人工智能(artificial intelligence，AI)在白内障手术中的应用越来越广泛，二者结合对于白内障手术的术前诊断和分级管理、术中人工晶状体选择、位置预测及术后管理(视力预测、并发症预测及随访)、手术培训和教学方面均起到巨大的促进作用。诚然，AI在与白内障手术相关的管理、分析和研究中还面临着许多问题，但其广泛的应用前景不可忽视。现对AI在白内障手术治疗和教学中的应用做以总结，并对其未来的发展做出展望。

Artificial intelligence (AI) has been widely used in cataract surgery. The combination of the two can play a great role in improving preoperative diagnosis, grading management of cataract surgery, intraoperative intraocular lens selection and location prediction, postoperative management (vision prediction, complication prediction and follow-up), surgical training and teaching. It is true that AI still faces many problems in the management, analysis and research related to cataract surgery, but its broad application prospects cannot be ignored. This review summarizes the application of AI in cataract surgery and teaching, and the future prospects of AI.

目的：探讨获得性免疫缺陷综合征（acquired immune deficiency syndrome, AIDS）合并巨细胞病毒性视网膜炎（cytomegalovirus retinitis，CMVR）抗病毒治疗后眼内液特征，为临床优化治疗方案、评估疗效提供参考。方法：回顾性分析2018年11月—2024年12月广州医科大学附属市八医院收治的49例AIDS合并CMVR患者的临床资料，按治疗方式的不同分为全身用药组（n=23，30眼）及联合组（n=26，30眼），全身用药组予静脉滴注膦甲酸钠全身抗病毒治疗，联合组在此基础上加用玻璃体腔注射更昔洛韦，比较两组的眼内液特征。结果：治疗后两组眼内液CMV核酸载量、白细胞介素（interleukin, IL）-6、IL-8、IL-10、血管内皮生长因子（vascular endothelial growth factor, VEGF）、碱性成纤维细胞生长因子（basic fibroblast growth factor，BFGF）、血管细胞黏附分子（vascular cell adhesion molecule, VCAM）水平低于治疗前，且联合组低于全身用药组（P＜0.05）；治疗前后两组均未检出单纯疱疹病毒（herpes simplex virus, HSV）、水痘-带状疱疹病毒（varicella-zoster virus, VZV）、爱泼斯坦-巴尔病毒(epstein-barr virus, EBV)、人疱疹病毒6型（human herpesvirus 6, HHV-6）。Spearman秩相关分析显示，房水中CMV核酸载量与IL-6、IL-8、IL-10、VEGF、BFGF、VCAM均呈正相关（P＜0.05）。结论：AIDS合并CMVR患者经全身联合局部抗病毒的疗效更佳，可更显著降低眼内液CMV核酸载量及相关炎症、生长因子水平，且房水CMV核酸载量与上述细胞因子水平呈正相关系。

Objective: To investigate the intraocular fluid characteristics of acquired immunodeficiency syndrome (AIDS) complicated with cytomegalovirus retinitis (CMVR) after antiviral treatment. Method: A retrospective analysis was conducted on the clinical data of 49 patients with AIDS and concomitant CMVR admitted to our hospital from November 2018 to December 2024. They were divided into a control group (n=23, 30 eyes) and a combination group (n=26, 30 eyes) according to different treatment methods. The control group received systemic antiviral treatment with intravenous sodium phosphonate, while the combination group received intravitreal injection of ganciclovir (GCV) on this basis. The intraocular fluid characteristics of the two groups were compared. Result: After treatment, the levels of CMV nucleic acid load, interleukin-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (BFGF), and vascular cell adhesion molecule (VCAM) in the intraocular fluid of both groups were lower than before treatment, and the combined group was lower than the control group (P<0.05); No HSV was detected in both groups before and after treatment EBV、VZV、HHV-6。 Spearman correlation analysis showed that the CMV nucleic acid load in aqueous humor was positively correlated with IL-6, IL-8, IL-10, VEGF, BFGF, and VCAM (P<0.05). Conclusion: AIDS patients with CMVR showed better efficacy after systemic and local antiviral treatment, and exhibited significant decreases in CMV nucleic acid load and related cytokines in aqueous humor.

先天性晶状体不全脱位是一种较为罕见的晶状体悬韧带异常的疾病，其手术治疗极具挑战性。以人工晶状体悬吊为代表的传统手术方式易出现囊袋破裂、玻璃体疝、人工晶状体脱位和继发性青光眼等严重并发症。近年来，以重建囊袋悬韧带隔为目标，新型囊袋辅助装置的应用极大程度提高了先天性晶状体不全脱位的手术成功率。然而，以改良式张力环为代表的囊袋辅助装置在我国仍难以得到普及且操作繁琐。因此，如何最大程度利用普通张力环等最常见的装备，设计出一种安全可靠手治疗先天性晶状体不全脱位的手术方式是眼科界亟待解决的问题。本文将介绍一种二期张力环缝合固定治疗先天性晶状体不全脱位手术技术。该技术仅需使用普通张力环，具有操作简单安全、术后效果稳定和易于技术推广的优点。

Congenital ectopia lentis is a relatively rare zonular disorder of the lens, and its surgical treatment is extremely challenging. The traditional surgical procedures represented by intraocular lens suspension are prone to result in serious complications such as capsular bag rupture, vitreous hernia, intraocular lens dislocation and secondary glaucoma. In recent years, with the goal of reconstructing the capsular bag–zonules diaphragm, the application of new capsular bag-assisted devices has greatly improved the surgical success rate of congenital ectopia lentis. However, the capsular-assisted devices, such as modified capsular tension ring, are still difficult to be popularized in China and the surgical procedures are complicated. Therefore, how to maximize the use of common equipment such as normal capsular tension rings and design a safe and reliable surgical method for the treatment of congenital ectopia lentis is an urgent issue for ophthalmologists. This article aims to introduce a two-stage capsular tension ring fixation for the treatment of congenital ectopia lentis, which has many advantages such as simple and safe operation, stable postoperative effect and less requirements for special equipment, and is worth promoting in clinical practice.

Schlemm管（Schlemm's canal，SC）作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索新的途径以增加房水排出，从而为降低眼压和青光眼治疗的新药物开发提供基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC靶向药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。

Schlemm's canal (SC), as the primary pathway for aqueous humor drainage, maintains intraocular pressure balance by regulating aqueous outflow. Abnormalities in its structure and function are closely associated with elevated intraocular pressure and the development of glaucoma. Research on SC aids in elucidating the mechanisms behind outflow resistance and exploring new avenues to enhance aqueous drainage, thereby providing a foundation for the development of new drugs aimed at lowering intraocular pressure and treating glaucoma. Currently, our understanding of the mechanisms regulating SC development and functionality remains limited, with a lack of specific therapeutic strategies targeting SC. In recent years, advancements in measurement and imaging technologies have revealed the molecular and cellular mechanisms underlying SC development, leading to the identification of key regulatory targets. This has enhanced our understanding of SC structural and functional regulation. Furthermore, innovative applications of SC as a target for intraocular pressure-lowering medications and surgical interventions are continually expanding. This article systematically reviews the research on the structure and function of SC, summarizes the key molecular and cellular regulatory mechanisms, and discusses the latest advancements in SC-targeted pharmacological and surgical therapies, providing new insights for the clinical diagnosis and management of glaucoma.

青光眼是世界首位不可逆性致盲性眼病，降眼压是唯一被证实有效的干预措施。手术是降低眼压的主要途径，近年来创伤更小、术后炎症反应更轻、并发症更少的微创青光眼手术逐渐在临床得到应用。超声睫状体成形术(ultrasound cycloplasty, UCP)是一种新型微创青光眼治疗技术。本文综述了国内外现有研究，表明UCP在治疗各种类型青光眼中均表现出良好的降眼压效果，但不同类型青光眼疗效存在一定差异。UCP可减少术后局部抗青光眼药物的使用数量，同时显示出较少的并发症和较轻的术后反应。与其他睫状体分泌功能减弱性手术相比，该手术在缓解难治性青光眼患者因高眼压导致的局部疼痛方面尤为有效。青光眼类型、超声探头型号匹配及治疗扇区数量是影响疗效的主要因素，其适应证的准确把握及手术参数设计的优化将进一步提高其治疗效果。本文归纳了UCP治疗青光眼的作用原理、手术操作与术后用药、适应证与禁忌证、有效性、安全性及其疗效的影响因素，以期为其临床应用和研究提供参考依据。

Glaucoma is the leading cause of irreversible blindness worldwide. Lowering intraocular pressure (IOP) is the only proven intervention to effectively prevent visual field deterioration and slow the progression of glaucoma. Surgery plays a critical role in reducing IOP, with traditional glaucoma surgeries focusing primarily on classic filtration procedures. In recent years, minimally invasive glaucoma surgeries (MIGS), characterized by less trauma, milder postoperative inflammation, and fewer complications, have been increasingly applied and continuously refined in clinical practice. Ultrasound cycloplasty (UCP) is a novel, minimally invasive technique for glaucoma treatment. This article reviews existing research both domestically and internationally, showing that UCP demonstrates good IOP-lowering effects in various types of glaucoma, though its efficacy varies across different glaucoma types. UCP reduces the need for postoperative anti-glaucoma medications, while also exhibiting fewer complications and milder postoperative reactions. Compared with other ciliary body function-reducing surgeries, UCP is particularly effective in alleviating local pain caused by elevated IOP in patients with refractory glaucoma. The type of Glaucoma, matching of the ultrasound probe model, and the number of treatment sectors are key factors influencing UCP efficacy. Accurate selection of indications and optimization of surgical parameters will further enhance its therapeutic outcomes. This article summarizes the mechanisms, surgical procedures, postoperative medication, indications and contraindications, efficacy, safety, and factors influencing UCP outcomes in glaucoma treatment, aiming to provide a reference for its clinical application and research.

视神经脊髓炎谱系疾病相关视神经炎是一种累及视神经的脱髓鞘性炎症疾病，视力损伤严重，预后差，复发率高。及时控制急性发作和有效预防复发是治疗的关键。目前治疗主要包括糖皮质激素、血浆置换、免疫吸附、免疫抑制剂、靶向单抗类药物。特别是近年来依库丽单抗、萨特利珠单抗、及依那利珠单抗取得重大进展。该文综述视神经脊髓炎谱系疾病相关视神经炎近年治疗研究进展，期望为临床决策提供有益参考。

Neuromyelitis optica spectrum disorders (NMOSD) is a central nervous system inflammatory demyelinating disease with involvement of the optic nerve and spinal cord, with poor prognosis and high recurrence rate. Timely control of acute attacks and effective prevention of recurrence are the keys to treatment. This article reviews the recent research progress in the treatment of optic neuritis associated with NMOSD , hoping to provide useful references for clinical decision-making.

目的：探讨人工晶状体(IOL)预先巩膜悬吊在严重晶状体半脱位中的应用效果。方法：选取 2018年12月至2022年7月四川省人民医院收治的>180°的严重晶状体半脱位患者8例(8 眼)。术中避开脱位的晶状体，预先将IOL悬吊于玻璃体腔，再将晶状体托起置于IOL上方，必要时辅助以虹膜拉钩，稳定晶状体，确保超声乳化手术安全完成。结果：严重的晶状体半脱位患者8例，其中晶状体核N1-N3硬度的患者各1例，单独使用IOL预先巩膜悬吊于术中稳定脱位的晶状体，3例超声乳化手术均顺利完成；达N4患者3例、N5患者2例，其中4例在虹膜拉钩的辅助下安全完成超声乳化；有1例N5的患者，由于悬韧带损伤超过270°，在将晶状体托起放置于IOL之上时，坠入玻璃体腔，给予玻璃体腔超声粉碎处理。8例患者术后IOL均居中，视力有不同程度的提高，眼压正常，未见严重并发症。结论：在严重晶状体半脱位的超声乳化手术中，对于N2~N3的软核，IOL预先巩膜悬吊可以良好地稳定晶状体，确保超声乳化手术的顺利进行；对于N4~N5的硬核，IOL预先巩膜悬吊可以作为一种辅助方法，联合虹膜拉钩共同稳定晶状体，确保超声乳化手术的安全进行。

Objective: To investigate the effect of intraocular lens (IOL) pre-suspension in thetreatment of severe lens subluxation. Methods: Retrospective case study. From December 2018 to July 2022, 8 eyes of 8 patients with severe lens subluxation greater than 180 degrees admitted to our hospital were selected. During surgery, the IOL should avoid the subluxated lens and be pre-suspended in the vitreous cavity, and then the lens is lifted and placed above the IOL. If necessary, the iris hook can be used to stabilize the lens to ensure the safe completion of phacoemulsification. Results: There were 8 patients with severe subluxation of lens. Among them, the hardness of 3 patients' lens nucleus ranged from N1 to N3. In these 3 patients, we used the IOL pre-suspension alone to stabilize the subluxated lens, and phacoemulsification in these 3 patients was successfully completed. Three patients had N4 and 2 patients had N5, of which 4 patients underwent phacoemulsification safely with the assistance of iris hook. In another patient with N5, the lens fell into the vitreous cavity during surgery (the suspension ligament rapture greater than 270 degrees) when it was lifted and placed on the IOL which was crushed by the vitreous cavity ultrasound. After surgery, the IOL was centered in all 8 patients, visual acuity was improved to varying degrees, intraocular pressure was normal, and no serious complications were observed. Conclusions: In severe lens subluxation surgery, IOL presuspension in soft nuclei of N2 to N3 can stabilize the lens well and ensure the safety of phacoemulsification. For hard nuclei N4 to N5, IOL presuspension can be used as an auxiliary method in combination with iris hook to stabilize the lens and ensure the safety of phacoemulsification.

登革热是由登革病毒引起的全球性虫媒传染病，近年来发病率在全球范围内呈指数级增长。随着登革热的流行，其相关眼部并发症逐渐受到眼科医生的关注。登革相关眼病（dengue-associated ocular diseases, DAOD）作为登革热感染的重要系统性并发症其病理机制涉及多个方面，包括病毒亚型、非结构蛋白 1（non-structureprotein, NS1）病毒抗原、宿主的抗 DENV NS1 抗体及免疫炎症反应等，这些因素的相互作用，引发一系列眼部并发症。DAOD的临床谱系复杂，可累及结膜、葡萄膜、视网膜、视神经和眼外肌等多个眼部结构，病变严重程度个体间差异较大，从自限性结膜出血到威胁视力的视神经炎等，临床表现多样，进一步增加了诊断和治疗的难度。由于缺乏明确的诊断金标准，DAOD的诊断通常需结合患者的全身症状、登革热特异性抗体血清学检测，以及眼部症状、临床特征和影像学检查等进行综合分析。治疗上则需根据患者具体情况制定个性化方案，以缓解症状、防止病情恶化并促进康复。本文旨在全面综述 DAOD的流行病学特征、发病机制、临床表现、诊断及治疗策略等方面的研究进展，为临床医生提供更全面、更准确的指导，从而提高 DAOD的诊治水平，降低患者致残率。

Dengue fever is a globally prevalent insect-borne disease caused by dengue virus, and its incidence has witnessed an exponential rise worldwide in recent years. Alongside the dengue fever epidemic, its related ocular complications have gradually drawn the attention of ophthalmologists. As a significant systemic complication of dengue infection, Dengue-associated Ocular Diseases (DAOD) have a multifaced pathological mechanism. This encompasses various factors, such as viral subtypes, non-structural protein 1 (NS1) viral antigens, host anti-DENV NS1 antibodies, and immune inflammatory responses. The clinical spectrum of DAOD is intricate, affecting multiple ocular structures including the conjunctiva, uvea, retina, optic nerve and extraocular muscles. The severity of lesions varies greatly among individuals, ranging from self-limited conjunctival hemorrhage to vision-threatening conditions like optic neuritis. This wide array of clinical manifestations further complicates the diagnosis and treatment process. Given the absence of a definitive gold standard for diagnosis, the diagnosing DAOD typically necessitates a thorough analysis encompassing the patient's systemic symptoms, dengue-specific antibody serological testing, ocular symptoms, clinical features, and imaging examinations. Treatment approaches are tailored to each individual, aiming to alleviate symptoms, prevent exacerbations, and facilitate recovery. The objective of this article is to conduct a comprehensively review of the research advancements in the epidemiological characteristics, pathogenesis, clinical manifestations, diagnosis and treatment strategies of DAOD. It aims to furnish clinicians with more comprehensive and precise guidance, thereby enhancing the diagnosis and treatment of DAOD and reducing the disability rate among patients.

息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病，发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离；其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式，其中，黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术，其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未形成共识，需要开展相关临床研究，提供更多依据。

Polypoidal choroidal vasculopathy (PCV) is a common blinding disease in Asian populations. Massive hemorrhage complications secondary to PCV include subretinal hemorrhage (SRH) and vitreous hemorrhage (VH). The risk factors for SRH include a long duration, clustered PCV, non-regression of polyp lesions and presented with retinal pigment epithelial detachment. The treatments for SRH include anti-vascular endothelial growth factor drugs, photodynamic therapy, laser, vitreous pneumatic displacement, intravenously injected tissue plasminogen activator, vitrectomy and combination therapy. Whether macular fovea is involved and the time since bleeding onset are the main factors afecting the choice of treatment for SRH. Older age of onset, higher white blood cell count, higher aspartate amino transferase and alanine amino transferase ratio, longer activated partial thromboplastin time retinal pigment epithelium detachment, photodynamic therapy history, intravitreal injection history larger SRH area and presented with retinal pigment epithelial detachment were associated with higher risk of VH. PCV patients with massive VH should be treated with vitrectomy, while the timing and technique of operation should be paid atention to. At present, the risk factors of PCV massive bleeding are not completely clear, and its treatment methods are diverse, which requires a large number of studies to prove its effectiveness and establish expert diagnosis and treatment consensus.

目的：初步评价折叠顶压球囊(foldable capsule buckle,FCB)治疗孔源性视网膜脱离(rhegmatogenous retinaldetachment,RRD)的有效性、安全性以及手术可操作性。方法：裂孔位置距角膜缘后≥15 mm的采用前瞻性临床病例研究。选择2020年3月至2021年9月在济南明水眼科医院院行FCB植入术治疗裂孔位置距角膜缘后≥15 mm的10例RRD患者(10眼)。应用眼部B型超声、眼底照相评价手术效果。根据术后有无FCB是否暴露、复视情况、排斥反应、眼球运动障碍等术后并发症的发生情况评价手术的疗效和安全性。结果：随访6个月~2年。10例RRD患者在术后通过眼部B超、眼底照相及光学相干断层扫描(opticalcoherence tomography,OCT)评估视网膜均复位。1例合并黄斑区视网膜脱离的患者视力提高。9例患者术后出现复视，术后1~3个月复视消失，1例在术后4个月仍存在复视，行FCB取出，术后视网膜未出现再脱离，复视症状消失。结论：初步研究可确定折叠顶压球囊植入治疗裂孔位置比较靠后(距角膜缘后≥15 mm)且传统巩膜扣带术操作难度大的孔源性视网膜脱离安全、有效，对眼球损伤小，易于操作。

Objective: To preliminarily evaluate the effectiveness, safety and surgical operability of foldable capsule buckle (FCB) in the treatment of rhegmatogenous retinal detachment (RRD). Methods: It is a prospective clinical case study. Ten patients (10 eyes), with a distance of ≥ 15 mm from the posterior margin of the angular membrane at the location of the fissure, who underwent FCB implantation surgery for RRD at Jinan Mingshui Ophthalmology Hospital from March 2020 to September 2021 were enrolled. The surgical outcome was evaluated by B-ultrasound, fundus photography and optical coherence tomography (OCT). The surgical efficay and safety were evaluated by the postoperative complications, such as FCB exposure, diplopia, rejection, and eye movement limitation. Results: The mean follow-up time was 1 year (6 months to 2 years). Retinal reattachment was evaluated by B-ultrasound, fundus photography and OCT after operation in 10 patients. One patient with macular retinal detachment had improved visual acuity. 9 patients developed diplopia after operation, but diplopia disappears 1-3 months after operation. One patient still had diplopia 4 months after operation, and FCB was removed 4 months after operation. No retinal detachment occurred after operation, and the symptoms of diplopia disappeared.Conclusion: It is confirmed by this preliminary research that the implantation of the foldable capsule buckle is safe and effective to treat rhegmatogenous retinal detachment with a relatively posterior position (≥15 mm from the back of the corneal limbus) with little damage to the ocular and easy to operate, compared with the difficulty and complexity in traditional scleral buckling surgery.