目的：探讨眼科显微器械清洗固定架在临床的应用效果。方法：将研究对象分为实验组与对照组，用于同类手术。实验组显微器械用眼科显微器械清洗固定架固定后进行机械清洗；蓝色对照组 40 把显微器械采用手工清洗方法，对器械的清洗效率、清洗质量及损耗情况进行比较。结果：实验组清洗效率、清洗质量、器械完好率均优于对照组。结论：眼科显微器械清洗固定架的应用可提高眼科显微器械的清洗质量、减少器械损坏、提高工作效率、降低工作人员职业暴露风险。

Objective: To explore the effect of cleaning fixture to clean ophthalmic micro-instruments. Methods: The ophthalmic micro instruments from the same surgery were divided into the exPerimental group and control group. The micro instruments of the experimental group were fixed with the cleaning fixture and cleaned mechanically. Those micro-instruments of the control group were cleaned by manual method. The cleaning efficiency, cleaning quality and damages of the instruments were analyzed in two groups. Results: The experimental group obtained a better cleaning efficiency, cleaning quality and less damages than the control group. Conclusion: Using cleaning fixture to clean ophthalmic micro-instruments is conducive to improve the cleaning efficiency, cleaning quality and reduce the damages of the instruments.

目的：分析目前滴眼剂中防腐剂的添加情况，为眼科临床针对不同疾病选择合适的滴眼剂提供参考，倡导合理用药。方法：对临床使用的 194 种滴眼剂说明书中防腐剂成分标注进行统计分析，并对防腐剂的种类、新型防腐剂、眼表毒性研究情况进行归纳综述。结果：滴眼剂中防腐剂大致可分为 5 类，如季铵盐类、醇类、羟苯酯类、有机汞、纯氯氧复合物等。进口滴眼剂的防腐剂以苯扎氯铵为主。国产滴眼剂中新药多以苯扎氯铵为防腐剂，老药则以羟苯乙酯防腐为主；国产药说明书中，有 20.83% 未注明所含防腐剂种类。目前防腐剂中苯扎氯铵抗菌活性虽强，但引起眼表损害的报道也最多，新型防腐剂的研发及无防腐剂滴眼剂可减少眼表的损害。结论：滴眼剂中防腐剂种类繁多、标准不统一，临床医生应熟悉每种眼用制剂防腐剂成分和含量，尤其对青光眼及中重度干眼症使用含防腐剂的滴眼剂时，应关注其对眼表的损害，尽量选择新型防腐剂或不含防腐剂的滴眼剂以减少不良反应的发生。

Objective: To provide guidance for ophthalmologist to choose suitable eye drops for different eye diseases and promote rational drug use by analyzing present situation of preservatives in eye drops. Methods: According to the instructions of 194 kinds of eye drops, statistical analysis was retrospectively carried out on the types, new type, and ocular surface toxicity of preservatives in eye drops. Results: The preservatives of eye drops could be basically divided into 5 categories, such as quaternary ammonium salts, alcohols, hydroxyphenyl esters, organic mercury compounds, pure chlorine oxygen complexes, etc. Besides, most of the preservatives in imported eye drops were benzalkonium chloride, and the new categories of domestic eye drops also utilized benzalkonium chloride as the preservative. However, ethylparaben was used to be considered as preservatives in old-brand domestic eye drops.Moreover, 20.83% domestic drugs’ instructions failed to describe its preservatives. In addition, benzalkonium chloride yielded stronger antibacterial activities compared with other preservatives, but a huge number of animal and in vitro studies demonstrated that benzalkonium chloride may cause or enhance harmful consequences on the eye structures of the anterior segment. Fortunately, preservative-free formulations and new categories would provide clinically benefits. Conclusion: Owing to the various kinds of preservatives and lacking of unified standard of application, clinicians should master the types and content of each preservative in ophthalmic drugs, especially in glaucoma, moderate, and severe dry eyes. Besides, considering ocular surface damage, ophthalmologists should choose new types or preservative-free eye drops to reduce the occurrence of adverse reactions.

目的：观察猪脱细胞角膜基质进行人板层角膜移植术后角膜植片上皮化的临床过程。方法：收集 2017 年 1 月至 2018 年 1 月在佛山市第二人民医院经药物治疗无效的感染性角膜炎患者 5 例。采用脱细胞角膜基质（商品名：艾欣瞳）行板层移植术，以对侧眼为对照。术后 3 d，7 d，1 个月，3 个月，6 个月对患者进行随访，在裂隙灯显微镜下观察移植后植片上皮化完成过程。术后 1，3，6 个月共聚焦显微镜观察植片上角膜上皮细胞密度及上皮下神经纤维修复情况。结果：脱细胞角膜基质板层角膜移植术后 3 d 开始出现上皮化，术后 10 d 上皮化逐步完成，但角膜上皮排列疏松，荧光素染色仍有点状染色。激光扫描共聚焦显微镜检查结果显示：术后 1，3，6 个月角膜上皮细胞排列规则、紧密，与对侧眼比较角膜上皮细胞密度差异无统计学意义（P > 0.05）。结论：应用脱细胞角膜基质行板层角膜移植术后植片上皮化过程能够顺利完成。

Objective: To observe the epithelization process of grafts after human lamellar keratoplasty with acellular porcine corneal stroma (APCS). Methods: Five patients with infectious keratitis who were unresponsive to medication treatment were enrolled from January 2017 to January 2018 at the Second People’s Hospital of Foshan. Corneal lamellar transplantation was performed with APCS (product name: Acornea) as grafts and the contralateral eyes as control. Patients were followed up at postoperative 3 d, 7 d, 1 month, 3 months and 6 months. The morphology and density of corneal epithelial cells and subepithelial neural fibers were examined by laser confocal microscope at 1, 3 and 6 months after surgery. Results: Epithelization of grafts was seen at postoperative 3 daysand gradually completed at 10 days after surgery, while the corneal epithelial cells were still loosely arranged with punctate fluorescein staining. Results of confocal laser scanning microscopy showed that corneal epithelial cells were regularly and tightly arranged at 1, 3 and 6 months after surgery without statistically significant difference compared with those in the contralateral eyes (P > 0.05). Conclusion: Complete epithelialization of corneal grafts can be successfully achieved after lamellar keratoplasty with acellular corneal stroma.

目的：探讨珠海地区早产儿视网膜病变（retinopathy of prematurity，ROP）的患病情况及临床特点。方法：回顾分析珠海市妇幼保健院2009年5月至2018年12月 5 473 例（10 946 只眼）早产儿的眼病筛查资料。结果：共筛查出 185 例（370 眼）患有不同程度的 ROP，患病率为 3.38%。33 例（66 眼）需要治疗，占 17.84%。低出生体重组出生孕周为 26～31，32～33，34～36的 ROP 患儿分别为 133，13，9 例，ROP 发病率分别为 14.9%，1.4%，1.3%，差异具有统计学意义（P < 0.05）。高出生体重组出生孕周为 26～31，32～33，34～36 的 ROP 患儿分别为 1，5，24例，ROP 发病率分别为 7.1%，1.1%，1.0%，差异无统计学意义（P > 0.05）。33 例严重 ROP 患儿（需要干预治疗的 ROP）中，低出生体重组出生孕周为 26～31，32～33，34～36 的严重ROP患儿分别为 29，3，1 例，发病率分别为 3.2%，3%，0.1%，差异具有统计学意义（P < 0.05）。高出生体重组无严重 ROP 患儿。结论：珠海地区近十年的早产儿 ROP 患病率为 3.38%，出生体重和胎龄是 ROP 发病的危险因素。严重ROP患儿的出生体重均 <2 000 g。

Objective: To investigate the clinical characteristics of retinopathy of prematurity (ROP) in Zhuhai. 

Methods: The eye screening data for 5,473 (10,946 eyes) premature infants born from May 2009 to December 2018 in the Maternal and Child Health Hospital of Zhuhai were retrospectively analyzed.

Results: In the 5 473 premature babies examination, 185 cases (3.38%) were detected with different degrees of ROP. The number of cases requiring treatment was 33 (17.84%). In the low birth weight group, the ROP patients with 26–31, 32–33, and 34–36 weeks were 133 (14.9%), 13 (1.4%), and 9 (1.3%), respectively; the difference was statistically significant (P < 0.05). In the high birth weight group, the ROP patients with birth weeks of 26–31, 32–33, and 34–36 were 1 (7.1%), 5 (1.1%), and 24 (1.0%), respectively; the difference was not statistically significant (P > 0.05). Among the 33 children with severe ROP (requiring intervention treatment), there were 29 (3.2%), 3 (3%), and 1 (0.1%) with birth weeks of 26–31, 32–33, and 34–36, respectively, in the low birth weight group; the difference was statistically significant (P < 0.05). The severe ROP was 0 in the high birth weight group.

Conclusion: The prevalence of ROP in premature infants is 3.38% in the past decade in Zhuhai. Birth weight and gestational age are risk factors for ROP. The birth weight of infants with severe ROP is less than 2 000 g.

目的：探讨近视与双眼视功能状态以及用眼时间的关系。方法：对广州市花都区 219 名 10~12 岁学生进行纵向队列研究，研究对象均于2016年基线检查时进行了眼部生物测定、散瞳下自动验光、主观验光、配镜，并在戴镜2周后测量散瞳验光结果，2017年11月再次重复上述检查。同时做调查问卷收集户外、户内活动时间，进一步比对。结果：219 名学生1年后近视度数加深值为 -1.05±0.44（P < 0.001），眼轴长度1年后增长 0.44±0.31，两者呈正相关（P < 0.001）；近视度数与调节滞后、调节幅度有相关性，同时与周一至周五户外活动时间呈负相关。结论：近视加深速度与调节滞后、调节幅度有关。在用眼时间方面，户外活动时间越短，近视加深越快；户内活动时间越长，近视加深越快。

Objective: To evaluate the relationship between myopia progression and binocular vision functions and the relationship between myopia progression and outdoor/indoor activities. Methods: A 1-year longitudinal study was carried out and 219 subjects were included. Subjects lived in Huadu District, Guangzhou, China. Binocular functions measurements, ocular biometry measurements and cycloplegic refraction were done at the first visit in 2016. Cycloplegic refraction were done 2 weeks after dispensing. The measurements were repeated in November 2017 and information about outdoor activities and indoor activities was gathered by questionnaires for comparison. Results: The myopia progression was measured to be -1.05±0.44 (P < 0.001) in 219 subjects, which was positively correlated with axial length elongation for 0.44±0.31 (P < 0.001) and correlated with accommodative lag and accommodative amplitude. Myopia progression was observed to be negatively related to outdoor activitytime. Conclusion: Myopia progression rate is related to accommodative lag and accommodative amplitude. Outdoor activities could be a protective factor for myopia progression.

目的：观察可折叠人工晶体单襻悬吊术在处理白内障超声乳化术中后囊膜破裂的临床应用效果及安全性。方法：回顾性分析 2015 年 1 月至 2016 年 12 月在南京医科大学附属无锡人民医院行白内障超声乳化术并出现后囊膜破裂的 64 例（64 眼）白内障患者，分为试验组（33 例 33 眼）和对照组。试验组行可折叠人工晶体单襻悬吊术；对照组（31 例 31 眼）行硬片式人工晶体双襻悬吊术。手术当天记录疼痛评分，并分别于术后 1 d、术后 1 周及术后 1 个月记录术眼视力、眼压、前房反应、晶体位置及并发症发生情况。结果：试验组的疼痛反应较对照组显著减轻（P < 0.05）。术后第 1 天，两组视力、眼压、前房反应差异均无统计学意义（P > 0.05）。术后 1 周试验组前房反应较对照组小（P < 0.05），两组视力、眼压差异均无统计学意义（P > 0.05）。术后 1 个月两组视力、眼压、前房反应差异均无统计学意义（P > 0.05）。试验组中 1 例（3.03%）术后第 1 天出现前房积血，2例（6.06%）出现人工晶体轻度偏位；对照组 1 例患者（3.33%）术后第 1 天出现一过性眼压增高，未发现其余并发症。结论：改良折叠型人工晶体上方悬吊术是处理白内障超声乳化术中后囊膜破裂安全可行的手术方式。

Objective: To evaluate the safety and effectiveness of foldable intraocular lens single loop suspension in the treatment of posterior capsule rupture in the phacoemulsification. Methods: Sixty-four patients (64 eyes) with posterior capsular rupture during cataract surgery from January 2015 to December 2016 were selected and divided into an experimental group (33 patients, 33 eyes) and a control group (31 patients, 31 eyes). The experimental group received foldable intraocular lens single loop suspension, and the control group received hard plate intraocular lens suspension. Pain score was recorded on the day of operation; visual acuity, intraocular pressure, anterior chamber response, crystal location and other complications were recorded separately on the dayafter operation, 1 week and 1 month after operation. Results: Patients felt less painful in the experimental group (P < 0.05). There was no significant difference in visual acuity, intraocular pressure and anterior chamber response between the two groups the day after operation (P > 0.05). But the anterior chamber reaction in the control group was more serious than in the experimental group when observed one week and one month after operation (P < 0.05), and there was no significant difference in visual acuity, intraocular pressure and anterior chamber response between the two groups. In the experimental group, 1 patient (3.03%) had hyphema, and 2 patients (6.06%) had a slight tilt of the intraocular lens. In the control group, 1 patient (3.33%) had transient intraocular hypertension. Conclusion: Foldable intraocular lens single loop suspension is a safe and feasible operation to treat posterior capsular rupture in phacoemulsification.

10% 水合氯醛是最常用的小儿镇静药之一，广泛应用于眼科小儿检查和治疗前。对于年龄小、不配合的患儿，如何合理、安全使用水合氯醛，提高其镇静效果，减少其并发症发生，笔者总结护理心得如下：使用前对小儿进行全身的评估和家长的准备，使用时要掌握口服或灌肠的操作技巧，使用后要注意观察小儿的全身反应、用药效果和做好家长的宣教。

10% chloral hydrate is one of the most commonly used pediatric sedatives, which is widely used before ophthalmic pediatric examination and treatment. For young uncooperative children, how to use chloral hydrate reasonably and safely to improve their sedative effect and reduce the occurrence of complications, we summarized the nursing experiences, including evaluating child’s whole body and the preparation of parents before its use; mastering operative techniques of oral or enema route of admission in its use; paying attention to observe the child's systemic response and efficacy of drug, and patient education

目的：研究准分子激光原位角膜磨镶术(laser in situkeratomileusis，LASIK)前后角膜滞后量(corneal hysteresis，CH)和角膜阻力因子(corneal resistance factor，CRF)变化量，对其相关因素进行多元线性回归分析。方法：前瞻性研究。纳入行LASIK手术的近视眼及近视散光患者70眼(38例)，术前与术后6个月各项参数分别由眼反应分析仪(ocular response analyzer，ORA)、非接触眼压仪、超声角膜测厚仪及Pentacam眼前节分析仪测量。分析LASIK手术前后△CH，△CRF与术前、手术设计等参数的相关性，并对相关参数进行多元线性回归分析。结果：手术前后CH分别为(10.05±1.36)，(8.15±0.90) mmHg(1 mmHg=0.133 kPa)，CRF分别为(9.91±1.38)，(6.92±0.88) mmHg，差异均有统计学意义(P<0.01)；△CH与△CRF分别为(1.90±1.15)，(2.99±1.23) mmHg。△CH与术前CH，CRF，眼压(intraocular pressure，IOP)，预计切削深度(ablative depth，AD)以及AD/CCT呈正相关；△CRF与术前CH，CRF，IOP，AD，AD/CCT，术前等值球镜(spherical equivalent，SE)以及预计基质床厚度(residual stromal bed’s thickness，RSBT)有相关性。采用多元线性回归对LASIK手术前后△CH，△CRF与术前、手术设计等各相关参数进行分析，回归方程为：△CH=?6.182+0.658CH_术前+8.421AD/CCT (R2=0.639，P<0.01)，△CRF=?0.007+0.725CRF_术前?0.014RSBT (R2=0.689，P<0.01)。结论：LASIK术前后CH与预计AD和角膜厚度比值密切相关，CRF变化量与预计角膜RSBT密切相关，在设计手术时应慎重考虑预计AD与预计RSBT。

Objective: To discuss the change of corneal hysteresis and corneal resistance factor before and after laser in situkeratomileusis (LASIK), and to analyze their related factors by multivariate linear regression. Methods: In this prospective study, 70 eyes (38 patients) with myopia and myopic astigmatism undergoing LASIK were included. Related factors were measured preoperatively and at 6 months postoperatively by ocular response analyzer, noncontact tonometer (NCT), ultrasonic pachymeter, and Pentacam system. TTe correlation was analyzed between △CH, △CRF and preoperative and operative design’s parameters, and correlative factors analyze. △CH and △CRF were analyzed by the multiple linear regression. Results: CH before and after LASIK were (10.05±1.36) and (8.15±0.90) mmHg, and CRF before and affer LASIK were (9.91±1.38) and (6.92±0.88) mmHg. TTere was signiffcant difference between preoperative and postoperative CH and CRF (P<0.01). △CH and △CRF were (1.90±1.15) and (2.99±1.23) mmHg. Preoperative CH, CRF, intraocular pressure (IOP), ablative depth (AD) and AD/CCT were positive correlated with △CH. Preoperative CH, CRF, IOP, AD, AD/CCT, preoperative spherical equivalent (SE) and predicted residual stromal bed’s thickness (RSBT) were correlated with △CRF. TTe regression equation of △CH and △CRF and influencing factors were △CH =?6.182 + 0.658CH_preoperative + 8.421AD/CCT (R2 =0.639, P<0.01), △CRF =?0.007 + 0.725CRF_preoperative ? 0.014RSBT (R2 =0.689, P<0.01). Conclusion: The change of CH before and after LASIK is correlative with AD/CCT. The change of CRF before and after LASIK is correlative with predicted residual stromal bed’s thickness. Ablative depth and predicted residual stromal bed’s thickness should be considered carefully during the surgical design.

目的：观察 1 g/L 玻璃酸钠滴眼液（不含防腐剂）对圆锥角膜患者配戴硬性透气性角膜接触镜（rigid gas permeable，RGP）相关性干眼的疗效。方法：选择 2016 年 1 月至 2017 年 5 月来沈阳何氏眼科医院门诊就诊的 90 例透气性角膜接触镜相关性干眼圆锥角膜患者，随机分为 3 组，每组 30 例（60 眼）：A 组使用 1 g/L 玻璃酸钠滴眼液（不含防腐剂），4 次/d，1 滴/次；B 组使用舒润液（博视顿），4 次/d，1 滴/次；C 组在使用舒润液（博视顿）（4 次/d，1 滴/次）后 10 min 再用 1 g/L 玻璃酸钠滴眼液（不含防腐剂）（4 次/d，1 滴/次）。观察各组用药前 1 d 与用药后第 1、2、4 周的眼部症状评分、Schirmer I 试验（Schirmer I test，SIT）、泪膜破裂时间（break-up time，BUT）、角膜荧光染色评分变化。结果：3 组在用药 1 周时的干眼症状、BUT 和角膜荧光染色均较治疗前有明显改善（P < 0.05），3 组 SIT 值治疗前后差异均无统计学意义（P > 0.05）。各组各项指标在治疗第 1、2、4 周时差异无统计学意义（P > 0.05）。A 组与 B 组对干眼症状、SIT 和 BUT 的改善作用差异无统计学意义（P > 0.05）；A 组较 B 组在改善角膜荧光染色的作用上更明显，差异有统计学意义（P < 0.05）。C 组对改善干眼症状上优于 A 组（P < 0.05）。C 组对改善干眼症状和角膜荧光染色作用优于 B 组（P < 0.05）。结论：1 g/L 玻璃酸钠滴眼液（不含防腐剂）能够稳定泪膜，促进角膜上皮损伤修复，改善圆锥角膜患者配戴 RGP 所致干眼症状，具有一定的临床应用价值。

Objective: To investigate the clinical efficacy of sodium hyaluronate eye drops in the treatment of dry eye in keratoconus patients wearing rigid gas permeable (RGP) contact lens. Methods: Ninety keratoconus cases of dry eye related to wearing RGP contact lens from January 2016 to May 2017 were enrolled and divided into 3 groups randomly, including 30 cases (60 eyes) in each group. In group A, preservative-free sodium hyaluronate eye drops (EUSAN GmbH, German, specifications: 10 mL) were administered, 1 drop each time, 4 times daily; In group B, rewetting drops (BOSTON), 1 drop each time, 4 times daily; In group C, rewetting drops were initially given, followed by sodium hyaluronate eye drops 15 min later. All patients were evaluated by subjective symptoms of dry eye, Schirmer I test (SIT), break-up time (BUT) and corneal fluorescent staining, at pre-therapy and 1, 2, 4 weeks after treatment. Results: The subjective symptoms of dry eye, BUT and corneal fluorescent staining of three groups were significantly improved at 1 week after therapy than the data before therapy (all P < 0.05), SIT of three groups did not significantly differ before and after therapy (P > 0.05). Each index when measured after 1, 2 and 4 weeks had no significant difference in each group (all P > 0.05). There was no significant difference in subjective symptoms, SIT and BUT between group A and group B (all P > 0.05), whereas corneal fluorescent staining in group A was superior to group B (P < 0.05). The subjective symptoms of dry eye were significantly better than those in group A (P < 0.05). The subjective symptoms of dry eye and corneal fluorescent staining in group C were significantly better than those in group B (both P < 0.05). Conclusion: Administration of sodium hyaluronate eye drops (preservative-free) at a dose of 1 g/L can stabilize the tear film, promote the repair of corneal epithelial defects and significantly improve dry eye symptoms and signs in keratoconus patients wearing RGP contact lens, which has application value in clinical practice.