目的：分析23G/25G微创玻璃体切割术后发生眼内炎的危险因素。方法：回顾性分析2014年6月—2023年5月于中国人民解放军中部战区总医院行微创玻璃体切割术后，临床诊断为眼内炎患者(开放性眼外伤患者除外)的临床特征。结果：纳入8 955例行微创玻璃体切割术患者，其中11例微创玻璃体切割术后患眼发生眼内炎，发生率为0.12％。平均年龄(60.8±7.6)岁。11例其中，5例(45.4%)患者合并糖尿病；原发眼疾构成情况：黄斑疾病7例(63.6%)、增殖期糖尿病性视网膜病变继发玻璃体积血2例(18.2%)，视网膜裂孔继发玻璃体积血1例(9.1%)、视网膜脱离1例(9.1%)；术中联合行白内障手术3例(27.3 %)；术毕8例(72.7%)患眼玻璃体腔填充无菌空气，3例(27.3%)填充平衡盐溶液，术毕所有患者均未缝合巩膜穿刺切口；术后低眼压3例(27.3 %)。术后发生眼内炎的时间为(2.8±1.1)d。11例患者经过局部和全身抗感染治疗后炎症控制不佳，均再次行玻璃体切割术联合术中配置万古霉素液灌注，其中9例术毕玻璃体腔填充硅油，术后所有眼内炎得到控制，10例(91.0%)患者最终矫正视力有所提高。结论：微创玻璃体切割术后，免缝合的巩膜切口可能是病原微生物侵入眼内导致眼内炎的潜在途径。尤其要重视黄斑手术中玻璃体不全切除引起巩膜切口处发生玻璃体束综合征可能是术后发生眼内炎的危险因素之一。

Objective: To analyze risk factors for endophthalmitis occurred after 23G/25G minimally invasive vitrectomy. Methods: Retrospective analysis of the clinical characteristics of patients with endophthalmitis (except patients with open eye trauma) after minimally invasive vitrectomy in General Hospital of Central Theater Command(Wuhan,430064) from June 2014 to May 2023. Results: This study included 8,955 patients, of which 11 cases occurred endophthalmitis after minimally invasive vitrectomy, with an incidence rate of 0.12%. The average age was (60.8±7.6) years, and 5 patients (45.4%) were complicated with diabetes; The composition of primary eye diseases: 7 cases (63.6%) of macular disease, 2 cases (18.2%) of vitreous hemorrhage secondary to proliferative diabetic retinopathy and 1 case (9.1%) vitreous hemorrhage secondary to retinal fissure, 1 case (9.1%) of retinal detachment; During the operation, 3 cases (27.3%) underwent combined cataract surgery; After the operation, 8 cases (72.7%) were filled with sterile air in the vitreous cavity of affected eye, the other 3 cases (27.3%) were filled with equilibrium liquid,and sclera puncture incision was not sutured in all patients; 3 cases (27.3%) had low intraocular pressure after operation. The time for postoperative endophthalmitis to occur after operation was 2.8±1.1day. 11 patients had poor inflammation control after local and systemic anti-inflammatory treatments, and all underwent vitrectomy combined with intraoperative injection of vancomycin solution. Among them, 9 patients were filled with silicone oil in the vitreous cavity after the surgery. After the operation, all the endophthalmitis were controlled and final corrected visual acuity of 10 patients improved. Conclusions: Minimally invasive vitrectomy and suture-free scleral incision may be a potential way for pathogenic microorganisms to invade the eye and cause endophthalmitis. Particular attention should be paid to the ‘Vitreous Wick Syndrome’ at the scleral incision caused by incomplete vitrectomy in macular surgery, which may be one of the risk factors for postoperative endophthalmitis.

玻璃体切割术是目前临床上常见的眼科手术之一，其应用广泛，且具有良好的治疗效果，但术后仍会出现各种并发症，眼压升高便是其中常见的一种。玻璃体切割术后眼压升高的病因复杂多样，术前原发病的不同、术中处理方式的差异以及术后并发症均可引起眼压升高，根据不同的病因可以选用更合适的治疗方法。早期的眼压升高较易控制，主要采用药物及激光治疗，晚期眼压升高导致继发性青光眼则相对复杂，以手术治疗为主。该文主要对玻璃体切割术后高眼压的原因分析及治疗进展进行综述。

Pars plana vitrectomy is one of the common ophthalmic surgeries in clinic practice currently, which is widely used with good therapeutic effect. However, various complications may still occur after operation. Elevated intraocular pressure is one of common complications. The causes of postoperative ocular hypertension are complex and diverse. Elevated intraocular pressure could be caused by different preoperative primary diseases, intraoperative management methods,and postoperative complication. More appropriate treatment methods can be selected based on different causes. Early elevated intraocular pressure iseasier to control and is mainly treated with medicine and laser. Late elevated intraocular pressure leads to secondary glaucoma, which is relatively complex and mainly treated with surgery. This review mainly states causes and treatment progress of high intraocular pressure after vitrectomy.

随着微创玻璃体切除术(pars plana vitrectomy，PPV)的广泛开展和手术技术的提高，患者对手术后视觉质量的要求越来越高。白内障是PPV术后最常见并发症，而具有玻璃体切除史的白内障患者屈光变异大，预测难度高。本文综述了生物测量误差、人工晶状体屈光力计算公式选择以及有效晶状体位置预测等影响有玻璃体切除手术史的白内障患者术后屈光误差的主要因素，旨在为降低这一类特殊人群白内障术后屈光误差提供参考。

With the widespread application of minimally invasive vitrectomy and the improvement of surgical techniques, the demands of patients for better postoperative visual quality are increasing. Cataract is the most common complication after vitrectomy, whereas the refractive outcomes of cataract patients with prior vitrectomy are viable and difficult to predict. In this paper, the main factors affecting postoperative refractive error of cataract patients with a history of vitrectomy, such as biometric error, selection of intraocular lens calculation formulas and prediction of effective lens position, were reviewed in order to provide reference for reducing postoperative refractive error of this special group of cataract patients.

目的：对比玻璃体切割术(pars plana vitrectomy, PPV)联合或不联合注射地塞米松玻璃体内植入剂(dexamethasone intraveal implant, DEX)治疗特发性黄斑前膜(idiopathic macular epiretinal membrane, IMEM)的临床疗效。
方法： 采用回顾性研究设计，收集2022年1月—2023年6月于惠州市中心人民医院就诊，被诊断为IMEM(Gass 2期)并行PPV联合phaco+IOL植入的患者49例(49只眼)。根据其治疗方案分为非联合注射DEX组(25例共25只眼)及联合注射DEX组(24例共24只眼)。记录所有患者术前术后的最佳矫正视力(best corrected visual acuity, BCVA)、黄斑中心凹视网膜厚度(central macular thickness, CMT)、平均神经节细胞层(ganglion cell layer, GCL)厚度，椭圆体带(ellipsoidal zone, EZ)完整性。使用OCTA测量视网膜浅层毛细血管层(superficial capillary plexus, SCP)、中心区域血管密度(vessel densities, VDs)及中心凹无血管区(foveal avascular zone, FAZ)面积。使用非接触性眼压计测量患者眼压。随访至术后6个月，记录上述指标，其中BCVA及CMT随访至1年。使用SPSS 29.0软件进行数据的统计分析(独立样本t检验、Mann-Whitney U检验、Pearson χ2检验等)。使用重复测量方差检验分析各项指标的时间差异及交互差异性。采用线性回归分析CMT、平均GCL厚度、EZ完整性、VDs、FAZ面积及联合注射DEX与BCVA的相关性。
结果：本研究两组间性别、年龄、眼压及术前各项指标差异均无统计学意义(P>0.05)。两种术式均能改善黄斑区结构、功能及微循环障碍，术后的BCVA在两组患者中均较术前有所改善，且持续至术后6个月，CMT的变化趋势同BCVA有高度一致性，而平均GCL厚度于术后3个月时开始恢复，而SCP中心凹VDs及FAZ面积于术后6个月时才有明显恢复，两种术式术后以上各指标均具有时间差异及交互差异性(P≤0.015)，且6个月内联合注射DEX组表现更佳(P=0.036)。相较于非联合注射DEX组，只有联合注射DEX组在术后6个月时，EZ完整性的改善具有统计学意义(P=0.009)。但随访至1年时，两组之间BCVA及CMT差异均无统计学意义(P=0.079)。术后6个月内BCVA的改善与术后6个月的CMT、平均GCL厚度、SCP中心凹VDs、FAZ面积的改善及EZ完整性及是否注射DEX与术后6个月内BCVA的改善均有相关性。随访期间两组患者均未发生眼内炎、玻璃体积血、视网膜脱离等眼部或全身严重并发症。
结论：微创玻璃体切割术联合玻璃体内注射DEX治疗相较于非联合注射DEX治疗组在6个月内疗效更佳。联合单次注射DEX治疗方案与非联合注射DEX治疗方案相比，在手术1年后对BCVA及CMT的改善无明显差异。

Objective: To analyze the efficacy and safety of minimally invasive vitrectomy (PPV) with or without intraoperative injection of dexamethasone intravitreal implant (DEX) for the treatment of Idiopathic Macular Epiretinal Membrane (IMEM), by comparing the relevant indicators.

Methods: A retrospective study design was used to collect 49 patients (49 eyes) who were diagnosed with IMEM (Gass2) and underwent surgical treatment(PPV+phaco+IOL implantation) at Huizhou Central People’s Hospital from January 2022 to June 2023. According to their treatment plan, they were divided into a non-combined injection DEX group (25 cases, 25 eyes) and a combined injection DEX group (24 cases,24 eyes). All patients underwent comprehensive optometry before and after surgery, and their best corrected visual acuity (BCVA) was recorded. Scan the central macular thickness (CMT) within 6x6mm of the macular area, while scanning the average ganglion cell layer (GCL) thickness. Record whether the elliptical zone (EZ) within 1x1mm of the macular area is complete and continuous. Use OCTA mode to scan the superficial capillary layer (SCP) of the retina within a range of 6x6mm, and record the measurements of vascular density (VDs) in the central area and the area of the foveal avascular zone (FAZ). Measure the patient's intraocular pressure using a non-contact tonometer. Follow up for 6 months and record the above indicators, with BCVA and CMT followed up for 1 year. Perform statistical analysis of data using SPSS 29.0 software (Independent sample t-test, Mann Whitney U-test and Pearson χ2-test). Use repeated measures ANOVA to analyze the time differences and interaction differences of various indicators. Linear regression analysis was used to examine the correlation between CMT, mean GCL thickness, EZ integrity, VDs, FAZ area, and combined injection of DEX with BCVA.

Results: There were no statistically significant differences in gender, age, intraocular pressure, and preoperative indicators between the two groups (P>0.05). Both surgical methods can improve the structure, function, and microcirculation disorders in the macular area. The postoperative BCVA in both groups of patients improved compared to before, and persisted until 6 months after surgery. The trend of CMT changes was highly consistent with BCVA, while the average GCL thickness began to recover at 3 months after surgery. The SCP fovea VDs and FAZ area did not show significant recovery until 6 months after surgery. Both surgical methods showed time differences and interaction differences in the above indicators after surgery (P=0.015), and the combined injection of DEX group performed better within 6 months (P=0.036). Compared to the non combined injection of DEX group, only the combined injection of DEX group showed statistically significant improvement in EZ integrity at 6 months after surgery (P=0.009). However, at 1 year of follow-up, there was no statistically significant difference in BCVA and CMT between the two groups (P≥0.079). The improvement of BCVA within 6 months after surgery is correlated with the improvement of CMT, average GCL thickness, SCP fovea VDs, FAZ area, EZ integrity, and injection of DEX within 6 months after surgery. During this study, no serious ocular or systemic complications such as endophthalmitis, vitreous hemorrhage, or retinal detachment occurred in either group of patients at each follow-up time point.
Conclusions: The efficacy of PPV combined with intravitreal injection of DEX is better within 6 months compared to the non-combined injection of DEX treatment group. There was no significant difference in the improvement of BCVA and CMT after one year of surgery between the combined single injection DEX treatment regimen and the non-combined injection DEX treatment regimen.

为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求，又能合理利用有限空间，本研究团队在原有的眼科日间病房座椅的基础上，增加玻璃体手术后体位护理等功能，发明了一种护理座椅[专利号：国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料，其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单，操作方便，安全使用，既能保证临床体位护理需求，又能节省空间，便于病房环境管理。

To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.

目的：了解玻璃体切除硅油填充术后患者(face-down positioning，FDP)依从性的相关影响因素。方法：采用随机抽样研究的方法，选取2018年1月至2019年12月于无锡市人民医院眼科行玻璃体切除硅油填充术后的患者100例，采用问卷调查对一般资料、FDP可能发生的反应和依从性进行调查。采用SPSS 19.0进行统计分析。结果：患者性别、对疾病的重视程度与FDP的依从性有显著差异(P<0.05)，但家庭支持系统与FDP的依从性差异无统计学意义(P>0.05)。患者术后第1天对FDP依从性的主要影响因素依次为呼吸不畅(84%)、睡眠不佳(78%)、肩颈部不适(10%)；术后第3天的主要影响因素依次为呼吸不畅(66%)、腰酸背痛(50%)、睡眠不佳(39%)；术后第5天的主要影响因素依次为肢体麻木(70%)、腰酸背痛(87%)、睡眠不佳(30%)、肩颈部不适(18%)以及肘关节疼痛(10%)。结论：影响患者依从性的主要因素主要有性别、对疾病的自我重视程度以及FDP引起的不适症状。需加强对高危因素的识别，不同病情时段给予征对性的宣教和指导，以提高患者对FDP的依从性。

Objective: To investigate the influencing factors of compliance of patients with silicone oil tamponade after vitrectomy. Methods: A total of 100 patients with silicone oil tamponade after vitrectomy in Wuxi People’s Hospital of Jiangsu Province from January 2018 to December 2019 were selected by random sampling method.The general information, possible reaction, and compliance of face-down positioning (FDP) were investigated by questionnaire. SPSS 19.0 was used for statistical analysis. Results: There were significant differences in patients’gender, attention to disease and FDP compliance (P<0.05), but there was no significant difference between family support system and FDP (P>0.05). The main influencing factors of FDP compliance were dyspnea (84%), poor sleep (78%), the discomfort of shoulder and neck (10%); on the third day after operation, the main influencing factors were dyspnea (66%), low back pain (50%) and poor sleep (39%); on the fifth day, the main influencing factors were numbness of the limbs (70%), low back pain (87%) and poor sleep (30%), the discomfort of shoulder and neck (18%) and elbow pain (10%). Conclusion: The main factors that affect the compliance of patients are gender, self-awareness of the disease and discomfort caused by FDP. It is necessary to strengthen the identification of high-risk factors, and give symptomatic education and guidance at different stages of illness, to improve the compliance of patients to FDP.

目的：探讨品管圈在提高玻璃体切除术后患者俯卧位执行率中的应用效果。方法：成立品管圈活动小组，选定提高玻璃体切除术后患者俯卧位执行率作为活动主题，运用品管圈工具和方法，对现状进行分析，找出影响因素，制定相应的措施并组织实施，比较品管圈活动前后玻璃体切除术后患者俯卧位执行率情况。结果：玻璃体切除术后患者俯卧位执行率由活动前的64.70%提高到95.83%。结论：运用品管圈能显著提高玻璃体切除术后患者俯卧位执行率，值得临床推广。

Objective: To explore the effect of quality control circle on improving the prone position execution rate of patients after vitrectomy. Methods: Establish quality control circle activity group, select improving the prone position execution rate of patients after vitrectomy as the activity theme, use quality control circle tools and methods to analyze the status quo, find out the influencing factors, formulate corresponding measures and implement them, and compare the prone position execution rate of patients before and after quality control circle activity. Results: The prone position execution rate of patients after vitrectomy increased from 64.70% to 95.83%.Conclusion: The application of quality control circle can significantly improve the prone position implementation rate of patients after vitrectomy, which is worthy of clinical promotion.