目的：分析鼻内镜下泪囊鼻腔吻合术手术疗效的影响因素。方法：纳入2021年1月—2023年7月在成都中医药大学附属医院眼科行鼻内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗的单眼慢性泪囊炎患者90例(90只眼)。所有患者均进行泪道CT造影检查及鼻内镜下泪囊鼻腔吻合术，术后随访6个月，评估手术疗效，分析手术疗效的影响因素。结果：本研究显示，慢性泪囊炎患者中女性占比为90%，平均年龄为(49.97±13.10)岁。单因素分析结果显示，术中是否置入引流管、下鼻甲肥厚与EnDCR手术疗效有关(P < 0.05)。Logistic多因素回归分析结果显示，下鼻甲肥厚为En-DCR手术疗效的危险因素(P < 0.05)。结论：慢性泪囊炎多发生于中老年女性。下鼻甲肥厚为En-DCR手术疗效的危险因素。

Objective: To analyze the influencing factors for effect of endoscopic dacryocystorhinostomy. Methods: A total of 90 patients (90 eyes) diagnosed with unilateral chronic dacryocystitis undergoing endoscopic dacryocystorhinostomy in the Department of ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine from January 2021 to July 2023 were included. All patients underwent lacrimal duct CT imaging and endoscopic dacryocystorhinostomy, and were followed up for 6 months to evaluate the efficacy of surgery. Results: This study showed that 90% of patients with chronic dacryocystitis were female, and the average age of patients was (49.97±13.096) years. The results of univariate analysis showed that there was a correlation between intraoperative drainage tube placement and inferior turbinate hypertrophy and the efficacy of En-DCR (P < 0.05). The results of Logistic regression analysis showed that inferior turbinate hypertrophy was a risk factor for the efficacy of En-DCR (P < 0.05). Conclusions: Dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy are the influencing factors of surgical effect. Chronic dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy is a risk factor affecting the curative effect of En-DCR surgery.

目的：比较中国南方地区与西北地区慢性泪囊炎患者的菌群分布，明确细菌谱的地理差异性，对不同地区抗生素使用因地制宜提供依据。方法：本研究为回顾性横断面研究。纳入2022年3月—2024年4月在中国西北地区三甲医院眼科诊断为慢性泪囊炎，拟行泪囊鼻腔吻合术的患者，并选取同时期在中国南方地区诊断为慢性泪囊炎的患者，所有患者在行经鼻镜泪囊鼻腔吻合术时切开泪囊取泪囊分泌物。两组标本均行一般细菌及真菌培养，比较两组细菌培养阳性率和构成比。结果：南方地区和西北地区泪囊分泌物细菌培养阳性率分别为26.0%和50.7%，差异有统计学意义(P < 0.001)。南方地区细菌分布中革兰阳性球菌、革兰阴性杆菌的构成比分别为 45.9%、37.6%，西北地区两种菌构成比为 71.4%、19.0%，差异有统计学意义(分别为P = 0.007，P = 0.003)。两地区检出率最高的菌均为凝固酶阴性葡萄球菌，链球菌属占比在两地区间比较差异有统计学意义(P = 0.004)。结论：中国南方地区比西北地区泪囊分泌物培养阳性率低，慢性泪囊炎细菌谱均以革兰阳性菌为主，南方地区革兰阴性菌占比较西北地区更高，链球菌属检出率较西北地区明显更低。这可能是不同地理环境、不同气候、不同生活习惯等共同因素的结果。

Objective: To compare the bacterial distribution of patients with chronic dacryocystitis from southern China and northwest China and to elucidate the geographical differences in the bacterial spectrum. Methods: This retrospective cross-sectional study included patients diagnosed with chronic dacryocystitis at the ophthalmology departments of tertiary hospitals in southern and northwest China between March 2022 and April 2024. Endoscopic dacryocystorhinostomy was performed on all patients to collect lacrimal sac secretions. The specimens were cultured for bacteria and fungi, and the positive rates and composition ratios of bacterial culture were compared between the two groups. Results: The positive rates of bacterial cultures from lacrimal sac secretions were 26.0% in southern China and 50.7% in northwest China (P < 0.001). The proportions of Gram-positive cocci and Gram-negative bacilli were 45.9% and 37.6%, respectively, in southern China, compared to 71.4% and 19.0%, respectively, in northwest China (P = 0.007 and P = 0.003, respectively). Coagulase-negative staphylococci were the most frequently detected bacteria in both regions. However, the proportion of Streptococcus species was significantly higher in northwest China compared to southern China (P = 0.004). Conclusions: The positive rate of lacrimal sac secretion cultures was lower in southern China compared to northwest China. The bacterial spectrum of chronic dacryocystitis in both regions was predominantly composed of Gram-positive bacteria. However, the proportion of Gram-negative bacteria was higher in southern China, while the detection rate of Streptococcus species was significantly higher in northwest China. These differences may be attributed to variations in climate, geographical features, and lifestyle habits.

血泪是指因各种原因导致眼部流出血性泪液的症状，其病因和临床表现复杂多样，往往涉及多学科多专业。不同病因引起的血泪，无论是临床表现，还是诊治方法均差异很大。为了向临床医生提供可参考的血泪临床诊疗流程，中国医师协会眼科医师分会泪器病专业委员会及中国中西医结合学会眼科专业委员会泪器病学组组织有关专家以临床实践经验为基础，经过认真讨论建立本共识，对血泪的病因、临床特征及诊疗流程提出指导性意见。

Bloody tears refers to the symptoms of blooding tears flowing from the eye due to various reasons. Its etiology and clinical manifestations are complex and diverse, often involving multiple disciplines and specialties. In order to provide clinicians with a reference for the clinical diagnosis and treatment process of bloody tears, Lacrimal Diseases Professional Committee of Ophthalmologist Branch of Chinese Medical Doctor Association and Lacrimal Diseases Group of Ophthalmic Professional Committee of Chinese Association of Integrated Medicine organized relevant experts to establish this consensus based on clinical practice after serious discussion, and put forward guiding opinions on the etiology, clinical characteristics, and diagnosis and treatment process of bloody tears.

      老年性黄斑变性(Age-related maeular degeneration，AMD)是老年人视力损伤和致盲的主要原因。视网膜的高耗氧性，高长链多不饱和脂肪酸含量，作为氧自由基的靶点和暴露于可见光的特性使其易产生氧化应激。大量研究均显示抗氧化营养素有助于老年性黄斑变性的防治，本文就其最新研究进展进行综述。

Age-related macular degeneration ( AMD)is the leading cause of irreversible visual impairent and blindness in elderly people. The retina seems particularly susceptible tooxidative stress because of its high concentration ofoxygen,polyunsaturated fatty acids, targets as oxygen free radical, and exposure to visible light.Multiple studies have suggested that antioxidative nutrients can play a role in slowing the onset or limiting the effects of AMD. The article has reviewed the latest research progress of antioxidative nutrients and age-related macular degeneration. 

目的：探讨上睑提肌缩短术和额肌肌瓣悬吊术后眼表改变和恢复的差异。

方法：对2007 年1 月至2007 年4 月在中山眼科中心住院的42例(62只眼)先天性上睑下垂患者，按手术方式和术后是否加用局部用药进行随机分组，观测各组术后2 d、5 d、7 d和2周患者泪液的分泌、泪膜破裂时间、结膜充血、角膜荧光染色、睑板腺功能、瞬目次数、上睑睫毛角度和眼睑闭合情况，并分析其观察结果的差异是否有统计学意义。

结果：3名患者(7.1 ％)因需要加用其它促角膜上皮生长的药物而退出本研究，其中1例(2.3 ％)因倒睫刺激角膜上皮水肿缺损需行手术调整，其余所有患者眼表检测项目的结果均显示不同程度地受到了手术影响，但是随着术后炎症的逐渐消退，这些受影响的眼表异常均会逐渐恢复正常。泪膜破裂时间、瞬目次数、眼睑闭合情况的影响在两种术式之间的差异有统计学意义，而在术后是否局部用药之间没有统计学差异；角膜荧光素染色在是否加用局部用药组之间有统计学差异，而不同术式之间没有统计学差异；泪液分泌量、结膜充血、睑板腺功能、睫毛角度则在所有组别之间均没有统计学差异。

结论：两种上睑下垂的矫正术均会引起患者眼表的改变，额肌肌瓣悬吊术对泪膜破裂时间、瞬目次数、眼睑闭合情况影响的程度较大，而局部用药只能改善角膜荧光素染色异常、对其它眼表因素影响不大。上睑睫毛角度异常是引起角膜损害最危险的因素。

Objective : To investigate the difference of ocular surface change and restoration after ex-ternal levator advancement and frontalis suspension.

Methods : Forty-two patients (62 eyes) with congenital ptosis hospitalized in ZhongshanOphthalmic Center from Jaruary to April in 2007 were randomly divided into four groups according to different surgery types and with or without post surgery ophthalmic medica-tion. Sehirmer test, tear film break-up time , conjunctiva congestion , cornea fluorescentpigmentation , tarsal gland function , winking frequency, angle of eyelash and eyelid clo-sure were all observed and statistically analyzed in all groups 2 days , 5 days , 7 days and 2 weeks after surgery.

Results : Except 3 patients needed advanced ophthalmic medicine, one of whom waswith corneal ulceration and needed another surgery, all the others were observed withocular surface items altered in varied degrees and gradually returned to normality as theinflammation caused by surgery recovered. Break-up time , winking frequency and eyelid closure were statistically diferent between the two types of surgery but not betweengroups with and without post surgery ophthalmic medication. Cornea fluorescent pigmen-tation was statistically different between groups with and without post surgery ophthalmicmedication but not between the two types of surgery. The other items did not have statis-tical difference in all groups.

Conclusion : The two types of surgery for ptosis correction could alter the ocular surface ,but frontalis suspension affect tear film break-up time , winking frequency and eyelid clo-sure much more than levator advancement. Ophthalmic medication after the surgerycould only ameliorate cornea fluorescent pigmentation but was not necessarily to restora-tion of normal ocular surface. Abnormality of eyelash angle was the most dangerous fac-tor to the corea injury.

       双眼自发晶状体悬韧带松弛，导致前房波动，进行性近视加重，继发闭角型青光眼的病例在临床比较少见。本病例报道了1例25岁女性双眼自发晶状体悬韧带松弛不伴有晶状体脱位及形态异常，出现双眼前房波动，近视加重，最终继发双眼闭角型青光眼。经过局部抗炎、散瞳处理和“PHACO+IOL(Phacoemulsification+intraocular lens)植入+前段玻璃体切除术”将IOL置于睫状沟后，患者眼压得到控制、视力基本矫正至正常。

Changeable anterior chamber depth due to spontaneous zonular laxity of thelens is a rare abnormality in clinic. Here is a 25 -year-old female with changeable anteri.or chamber depth due to bilateral spontaneous zonular laxity which also finally led toprogressive myopia and angle-closure glaucoma is deseribed. After using local anti-in-fammation and dilation of the pupil, and carrying out “ Phacoemulsification + anteriorvitrectomy" putted intraocular lens ( IOL) into the ravine of ciliary body , the womansintraocular pressure was controlled and visual acuity was corrected to 20/20. 

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Purpose: To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults．

Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study.  Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA’s integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values.

Results: Longer axial length (P=0.0001), lower IOPG (P=0.03),  older age (P=0.003), and thinner central corneal thickness (P=0.0001) were significantly associated with lower CH. The anterior chamber depth (P=0.34), gender (P=0.23), and corneal curvature (P=0.18) had no relationship to CH.

Conclusion: Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

Purpose: To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults．

Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study.  Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA’s integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values.

Results: Longer axial length (P=0.0001), lower IOPG (P=0.03),  older age (P=0.003), and thinner central corneal thickness (P=0.0001) were significantly associated with lower CH. The anterior chamber depth (P=0.34), gender (P=0.23), and corneal curvature (P=0.18) had no relationship to CH.

Conclusion: Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

目的:探讨眼铁质沉着症(ocularsiderosis)的临床特点及治疗方案。
方法:对我院2002年1月至2006年12月的64例眼铁沉着症患者进行回顾性分析。
结果:56例手术取出残留的异物，其中33例异物最大长径<2.0 mm，位于下方睫状体扁平部或锯齿缘附近26例；眼眶X光正侧位照片联合薄骨位照片异物显影阳性率76.56%，超声生物显微镜(Ultrasound biomicroscope，UBM)异物显影阳性率47.62%；晶状体前囊铁锈沉着发生率100%；继发性青光眼发生率7.69%；视网膜脱离发生率13.84%；视网膜电流图(Electroretino-gram，ERG)karpe分期亚期占7/10和I期占3/10；56例患者作了眼内异物取出，异物取出率100%，术中发现16.07%病例异物磁性消失。
结论:眼铁质沉着症残留的异物以最大长径≤2.0 mm为主，主要位于下方睫状体扁平部或锯齿缘附近；眼眶X光照片为首选的检查方，UBM可作为眼前段异物影像学检查辅助手段；ERG改变以karpe分期的Ⅲ期和期为主；玻璃体手术是取出眼内异物最有效的治疗手段。

Purpose : To study the clinical characteristics of ocular siderosis and discuss the way for treatment.

Methods : Sixty-four patients (64 eyes) with ocular siderosis treated in Ophthalmic Cen-ter of Zhongshan University from January 2002 to December 2006 were retrospectivelyanalyzed.

Resuls: The intraocular foreign body( IOFB)was found in 56 cases, with maximum length<2.0 mm in 33 cases; 26 eyes with foreign body located on pars plane or near the ora serrate. The positive rate of foreign body was 76.56% by orbital posteroanterior and lateral radiogram combined with Belot 's radiogram and 47.62% by ultrasound biomicroscope( UBM). The occurrence rate of iron deposits in the epithelial cells of the anterior capsule was 100% , secondary glaucoma was 7. 69% and retina detachment was 13.84% respectively.Electroretinogram (ERG) was abnormal in 10 case , 7 cases withstage Il and 3 cases with stage IV. The intraocular foreign body extraction was done in 56 cases and the success rate was 100%. The magnetism of the intraocular foreign body disappeared in 16.07% of the cases.
Conclusions : The intraocular foreign body <2.0 mm was most frequently found in ocu-lar siderosis and mainly located on pars plane or near the ora serrate. Orbital radiogram has advantage to diagnose the intraocular foreign bodies, and UBM can be used as an assistant image-related approach for checking the intraocular foreign body on the anterior segment. Most cases were in $tage lll and IV by ERG. Vitrectomy is the most effective approach to remove the intraocular foreign bodies.

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、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。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相关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、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。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相关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。