目的：探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法：通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗，对其疗效进行回顾性分析。结果：术后修复皮瓣均成活，眼睑功能良好，随访 4 个月~10 年，期间无复发及转移病例。结论：对于眼睑部的基底细胞癌，采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率，同时最大限度地保留了眼睑的正常组织，达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

目的：探索适合本地实际情况的屈光发育档案管理模式。方法：总结本区屈光发育档案推行数据，采用鱼骨图系统分析影响屈光发育档案在基层医院推行的关键因素。结果：影响屈光发育档案在基层医院推行的关键因素包括家庭因素、个人因素、学校因素、医院因素。建议通过与学校加强合作，进行健康教育，加强与学生、家长的沟通，开发简易技术，加强医院信息化建设，逐步建立适合本地实际情况的屈光发育档案管理模式。结论：在基层医院建立青少年屈光发育档案受多种因素影响，需平衡家庭、学校、医院的关系，加强数字化平台建设。

Objective: To explore an appropriate management model of refractive development archives suitable for local conditions. Methods: The main influencing factors of refractive development archives in primary hospitals were analyzed by using fishbone diagram. Results: The influencing factors included family factors, personal behavior, school and medical factors. It was recommended to improve the cooperation with school and strengthen communication with students and parents. The hospital should develop simple technologies to strengthen the construction of information technology. An appropriate model of refractive development archives was established according to the local situation. Conclusion: The establishment of adolescent refractive development archives in primary hospitals is affected by many factors. It is necessary to balance the relationship among families, schools and hospitals, and strengthen the construction of digital platforms.

目的：观察后房型有晶体眼人工晶体(implantable collamer lens，ICL)V4c植入术后2年的有效性、安全性和稳定性，评估ICL V4c矫正屈光不正的中远期临床疗效。方法：回顾性病例研究。收集在河 北省沧州市中心医院眼一科行ICL V4c手术治疗的屈光不正患者，观察并记录术前至术后2年的裸眼视力、最佳矫正视力、屈光状态、对比敏感度、高阶像差、眼压、人工晶体拱高、角膜内皮细胞 计数、不良反应、主观视觉质量等临床资料，进行统计学分析。结果：完成随访的96例术眼，术后2年的平均裸眼视力(LogMAR)为0.021±0.065，平均最佳矫正视力(LogMAR)为0.002±0.041，优于术前最佳矫正视力，有效性指数为1.05，安全性指数为1.09，等效球镜数值稳定，对比敏感度提升，高阶像差有所增加，但主观视觉质量良好，眼压基本稳定，内皮细胞丢失率为1.6%，平均拱高为(549.6±50.0) μm，随访期间未发现眼内感染、继发性青光眼、晶状体混浊、黄斑水肿、视网膜脱离等并发症。结论：ICL V4c植入术矫正屈光不正具有良好的中远期临床效果。

Objective: To assess the medium-long term efffcacy, safety and stability of a newly developed posterior chamber phakic intraocular lens (model V4c Visian Implantable Collamer Lens) to correct refractive errors. Methods: Retrospective case series. This study evaluated eyes that had implantation of ICL V4c to correct ametropia for at least two years. Uncorrected and corrected distance visual acuities, refraction, contrast sensitivity, high-order aberration, quality of life, intraocular pressure, endothelial cell density, pIOL vault, and adverse events were evaluated to assess the efffcacy, safety and stability of V4c. Results: The study comprised 96 eyes of 50 patients. At 2 years postoperatively, the mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.021±0.065 logMAR and 0.002±0.041 logMAR, which were better than preoperative CDVA. The efffcacy and safety indices were 1.05 and 1.09, respectively. The spherical equivalent was stable with improved contrast sensitivity and increased high-order aberrations, but the subjective visual quality was well. The IOP remained stable over time. The mean vault was (549.6±50.0) μm and the mean endothelial cell loss was 1.6%. No eye developed intraocular infection, secondary glaucoma, lens opacity, macular edema or retinal detachment.Conclusion: The good medium-long term outcomes support the use of ICL V4c for the correction of myopia. 

目的：观察健康中老年人群中心凹视觉敏感度阈值(foveal threshold，FT)及光相干断层扫描血管成像(optical coherence tomography angiography，OCTA)的双眼对称性。方法：横断面观察性研究。纳入33例66眼，测量并比较眼灌注压(ocular perfusion pressure，OPP)，FT，黄斑区3 mm × 3 mm范围内中心凹无血管区面积(non-flow area，NFA)，浅层视网膜血管密度(superior vessel density，SVD)和深层视网膜血管密度(deep vessel density，DVD)的双眼对称性；分析各指标双眼差值、均值及其比值与年龄、性别的相关性。结果：配对样本t检验结果显示除FT(t=?2.118，P=0.042)外，左右眼OPP，NFA，SVD和DVD差异均无统计学意义(P>0.05)；Pearson相关性分析和同类相关系数(intra-class correlation coefficient，ICC)检验结果显示5项指标左右眼测量值相关强度由强到弱为OPP>FT>NFA>DVD>SVD；Bland-Altman分析结果提示5项指标双眼间一致性良好。5项指标的双眼对称性不随性别、年龄改变。结论：健康中老年人群FT、黄斑区NFA，SVD及DVD的测量值具有双眼对称性。

Objective: To observe the interocular symmetry of foveal threshold (FT) and optical coherence tomography angiography (OCTA) parameters in healthy middle-aged and elderly subjects. Methods: Cross-sectional observational study. Sixty-six eyes from thirty-three subjects were enrolled to compare binocular ocular perfusion pressure (OPP), FT, non-flow area (NFA), superior vessel density (SVD) and deep vessel density (DVD) in a 3 mm × 3 mm OCTA scan of macula. The interocular symmetry of all the parameters was analyzed; the correlations of the differences (△), mean value (m) and the ratio of all the parameters with age and gender were analyzed. Results: There was no significant interocular difference revealed by paired-samples t-tests in all the parameters (P>0.05) except FT (t=?2.118, P=0.042), while the rank of Pearson’s correlation index and intraclass correlation coefffcient (ICC) from strong to weak was OPP > FT > NFA > DVD > SVD. The interocular symmetry of all the parameters was proved to be good with Bland-Altman plots, and it changed little with the variations of age and gender. Conclusion: Interocular symmetries of FT and OCTA parameters are observed in healthy middle-aged and elderly subjects.

目的：分析临床路径下青光眼住院费用变化情况，为制定合理的临床管理方法提供参考。方法：收集青光眼临床路径患者数据，建立 Excel 数据库，以 2016 年为基准对住院费用进行贴现计算后，应用 SPSS 软件对住院数据进行统计分析。结果：手术费用占总费用的比例最大，人均住院费用变化不明显，诊疗费逐年上升。随着日间手术的开展，实施临床路径管理的患者数量下降。结论：诊疗费用对提高医务人员工作积极性具有很重要的意义，随着日间手术的推广，将对临床路径的实施产生影响。

Objective: To investigate hospitalization costs through the inpatient costs of primary acute angle closure glaucoma between 2009 to 2016, and to provide a more suitable method for clinical management.

Methods: We collected the data of hospitalization patients with glaucoma from 2009 to 2016, coded and established the corresponding Excel databases. Based on a variety of statistics tables, descriptive analysis (according to SPSS for Windows 17.0) was applied to analyze the proportion of different types of hospitalization costs and simple linear regression was used to analyze the tendency of costs with years.
Results: Operation costs was the largest percentage of total cost; the average hospitalization cost change was not obvious, and the treatment costs rose year by year. With the development of day surgery, patients of clinical pathway management was decreased.
Conclusion: Increasing the medical expenses to improve medical staff’s work enthusiasm has very important significance. As day surgery, will affect the implementation of clinical pathway.

      原发性玻璃体视网膜淋巴瘤(primary vitreoretinal lymphoma, PVRL)作为原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma，PCNSL)的一个亚型，是一种罕见的致命性眼部恶性肿瘤。多数PVRL会伪装成慢性后葡萄膜炎，这使得临床诊断具有挑战性。玻璃体细胞、视网膜下液和影像学检查对临床诊断至关重要。而对恶性细胞的细胞学检查与组织病理学诊断是PVRL诊断的金标准。此外，免疫球蛋白重链(immunoglobulin heavy chain, IgH)或T细胞受体(Tcell receptor, TCR)基因重排的分子生物学检测、细胞标志物的免疫表型检测、以及细胞因子检测如IL-10的表达升高均可作为辅助诊断工具。目前PVRL的治疗主要包括局部放射及玻璃体腔内注射化疗药物(甲氨蝶呤和利妥昔单抗)，根据眼外组织是否受累决定是否联合全身化疗。对伴随PCNSL的患者，在全身大剂量甲氨蝶呤联合利妥昔单抗治疗的基础上，考虑联合局部治疗、全脑放疗和/或自体干细胞移植。尽管PVRL对初始治疗反应良好，但因其复发率高，常出现CNS受累，使PVRL的生存期预后较差。因此建立一个包含眼科医师、眼科病理学家、神经肿瘤学家以及血液肿瘤学家在内的专业团队来优化患者的治疗方案显得尤为重要。

      一名36岁的女性于16年前因静脉滴注“青霉素”引发Stevens-Johnson综合征，出现皮肤剥脱，口、鼻腔黏膜破损出血，双眼红肿伴分泌物增多等症状，当时经过治疗症状基本缓解。数月后开始反复出现眼部不适，2010年患者的视力明显下降，眼部疼痛加重，伴畏光流泪。至2016年入暨南大学附属第一医院时双眼最佳矫正视力仅0.1(右眼)、光感(左眼)，双眼角膜混浊，新生血管长入，甚至出现睑球粘连。80%的SJS患者可伴有眼部并发症，经过治疗症状缓解后，眼部病变仍可能继续进展，最终导致视力障碍甚至更严重的后遗症。因此患者病情稳定后仍须随诊，密切关注眼部、皮肤及黏膜的变化情况。

A 36-year-old woman developed Stevens-Johnson syndrome 16 years ago due to intravenous infusion of “penicillin”. She developed symptoms such as skin exfoliation, oral and nasal mucous damage, redness and swelling of the eyes, and increased secretions. TTe condition was relieved affer treatment. A few months later she repeated eye discomfort, in 2010 the patient’s visual acuity decreased significantly, eye pain increased with photophobia and tears. Her best-corrected visual acuity (BCVA) was only 0.1 for the right eye and light perception for the left eye, corneal opacity, angiogenesis, and even the symblepharon were observed when admitted to First Affiliated Hospital of Jinan University in 2016. About 80% of Stevens-Johnson syndrome patients may be accompanied by ocular complications. Although the ocular symptoms are relieved after treatment, eye disease is still likely to progress, eventually leading to visual impairment and even more serious sequelae. TTerefore, patients with stable condition still need follow-up, and close attention should be paid to the changes of the eyes, skin and mucous membranes.

目的：探讨飞秒激光辅助角膜内皮移植(endothelial keratoplasty，EK)患者的护理。方法：对40例 行飞秒激光辅助EK术的患者做好术前心理护理，完善术前检查及术前准备，术后重点做好体位护 理、病情观察及出院指导。结果：4例患者术后发生植片移位，经再次复位后贴合良好，1例术后第1天气泡到后房行前房成形术；13例患者术后出现眼压升高，经治疗眼压得到控制；40例患者全 部治愈出院。结论：对EK术患者应做好术前及术后的护理，及时发现并发症并采取相应的治疗与护理措施，以提高手术的成功率。

Objective: To explore the nursing care of patients with femtosecond laser assisted endothelial transplantation. Methods: Forty patients were involved in this study. Preoperative psychological nursing, ocular examination, and surgical preparation were taken, and the main nursing postoperation focused on patients’ position and the discharge guidance. Results: TTe graffs in 4 cases were displaced, and were all in place affer resetting. The bubble was observed in posterior chamber in 1 case, this case was taken anterior chamber forming operation. Intraocular pressure was high in 13 cases, and those cases were treated with topical medicines. Conclusion: Completing the preoperative nursing of patients with corneal endothelial transplantation, observing the complications and taking corresponding treatment and nursing measures help improve the success rate of the operation.  

目的：探讨延伸护理对角膜移植术后的作用及临床意义。方法：回访收集 71 例角膜移植术后患者院外用药、视力及门诊随访病情信息，将患者随机分为延伸护理组与常规护理组，延伸护理组 36 例，常规护理组 35 例，比较两组术前后视力变化值、家庭功能与生活质量评分及遵医行为。结果：延伸护理组与常规护理组在手术前后视力均明显改善，而两组组间差异无统计学意义（P > 0.05）。延伸护理前后家庭功能与生活质量评分差异有统计学意义（P < 0.05），而常规护理前后评分无差异（P > 0.05），两组间比较差异有统计学意义（P < 0.05）。延伸护理在遵医嘱行为方面显著优于常规对照组（P < 0.05）。结论：延伸护理能明显改善角膜移植术后患者治疗与护理依从性，能良好体现护理专业价值与社会服务功能，有助于患者从医院到居家的平稳过渡。

Objective: To investigate the effect of extended nursing care on corneal transplantation and its clinical significance. Methods: Clinical data of 71 patients after corneal transplantation, including extramural medication, visual acuity and outpatient follow-up were collected. The patients were randomly divided into the extended nursing care (n = 36) and routine nursing care groups (n = 35). The changes of visual acuity, family function and quality of life were compared between two groups. Results: The visual acuity in two groups was significantly improved after surgery, but no significant difference was noted between two groups (P > 0.05). The family function and quality of life scores significantly differed before and after extended care (P < 0.05), and there was no difference in the score before and after routine care (P > 0.05), there was a significant difference between the two groups (P < 0.05).Extended care was significantly superior to the routine care (P < 0.05). Conclusion: Extended nursing care can obviously improve the compliance of treatment and nursing of patients after corneal transplantation. It can reflect the value of nursing profession and social service function, and help patients to make a smooth transition from hospital to home.

目的：研究佛山市南海区第四人民医院（以下简称 “我院”）五官科 2016 年白内障入院治疗的患者临床资料。方法：回顾性分析 2016 年间在我院五官科的住院患者，以 “白内障” 为检索词查阅病历管理系统，导出 Excel 文件，查阅相关病例资料进行统计分析。结果：2016 年共收治白内障患者 132 例 145 眼，其中男 56 例 59 眼，女 76 例 86 眼，年龄（72.98±6.89）岁。年龄相关性白内障占91.72%。其中 136 例接受白内障手术治疗。手术患者术前最佳矫正视力1.31±0.41，术后最佳矫正视力0.20±0.16，各月份入院患者人数平均。核性白内障患者入院年龄与皮质型及后囊下型患者有统计学差异，但3种类型的术前及术后视力无统计学差异。结论：我院白内障患者入院临床分布年龄多集中于 70~79 岁，女性患者，皮质型及后囊下型年龄相关性白内障患者选择手术时间早于核性年龄相关性白内障。

Objective: To study the clinical data of cataract patients admitted to the Fourth People’s Hospital of Nanhai Destrict of Foshan City in 2016. Methods: We retrospectively analyzed the inpatients in the Department of Eye & ENT of the hospital. We consulted the medical record management system with the term “cataract” and the results were derived to Excel files for statistical analysis. Results: A total of 132 cases (145 eyes) of cataract were hospitalized in 2016, including 56 male cases (59 eyes) and 76 female cases (86 eyes). The age was (72.98±6.89) years old. Among them, the percentage of age-related cataract was 93.72%; 136 cases were treated with cataract surgery. The preoperative best corrected visual acuity was 1.31±0.41, and the postoperative best corrected visualacuity was 0.20±0.16. The number of patients admitted to hospital was almost equivalent in each month. The admission age of nuclear cataract patients was significantly different from that of those with cortical type and posterior subcapsular type cataract, but there was no significant difference in preoperative and postoperative visual acuity among the three types of age-related cataract. Conclusion: The cataract patients in our hospital are mainly aged 70–79 years old, primarily in female patients. The operation time for patients with cortical and posterior subcapsular age-related cataract is earlier compared with that for those with nuclear age-related cataract.