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.

原发性干燥综合征 (primary Sjogren' s syndrome，SS) 是一种主要累及外分泌腺体的自身免疫性疾病，患者通常因为严重的干眼症状首先就诊于眼科，大多数临床医师对原发性干燥综合征相关性干眼 (Sjogren' s syndrome dry eye disease，SS-DED) 认识不足，可能导致漏诊和误诊。侵入性极小的客观检查及生物标志物的发展，将有助于发现 SS-DED 的真面目，并可能从新的角度阐释其发病机制，为其诊断、分类及治疗提供新的思路。SS-DED 的治疗没有特效的药物，大多数患者需接受多种方法的治疗，以了解哪些方法最有效。

Primary Sjogren' s syndrome is an autoimmune disease that mainly affects exocrine glands. Patients usually refer to ophthalmologists because of severe dry eye symptoms. Most clinicians have insufficient knowledge with dry eye disease associated with primary Sjogren' s syndrome probably leading to misdiagnosis or missing the diagnosis. The diagnosis of Sjogren' s syndrome dry eye disease (SS-DED) is difficult, but the extremely invasive objective examination and the development of biomarkers will help to understand this disease and explain its pathogenesis from a new perspective. There is no specific treatment for the SS-DED, and most patients should receive multiple treatments to select the optimal treatment. 

目的：探索斜视患者手术治疗后的眼表恢复状况。方法：选取2015年1月至2018年6月于如皋市广慈医院接受门诊手术治疗的 92 例水平性斜视患者为研究对象，共 126 眼，按照手术切口将患者分为 3 组，行角膜缘切口的 42 例 52 眼患者为 A 组，行跨肌止端切口的 17 例 19 眼患者为 B 组，行近穹窿切口的 33 例 55 眼患者为C组。再根据手术累及肌肉条数将患眼分为 3 组，行单条眼外肌的29眼手术者为单肌组，行2条眼外肌的42眼手术者为双肌组，行3条眼外肌的 21 眼手术者为三肌组。比较不同切口类型和肌肉累及数患者的眼表健康恢复时间。结果：A，B，C3组间首次泪膜破裂恢复时间、泪河高度时间差异有统计学意义(P < 0.05)；A组首次泪膜破裂恢复时间 (14.33±3.26) d和泪河高度时间 (14.54±1.58) d显著低于B组和C组，差异具有统计学意义(F = 4.876，P = 0.032；F = 4.612，P = 0.036)。单肌组，双肌组及三肌组3组间首次泪膜破裂恢复时间、泪河高度时间差异有统计学意义(P < 0.05)；单肌组的首次泪膜破裂恢复时间 (13.42±3.57) d和泪河高度时间 (8.65±1.62) d显著低于双肌组和三肌组，差异有统计学意义(F = 4.975，P = 0.028；F = 5.024，P = 0.025)。结论：手术累及的肌肉数和手术切口类型对术后眼表健康状况具有重要影响，近穹窿切口的手术方式和累及较少肌肉数量有助于患者术后眼部健康状况的恢复。

Objective: To explore the ocular surface recovery after surgical treatment of strabismus patients. Methods: A total of 92 patients (126 eyes) with strabismus who underwent surgery in our hospital from January 2015 to June 2018 were enrolled. The patients were divided into three groups according to the surgical incision, 42 patients (52 eyes) underwent limbal incision were in group A, 17 patients (19 eyes) underwent trans-muscle end-point incision in group B, and 33 patients (55 eyes) underwent proximal hernia incision in group C. According to the number of muscles involved in the operation, the sick eyes of patients were divided into three groups. The 29 eyes with a single extraocular muscle were a single muscle group, the 42 eyes with 2 extraocular muscles were a double muscle group, and the 21-eye treated with 3 extraocular muscles were a three-muscle group. The ocular surface health recovery time of patients with different incision types and muscle involvement were compared. Results: The first tear film rupture recovery time and tear river height time between group A, B, and C were significantly different, and the data were statistically significant (P < 0.05); the first tear film rupture recovery time (14.33±3.26) d and tear river height time (14.54±1.58) d in group A were significantly lower than those in group B and C. The data were statistically significant (F = 4.876, P = 0.032; F = 4.612, P = 0.036). The first tear film rupture recovery time and tear river height time between the single, double and three muscle groups were significantly different, and the data were statistically significant (P<0.05); the first tear film rupture recovery time (13.42±3.57) d and tear river height time (8.65±1.62) d were significantly lower in the single muscle group than in the double muscle group and the third muscle group. The data were statistically significant (F = 4.975, P = 0.028; F = 5.024, P = 0.025). Conclusion:The number of muscles involved in the operation and the type of surgical incision have an important impact on the health of the ocular surface after surgery. The proximal ankle incision and less number of muscles involved would improve the postoperative recovery of eye health.

目的：比较不同受检者在相同近视屈光欠矫下使用 C 字视力表和 E 字视力表所测得的视力差别及探讨导致这种差别的原因。方法：选取不同年龄段 250 名受检者，在完全矫正屈光度 [最正之最佳视力 (maximum plus to maximum visual acuity，MPMVA)] 情况下附加相应的球镜造成相应的近视度数后比较使用2种不同的视力表测出的视力值变化情况。同时根据2种视力表的设计原理及视力表的不同记录法探讨造成数值不同的可能原因。结果：同一附加度情况下分别用C字视力表组和E字视力表组行方差分析，不同年龄组间差异无统计学意义(P > 0.05)。相同附加度情况下同一受检者使用C字视力表组和E字视力表组行t检验，两者差异具有统计学意义(t = -15.798，P < 0.05)，C 字视力表测得视力平均值小于E字视力表测得视力平均值。结论：受检者使用 C 字视力表比 E 字视力表检测视力结果更加优异；C 字视力表和 E 字视力表的视标形状及开口方向不同是 2 种视力表检测结果差异的主要原因。

Objective: To compare the difference of visual acuity measured by C-chart and E-chart in the same myopic refractive undercorrection and to explore the causes of the difference. Methods: Two hundred and fifty subjects of different ages were selected to compare the changes of visual acuity measured by two different visual meters after adding corresponding spherical lenses to the maximum plus to maximum visual acuity (MPMVA) corrected diopter. At the same time, according to the design principle of the two kinds of visual acuity meters and the different recording methods of visual acuity tables, the possible reasons for the different values were discussed.Results: There was no significant difference between different age groups (P > 0.05). Under the same degree of additionality, the visual acuity of the same subjects was tested by t-test with C visual acuity chart and E visual acuity chart. The difference was statistically significant (t = -15.798, P < 0.05). The average visual acuity of C visual acuity table was smaller than that of E visual acuity table. Conclusion: The visual acuity of myopic patients tested by C visual acuity chart is better than by E visual acuity chart. The main reason for the difference between C visual chart and E visual chart was the different shape and opening direction of visual icons.

目的：开发眼科供应室质量管理追溯系统的实时回收、科室签收功能模块，实现消毒供应中心无纸化办公，提高工作效率。方法：通过构建眼科消毒供应中心质量管理追溯系统的实时回收、科室签收功能模块，消毒供应中心工作人员使用个人数字助理（personal digital assistant，PDA）与临床科室人员进行面对面的器械回收清点和下送物品的清点签收，通过实施该模块等数据信息进行前后比较以评价其应用效果。结果：通过使用 PDA 对眼科器械进行实时回收、物品签收，回收器械物品清点记录的差错率由原来的 3.32％ 下降到 0.51％，实施前后因物品数目、名称等不符发生纠纷例数由原来的 14.39％ 下降到 1.56％。结论：该模块实现了无纸化办公，提高了回收、下送物品的精准性，提高了工作效率；减少了与临床科室的纠纷，提高了临床科室对消毒供应中心的满意度。

Objective: To develop the function module of real-time recovery counting and department receipt signing of the quality management traceability system of the ophthalmic supply room, realize the paperless office of the disinfection supply center, and improve the work efficiency. Methods: Eye disinfection supply center is built with quality management traceability system of real-time collection, department to sign for function module, counting supply room staff use personal digital assistants (PDAs) and clinical departments personnel under the face-to-face equipment recycling counted and send goods receipt, counting of implementation process control, reducing disputes. Results: By using PDA to collect and count the ophthalmic instruments in real time and sign for the receipt of the articles, the accuracy of the recovery and delivery of the articles was improved, the disputes between the supply room and the clinical department caused by the difference in the quantity of the recovered and delivery of the articles were solved, and the paperless management was realized. Conclusion: The module realizes paperless office and improves work efficiency. It reduces the disputes with the clinical departments and improves the satisfaction of the clinical departments with the supply department.

目的：评价海藻糖滴眼液对摘除眶内眶外泪腺的实验性大鼠干眼的疗效。方法：SD 大鼠 30 只，随机分成正常组、对照组、实验组，每组 10 只（20 只眼）。正常组不给予处置，实验组和对照组通过摘除大鼠主泪腺制作干眼动物模型。对照组和实验组于造模完成术后 1 周后分别给予生理盐水、海藻糖滴眼液点双眼，每天 4 次，治疗共 4 周。分别于造模术前和造模术后 1、2、3、5 周进行基础泪液分泌试验（Shirmer I test），角膜上皮荧光染色评分检测；造模 5 周后将大鼠处死，采用免疫组织化学方法对结膜上皮细胞中 Bcl-2 和 Bax 凋亡基因蛋白表达进行检测，观察干眼动物模型结膜上皮细胞凋亡与眼表干眼病变及组织损伤的关系。结果：基础泪液分泌试验结果显示，对照组和实验组除术后第 5 周比较差异有统计学意义外（P < 0.05），其余时间点差异无统计学意义（P > 0.05），术后各时间点与正常组比较差异均有统计学意义（P < 0.05）。造模术后第 1 周，对照组和实验组角膜荧光染色评分明显高于正常组；术后第 2 周后，对照组和实验组评分差异无统计学意义（P > 0.05），随着时间的延长，术后第 3 周和第 5 周，两组评分差异均有统计学意义（P < 0.05），且实验组评分小于对照组。结膜上皮细胞免疫组织化学检测结果显示：正常组结膜上皮细胞 Bax 蛋白阳性表达的细胞数较对照组和实验组少，与对照组比较，差异有统计学意义（P < 0.05），与实验组比较差异无统计学意义（P > 0.05）；正常组可见大量 Bcl-2 蛋白阳性表达，且多于实验组，差异无统计学意义（P > 0.05），多于对照组，差异有统计学意义（P < 0.05）；对照组结膜上皮细胞中可见大量 Bax 蛋白阳性表达于细胞质，呈棕黄色颗粒，实验组中 Bax 蛋白阳性表达相对于对照组明显较少，两者差异有统计学意义（P < 0.05）；实验组结膜上皮细胞中可见大量 Bcl-2 蛋白阳性表达，对照组 Bcl-2 蛋白表达相对于实验组明显减少，差异有统计学意义（P < 0.05）。结论：海藻糖滴眼液可以减少角膜表层上皮脱落，对结膜上皮细胞有一定的保护作用，可以拮抗结膜上皮细胞的凋亡，从而增强角结膜上皮屏障功能，改善由干燥引起的眼表上皮的损伤。海藻糖溶液可用于眼表上皮疾病的潜在临床应用，为治疗眼表疾病如干眼症提供治疗选择。

Objective: To observe the efficacy of trehalose eye drops on experimental dry eye rat with removal of inside and outside lacrimal glands. Methods: A total of 30 SD rats were randomly divided into a normal group, a control group, and an experimental group, with 10 rats for each group (20 eyes). The normal group was not treated, and the experimental group and the control group were made into a dry eye animal model by removing the main lacrimal gland of the rat. The control group and the experimental group were given with normal saline and trehalose eye drops once a week after the completion of modeling, 4 times a day for 4 weeks. Shirmer I test and fluorescence staining test were carded before and 1, 2, 3, and 5 weeks after modeling. After 5 weeks of modeling, the rats were sacrificed and the expression of Bcl-2 and Bax apoptosis protein in conjunctival epithelial cells was detected by immunohistochemistry in order to observe the relationship between apoptosis of conjunctival epithelial cells and dry eye lesions and tissue damage in dry eye animal models. Results: Schirme I test results showed that there was no significant difference between the control group and the experimental group (P > 0.05) except for the 5th week after operation (P < 0.05). There was a statistical difference between the two groups and the normal group at each time point after surgery (P < 0.05). At the first week after modeling, the corneal fluorescence staining scores of the control group and the experimental group were significantly higher than those of the normal group. After the second week after surgery, there was no significant difference between the control group and the experimental group (P > 0.05). The prolongation of time, the 3 week and the 5th week after surgery, the difference between the two groups was statistically significant (P < 0.05), and the score of the experimental group was smaller than the control group. The immunohistochemical results of conjunctival epithelial cells showed that the number of Bax protein positive cells in the normal conjunctival epithelial cells was less than that in the control group and the experimental group. The difference between the normal group and the control group was statistically significant (P < 0.05). There was no significant difference between the two groups (P > 0.05). There was a large amount of Bcl-2 protein in the normal group, which was more than the experimental group. The difference was not statistically significant (P > 0.05), which was more than the control group. The difference was statistically significant (P < 0.05); a large amount of Bax protein was positively expressed in the cytoplasm and brownish-yellow particles in the conjunctival epithelial cells of the control group. The positive expression of Bax protein in the experimental group was significantly less than that in the control group, and the difference was statistically significant (P < 0.05). A large amount of Bcl-2 protein was positively expressed in the conjunctival epithelial cells of the experimental group, and the expression of Bcl-2 protein in the control group was significantly decreased compared with the experimental group (P < 0.05).Conclusion: Trehalose eye drops can reduce epithelial detachment of the cornea and have a protective effect on conjunctival epithelial cells, which can antagonize the apoptosis of conjunctival epithelial cells, thereby enhancing the keratoconjunctival barrier function and improving the ocular surface epithelium caused bydryness. The potential clinical application of trehalose solution for ocular surface epithelial diseases and provide treatment options for ocular surface diseases, such as dry eye.

目的：探讨医护一体化管理模式在眼底病中心日间病房中的应用与成效。方法：2015年6月至2016年6月于眼底病中心实行医护一体化管理模式，通过问卷调查比较实施前后医生和患者对护理工作的满意度。结果：医护一体化管理模式实行后，医生满意度显著提高，差异有统计学意义(t=?4.412，P<0.01)，患者满意度有所提高，差异有统计学意义(t=2.592，P=0.01)。结论：采用医护一体化管理模式对眼底病日间手术住院患者进行管理，加强医护沟通，可有效提高护理质量，保障患者医疗、护理的安全性。

Objective: To explore the effect of the medical integration mode applying in the day ward of ophthalmic clinical key specialty. Methods: The ophthalmic fundus center started to carry out the medical integration mode from June 2015 to June 2016. Doctors’ and patients’ satisfaction towards nurses were surveyed before and after the implementation. Results: The doctors’ satisfaction towards nurses was statistically higher than before (t=?4.412, P<0.01). TTe patients’ satisfaction also improved, and the difference was statistically signiffcant (t=2.592, P=0.01). Conclusion: The medical integration mode strengthens the communication with doctors and patients, improves the nursing quality, and ensures the medical safety.

      3位国际视网膜专家在中山眼科中心(Zhongshan Ophthalmic Center，ZOC)眼底病中心进行临床查房并讨论了4例具有挑战性且不寻常的视网膜病例：1)VHL病合并视网膜血管母细胞瘤的11年 随访观察；2)半剂量光动力疗法(photodynamic therapy，PDT)或微脉冲激光光凝治疗中心性浆液性视网膜病变(central serous chorioretinopathy，CSC)的观察；3)视神经缺陷儿童的诊断与治疗；4)合并虹膜晶状体脉络膜缺损的视网膜脱离(retinal detachment，RD)的治疗选择。通过讨论有助于我们更好地了解这四例视网膜疾病的发病机制和治疗方法，及其与全身疾病的关系。

目的：研究M22优化脉冲光技术治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)所致干眼的疗效，并用keratograph 5M干眼分析仪分析评估患者治疗前后病情变化。方法：收集汕头博德眼科医院门诊患者46例，年龄31~85(55.39±14.02)岁，行M22优化脉冲光治疗1个疗程(每月1次，共3次)，治疗前后均采用keratograph 5M干眼分析仪分析评估患者泪河高度情况、泪膜破裂时间(break-up time，BUT)、脂质层、睑板腺情况的变化，采用t检验分析对比治疗前后 变化情况。结果：患者治疗后泪河高度较强脉冲光治疗前明显增高，由(0.20±0.11) mm增加到(0.35±0.11) mm，BUT时间延长，由(4.98±2.13) s延长到(10.12±1.86) s，脂质层异常情况好转，有效率达93.48%，睑板腺阻塞情况减轻，有效率达84.78%以上，治疗后与治疗前差异有统计学意义(P<0.01)。结论：M22优化脉冲光技术在治疗MGD导致的干眼有较好的效果，没有出现并发症，是较安全有效地治疗方法，且keratograph 5M干眼分析仪可以较全面的对该病进行评估。

Objective: To study the efficacy of M22 Optimal Pulsed Technology in the treatment of dry eye caused by meibomian gland dysfunction and to evaluate the changes of patients affer treatment with keratograph 5M dry eye analyzer. Methods: Forty-six patients collected from Shantou Balder Eye Hospital receiving M22 Optimal Pulsed Technology treatment for three times, once a month, then using keratograph 5M dry eye analyzer to assess the height of tears river, break-up time (BUT), lipid layer, and meibomian gland. The results before and affer laser treatment were compared using t-test in this study. Results: Affer treatment, there was signiffcant effect than those of before treatment, the BUT time was prolonged from (0.20±0.11) mm to (0.35±0.11) mm, the abnormalities of the lipid layer were alleviated, the cure rate exceeded 93.48%, and the obstruction of the meibomian gland was reduced, the cure rate was higher than 84.78%. TTe difference before and affer corresponding treatment was statistically signiffcant (P<0.01). Conclusion: M22 Optimal Pulsed Technology has a good effect in the treatment of MGD-induced dry eye without complications. So M22 Optimal Pulsed Technology is a safe and effective treatment method. And keratograph 5M dry eye analyzer can deliver comprehensive assessment of dry eye.