1 (Th1), T helper cell 2 (Th2), regulatory T cells (Tregs), and follicular helper T cells (Tfh), along with cytokines interleukin 4 (IL-4), interleukin 13 (IL-13), and transforming growth factor-β (TGF-β). They promote B cell activation and IgG4 production, and also facilitate the development of fibrosis. Diagnosis of IgG4-ROD is mainly based on histopathological features. Treatment typically involves the use of glucocorticoids and immunosuppressive agents, which aim to control immune-mediated inflammation and fibrosis, alleviate symptoms, and prevent organ damage. As our understanding of the molecular pathogenesis of IgG4-ROD advances, it is anticipated that treatment strategies will be continuously refined. This will enable us to offer patients more precise and effective therapeutic options, ultimately improving prognosis and quality of life. This article provides a summary and clarification of the key molecules and signaling pathways involved in the pathogenesis of IgG4-ROD. It also reviews,   from a molecular perspective, the interplay between autoimmunity and fibrosis, as well as their transformations.

急性泪囊炎常由慢性泪囊炎急性发作引发，典型症状为流泪，异常分泌物增多等慢性泪囊炎症状，继发泪囊区红肿热痛等急性泪囊炎表现，多为单眼发病。慢性淋巴细胞白血病（chronic lymphocytic leukemia, CLL）属于原发于造血组织的恶性血液疾病，从表面看这两种疾病在病理生理方面没有直接联系。本研究报告了1例以急性泪囊炎作为首发症状的CLL患者，表现为双眼急性泪囊炎体征，经全身检查确诊为CLL。同时，通过回顾相关文献，发现有类似报道，但一例为小儿白血病患者以急性泪囊炎首发体征出现，一例急性泪囊炎患者泪囊摘除后经病理活检确诊为CLL，目前尚未见关于CLL保守治疗后急性泪囊炎明显缓解的报道。该病的发生可能与泪道引流相关淋巴组织（lacrimal drainage-associated lymphoid tissue, LDALT）改变有关，它作为黏膜免疫系统的一部分，可引导CLL细胞向LDALT迁移并定植，破坏局部的免疫微环境，干扰泪道的免疫平衡，抑制正常免疫细胞的功能，促进鼻泪管淋巴细胞异常增生等，引发泪道系统引流不畅。同时，此外，CLL所致的全身免疫抑制状态，也使得机体整体抗感染能力降低，增加了泪囊感染的风险，最终导致急性泪囊炎的发生和发展。通过对该病例的潜在发病机制进行综合分析，并探讨其为临床诊疗带来的启示。

Acute dacryocystitis often results from the acute attack exacerbation of chronic dacryocystitis. Typical symptoms include those of chronic dacryocystitis, such as persistent tearing, increased abnormal secretions, as well secondary manifestations of acute dacryocystitis like redness, swelling, heat and pain in the lacrimal sac area, which are predominantly unilateral. Chronic lymphocytic leukemia (CLL) is a malignant blood disorder originating from hematopoietic tissue. On the surface, these two diseases do not appear to be directly related in terms of pathophysiology. This study reported a case of CLL presenting with acute dacryocystitis as the initial symptom. The patient exhibited signs of acute dacryocystitis in both eyes, and was subsequently diagnosed with CLL following a systemic examination. Meanwhile, a review of the relevant literature revealed similar reports. However, in one instance, acute dacryocystitis in children with leukemia appeared as the first sign of acute leukemia itself, while in another, acute dacryocystitis was diagnosed as CLL by pathological biopsy after dacryocystectomy. At present, there have been no report of significant remission of acute dacryocystitis following conservative treatment for CLL. The occurrence of this condition may be related to the changes in lacrimal drainage-associated lymphoid tissue (LDALT). As a part of the mucosal immune system, LDALT can guide CLL cells to migrate and colonize within it, thereby disrupting the local immune microenvironment, interfering with the immune balance of the lacrimal passage, inhibiting the function of normal immune cells, promoting abnormal lymphocyte proliferation in the nasolacrimal duct, and ultimately leading to impaired drainage of the lacrimal passage system. Additionally, the systemic immunosuppressive state induced by CLL reduces the body’s overall anti-infective capacity, increasing the risk of dacryocystal infection and ultimately contributing to the onset and progression of acute dacryocystitis. Through a comprehensive analysis of the potential pathogenesis of this case, we aim to explore its implications for clinical diagnosis and treatment.

目的：探讨眼眶泪腺导管囊肿的临床特征及手术治疗方式，提高对该疾病诊疗的认识。方法：回顾性分析天津医科大学第二医院1991年1月—2023年12月经手术后病理证实的14例眼眶泪腺导管囊肿患者的临床资料。结果：14例患者中，男性9例，女性5例；年龄8个月~59岁，平均年龄为26.5岁；均为单眼，其中左眼9例，右眼5例；多以发现眼眶肿物或眼睑肿胀隆起就诊。B超/彩色多普勒超声或CT均提示囊性占位性病变。所有患者均接受了囊肿切除术，全身麻醉手术4例，局部麻醉手术10例；其中前路皮肤切口6例，结膜切口8例，辅助外眦切开3例。术中6例囊肿破裂，囊腔内注入医用透明质酸钠凝胶，辅助完整摘除囊壁。术后病理均提示泪腺导管囊肿，其中睑叶泪腺导管囊肿4例，眶叶泪腺导管囊肿4例，副泪腺导管囊肿5例，异位泪腺导管囊肿1例。术后复查未见并发症。结论：泪腺导管囊肿是临床较少见的疾病，可以发生在眼部的任何部位，结合典型的临床及影像学表现，主泪腺导管囊肿可基本明确诊断，但仍需与上皮/结膜包含性囊肿及皮样囊肿等鉴别，最终需病理确诊。手术完整切除囊肿是治疗该病的主要方法，切除不完全，有复发可能；术中辅助应用医用透明质酸钠凝胶囊内注射有助于囊肿完整摘除。

Abstract Objective:To explore the clinical characteristics and surgical treatment for lacrimal duct cyst, aiming to enhance the diagnosis and therapeutic outcomes of this disease. Method: We conducted a retrospective analysis of the clinical data from 14 patients with lacrimal duct cysts all of which were confirmed by postoperative pathology. These patients were treated at our hospital from January 1991 to December 2023. Results: Among the 14 patients,  there were 9 male and 5 females, with age ranging from 8 months to 59 years (mean: 26.5 years). All cases involved unilateral involvement, with 9 affecting the left eye and 5 affecting the right eye. The majority of patients sought medical care due to the presence of an orbital mass or eyelid swelling and protrusion. Imaging studies, including B-ultrasound, color Doppler ultrasound, or CT scans, consistently revealed cystic space-occupying lesions. All patients underwent cystectomy, with 4 cases performed under general anesthesia and 10 cases under local anesthesia. Surgical appoaches included anterior skin incision in 6 cases, conjunctival incision in 8 cases, and  auxiliary lateral canthotomy in 3 cases involving. During surgery, cyst rupture occurred in 6 cases, necessitating the injection of medical sodium hyaluronate gel into the cyst cavity to facilitate the complete removal of the cyst wall. Postoperative pathological analysis confirmed the presence of lacrimal gland duct cysts, which were further classified as follows: 4 cases of eyelid lobe lacrimal gland duct cysts, 4 cases of orbital lobe lacrimal gland duct cysts, 5 cases of accessory lacrimal gland duct cysts, and 1 case of ectopic lacrimal gland duct cyst. No postoperative complications were observed in any the patients. Conclusions: Lacrimal duct cysts are relatively uncommon in clinical practice and can arise in any part of the eye. Given their typical clinical and imaging features, a primary lacrimal duct cyst can generally be diagnosed with reasonable degree of certainty. However, it is still necessary to be differentiated it from epithelial/conjunctival inclusion cysts and dermoid cysts, and other similar conditions, with the final diagnosis relying on pathological confirmation. Complete surgical resection of the cyst is the primary treatment approach for this disease, as incomplete resection may result in recurrence. Intra-capsular injection of medical sodium hyaluronate gel during surgery can aid in the complete remval of the cyst.

目的：识别新生血管性年龄相关性黄斑变性（neovascular age-related macular degeneration,NVAMD）患者接受抗血管内皮生长因子（vascular endothelial growth factor,VEGF）药物治疗后出现的黄斑萎缩事件，并评估其治疗前的眼部解剖结构变化。方法：回顾 2014 全年期间由采用抗 VEGF 药物治疗的所有 NVAMD 患者，这些患者的随访时间均超过 12 个月，并评估了从首次治疗（通常在 2014 年前）至 2018 年 6 月最后一次随访期间的所有谱域光学相干断层扫描（spectral domain-optical coherence tomography, SD-OCT）图像。结果：在既定的研究流程中，共识别出 278 例 NVAMD 患者的 342 眼，其中 47 眼发生了黄斑萎缩。从治疗开始到黄斑萎缩出现的中位时间为 29.6 个月（四分位距：17.7-43.4）。在发生萎缩的区域中，发现了三种黄斑结构改变（部分眼睛存在不止一种改变）：在 25 眼中观察到血管化色素上皮脱离（pigment epithelial detachment,PED）的塌陷和脉络膜新生血管（choroidal neovascularization，CNV）的消退；在 15 眼中观察到视网膜下高反射物质和(或)视网膜下纤维化的形成；在 13 眼中观察到黄斑萎缩与大玻璃膜疣及色素改变相关联，呈现出通常称为地图状萎缩的典型模式。结论：这些数据表明，在某些情况下，CNV 可能补偿脉络膜的缺血状态，而 CNV 的消退则可能使 RPE 细胞和光感受器暴露于缺血性损伤和萎缩的风险之中。

Background/Aims: To identify incident macular atrophy and evaluate antecedent anatomic alterations in eyes with neovascular age-related macular degeneration (NVAMD) that were treated with anti-vascular endothelial growth factor (anti-VEGF) agents. Methods: All patients treated with anti-VEGF agents for NVAMD by one of the authors during the 2014 calendar year who had follow up ≥ 12 months had evaluation of all SD-OCT scans from first treatment (usually prior to 2014) to last follow up through June 2018.  Results: The ascertainment procedure identified 342 eyes of 278 patients with NVAMD among which 47 developed macular atrophy. The median time from treatment initiation to development of macular atrophy was 29.6 (interquartile range, 17.7 - 43.4) months. Three macular alterations were identified in areas that developed atrophy (some eyes had more than one); collapse of a vascularized pigment epithelial detachment (PED) and regression of choroidal neovascularization (CNV) in 25 eyes, development of subretinal hyper-reflective material and/or subretinal fibrosis in 15 eyes, or atrophy occurring in association with large drusen and pigmentary changes resulting in an arc of atrophy in a pattern typically referred to as geographic atrophy in 13 eyes. Conclusions: These data suggest that in some instances CNV may compensate for choroidal ischemia and the loss of CNV may expose retinal pigmented epithelial cells and photoreceptors to ischemic damage and atrophy.

广州双生子眼病研究（The Guangzhou Twin Eye Study, GTES）是一项针对中国南方双胞胎人群的长期队列研究，通过15年纵向随访数据，系统解析了遗传与环境因素对近视的影响。研究证实，眼轴长度与视网膜周边屈光度具有高度遗传性，且教育负担的加重是近视进展的核心环境驱动因素。GTES基于1291对双生子数据建立了近视预测模型，为近视早期筛查与干预提供科学依据。此外，该研究还探讨了遗传因素和环境因素对近视发展的共同影响。本文基于GTES研究的主要结论，以期为公共卫生策略和临床实践提供更有力的科学依据，以遏制全球近视流行的趋势。

The Guangzhou Twin Eye Study (GTES) is a cohort of twins living in South China that has been longitudinally followed for more than 15 years. This study has extensively investigated the heritability of myopia and the influence of environmental factors, producing significant and far reaching impacts. GTES has found a high heritability of axial length and peripheral refraction, the significant role of education in myopia progression, and established a prediction model for myopia onset and progression. The study has also explored the impact of both genetic and environmental factors on myopia development. By reviewing the major findings on myopia from the GTES, we hope to better inform public health strategies and clinical practices aimed at mitigating the global myopia epidemic.

目的：探索采用一眼眼罩联合另一眼眼垫的改良包眼方式对斜视患者双眼矫正术后恢复期生活质量及焦虑情绪的影响。 方法：于2024年9—10月在中山大学中山眼科中心招募日间手术接受双眼斜视矫正术的患者80例，按入院时间单双周分为联合眼罩组和眼垫组，每组各40例。联合眼罩组在手术肌肉少的眼睛或主导眼佩戴多小孔塑料眼罩，另一眼用眼垫包眼；眼垫组采用双眼眼垫包眼。主要结局指标为术后1 d的视功能相关生活质量。次要结局指标包括术后1 d的睡眠评分、疼痛评分、球结膜充血水肿、切口外观及术后1周患者满意度。 结果：两组患者在性别、年龄、术前斜视情况和斜视手术肌肉条数等基线特征分布的差异无统计学意义（P>0.05）。联合眼罩组术后1 d视功能相关生活质量、睡眠和术后1周患者满意度均优于眼垫组，差异具有统计学意义（P＜0.05）。两组患者在术后1 d疼痛程度、球结膜充血、切口外观、斜视改善程度的比较，差异无统计学意义（P＞0.05）；结论：斜视双眼矫正术后采用一眼眼罩联合一眼眼垫遮盖的方式，在保证术后恢复效果的同时，能够有效改善患者术后视功能相关生活质量和睡眠质量，并提升患者满意度。

Objective:To investigate the effects of a modified eye-patching technique, which combines the use of an eye shield on one eye and an eye patch on the other, on the quality of life and anxiety levels of strabismus patients during the recovery period after binocular correction surgery. Methods: A total of 80 patients who underwent bilateral strabismus correction as day surgery at our hospital between September and October 2024 were recruited for this study. Based on whether their admission week was odd or even, they were randomly assigned to two groups: the combined patching group (n=40) and the conventional patching group (n=40). In the combined patching group, patients wore a multiple-aperture plastic eye shield on the eye with fewer operated muscles or the dominant eye, while the other eye was covered with a conventional eye patch. In the conventional patching group, patients received bilateral eye patches. The primary outcome measure was vision-related quality of life on the first postoperative day. Secondary outcomes included the sleep quality score, pain score, conjunctival hyperemia and edema, incision appearance on the first postoperative day, and patient satisfaction one week after surgery. Results: There were no statistically significant differences in baseline characteristics, such as gender, age, preoperative strabismus status, or the number of operated muscles, between the two groups. Compared to the conventional patching group showed significantly better vision-related quality of life and sleep quality on the first postoperative day, as well as higher patient satisfaction one week after surgery (P< 0.05). On the first postoperative day, there were no significant differences between the two groups in pain level, conjunctival hyperemia, incision appearance, or degree of strabismus improvement (P > 0.05). Conclusions: The application of a modified eye-covering method, which combines an eye shield on one eye and an eye patch on the other, after bilateral strabismus correction surgery, can effectively enhance postoperative vision-related quality of life and sleep quality. Moreover, it can maintain recovery outcomes and increase patient satisfaction. This approach holds clinical value and is worthy of wider promotion.

全眼球移植（Whole eye transplantation, WET）是治疗因外伤、肿瘤等导致眼球不可逆损伤及永久性失明的潜在终极手段。其核心不仅在于实现眼球解剖结构的完整移植，更关键的是实现功能性视觉恢复，关键挑战包括优化手术策略重建眼球血液循环，实现供体视神经与受体视觉中枢的神经连接，建立精准有效的免疫调控策略以平衡移植耐受与感染风险。本文系统梳理了WET领域的研究进展与发展挑战。早期研究以变温动物模型为主，这些模型在一定程度上证实了视觉通路在眼球移植后仍具有一定的可塑性，但由于其眼球结构与人类存在显著解剖差异，且实验设计中未涉及精细的血管与神经吻合，因而临床转化价值有限。随着显微血管技术的发展，哺乳动物模型及人眼球移植的初步探索在显微外科血管吻合技术方面取得重要突破，实现了移植眼球视网膜血液灌注的短期重建，但仍面临视神经再生障碍和功能维持难题。当前的研究瓶颈主要集中在三个方面：血液循环重建技术优化、神经轴突精准再生及免疫微环境调控。建立与人类接近的标准化非人灵长类动物模型，并开展系统性的实验研究，将为克服现有技术障碍、推动WET走向临床提供至关重要的实验依据和新思路。

Whole eye transplantation (WET) is a potential definitive treatment for irreversible ocular damage and permanent blindness caused by conditions like trauma or tumors. The success of WET depends not only on the complete anatomical restoration of the transplanted eye but, more critically, on the recovery of functional vision. Key challenges in this field include optimizing surgical strategies to re-establish ocular blood circulation, achieving functional neural integration between the donor optic nerve and the recipient's visual centers, and developing precise and effective immunomodulation strategies to strike a balance transplant tolerance and infection risk. This review provides a systematic review of the research progress and developmental challenges in the field of WET. Early studies primarily utilized poikilothermic animal models, which demonstrated a certain degree of plasticity in the visual pathway following transplantation. However, due to significant anatomical differences compared to humans and the lack of sophisticated vascular and neural anastomosis in experimental designs, their clinical translatability of these studies remained constrained. With the progress in microvascular techniques, preliminary explorations in mammalian models and human eye transplantation have achieved significant breakthroughs in microsurgical vascular anastomosis, enabling the short-term reestablishment of retinal blood perfusion in transplanted eyes. Nonetheless, perisitent obstacles include inadequate optic nerve regeneration and poor long-term functional maintenance. Currently, research bottlenecks mainly focus on three aspects: optimizing surgical techniques for blood circulation reconstruction, precisely regenerating nerve axons, and regulating the immune microenvironment. Establishing standardized non-human primate models that closely mimic humans and conducting systematic experimental studies will furnish crucial evidence and novel insights to overcome existing technical hurdles and propel WET toward clinical application.