患者青年女性，工作时不慎从 4 m 高处跌落，伤后 1 周眼科检查时发现左眼上睑下垂、眼球固定、眼球突出、结膜下出血，复视，伤后 2 周进展为右眼结膜下出血水肿，并出现左侧搏动性血管杂音，进行全脑血管造影证实为左侧颈动脉海绵窦瘘，并予以介入海绵窦瘘栓塞术治疗，治疗效果满意后出院。

The patient, a young woman, was referred to ophthalmology department at 1 week after her falling from 4 meters high during her work. Her left eye was diagnosed with ptosis, eyeball fixation, exophthalmos, subconjunctival hemorrhage and diplopia. After 2 weeks, her conditions progressed to subconjunctival hemorrhage and edema of the right eye, with pulsatile vascular murmur on the left side. Left carotid-cavernous fistula was confirmed with digital subtraction angiography, and treated with interventional embolization. Satisfactory outcomes were obtained and the patient was discharged.

栏目导读：为进一步满足期刊发展需求、活跃学术氛围、增强本刊的互动性和艺术性，本刊特面向社会公开征集《眼科学报》封面艺术画或摄影作品。被选中的作品，将以“封面故事”专栏的形式，或展示作品背后的精彩瞬间、或抒发医者仁心的艺术情怀。

       患者女，54 岁，因“左眼视物模糊 4 个月余”入院，视力 0.5，虹膜表面可见大量棕色色素结节，且多数带蒂。房角镜下见下方、鼻侧及颞侧房角大量色素沉着。超声生物显微镜检查：左眼虹膜表面欠光滑并见多个高反射点。光学相干断层扫描：左眼见上方及下方视神经纤维层厚度变薄。用药后眼压：34 mmHg。诊断为 Cogan-Reese 综合征并继发性青光眼，予多种药物以降低眼压，无效后行复合式小梁切除术。术后 3 个月内随访，视力、视野保持稳定，眼压 8 ~ 20 mmHg。前房中深，滤过泡功能良好，视野显示 MD = –10.77 dB，局部未用降眼压药。抗青光眼手术能控制眼压防止病情进一步进展，但长期有效性仍需继续随访观察。

A 54-year-old woman presented to our department with complaints of blurred vision for more than 4 months in her left eye. Upon examination, the patient had best corrected visual acuity of 0.5 OS, intraocular pressure (IOP) OS was 34 mmHg after medication. On slit-lamp examination, there were multiple iris nodules, most of them pedunculated and intensively distributed in the inferior direction. On gonioscopic examination, a large number of pigments were noticed at the inferior, nasal and temporal direction. Fundus examination revealed glaucomatous cupping of 0.7. Optical coherence tomography showed marked loss of thickness of retinal nerve fiber layer fibers in the inferior, and superior direction. Based on the clinical features, the diagnosis of secondary angle closure due to Cogan-Reese syndrome was reached. As the medical therapy was ineffective, it was planned to go for surgical management in the form of trabeculectomy with 5-FU. At the 3-month follow-up, best corrected visual acuity OS was 0.5, IOP OS was 8–20 mmHg, the anterior chamber depth was medium and the filtering bleb was functional. A visual field was performed, which showed MD=–10.77 dB and the patient wasn’t given topical medication. A long-term follow-up is necessary because the disease itself is progressive in nature.

角膜损伤是眼科临床常见疾病，角膜愈合过程对视力恢复至关重要。角膜损伤后的愈合过程是多种细胞及细胞因子的共同作用，IL-6 在介导炎症反应及组织修复及角膜损伤修复过程中均发挥重要作用。

Corneal injuries are common in ophthalmology clinic, and corneal healing is critical for visual recovery. The healing process after corneal injury is the combined effect of various cells and cytokines. IL-6 plays an important role in mediating inflammatory response and tissue repair. In recent years, studies have shown that IL-6 plays an important role in the process of corneal healing.

      飞秒激光是一种以脉冲形式转运的红外线激光，可穿透透明组织，在组织内完成高精度切削，制作出不同形状的角膜植片和植床，在角膜移植方面取得了良好的应用效果。近年来多项相关研究阐述了飞秒激光辅助角膜移植术的有效性、安全性、稳定性，并提出一些新的技术和观点。

      Femtosecond laser is a kind of infrared laser transported in pulse form, and it can penetrate transparent tissue and perform high precision cutting in tissues. It can make corneal implants and beds with different shapes, and has achieved good results in corneal transplantation. In recent years, a number of related studies have described the effectiveness, safety and stability of femtosecond laser assisted keratoplasty, and have put forward some new techniques and viewpoints. 

药源性葡萄膜炎是一种较少见的疾病。尽管如此，九十年代在艾滋病患者中使用预防结核药物利福布丁而引发葡萄膜炎，加深了对药物在葡萄膜炎炎症发生中潜在作用的认识。以 Naronjo 建立的药源性疾病的诊断标准衡量，可以获知至少 120 种药物与葡萄膜炎发生相关，本文重点介绍其中最为常见的 7 类药物，包括抗骨质疏松类（二碳磷酸盐类），抗病毒类（西多福韦），抗结核药（利福布丁），抗青光眼药，眼内注射药，抗 TNFα 药物以及疫苗。了解这些常见的药源性葡萄膜炎药物，有利于临床识别这种特殊类型的葡萄膜炎。

Drugs induced uveitis is a rare disease. Nevertheless, uveitis induced by rifabutin which used as preventing tuberculosis drug in AIDS patients in 1990s, to some extent, enhance the knowledge of the potential effect of some drugs causing uveitis. According to the diagnostic criteria of drug-induced diseases developed by Naronjo, more than 120 drugs had been found to be related with uveitis. This review mainly introduces 7 common drugs, including anti-osteoporosis drugs （bisphosphonates）, anti-virus drugs （cidofovir）, anti-tuberculosis drugs （rifabutin）, anti-glaucoma drugs, intravitreal drugs, anti-TNFα antibody, and vaccines. Therefore, knowing the common known drugs can help better understand and distinguish the disease.

目的：比较过碘酸 -Schiff 法（Periodic Acid-Schiff，PAS)，六亚甲基四胺银法（Grocott Methenamine silver，GMS），Gomori 氏氢氧化银氨法（Gomori）三种特殊染色方法显示角结膜原位癌基底膜完整性的优缺点，寻找较合适的染色方法。方法：选取中山大学中山眼科中心 2012 年 1 月至 2017 年 9 月期间收治的 20 例角结膜原位癌标本，分别采用 PAS、GMS、Gomori 三种染色，显微镜下观察角结膜原位癌基底膜显示状态。结果：三种染色方法都能显示角结膜原位癌基底膜，但其鲜艳程度不同，与背景反差程度不同。GMS 染色基底膜呈深棕色而与黄棕色背景反差较小；Gomori 染色基底膜显黑色与背景区分较明显，但有较多银颗粒沉积而影响观察；PAS 染色基底膜呈紫红色，基底膜形态清晰可见，背景浅，反差明显。结论：三种染色均可良好地显示角结膜原位癌基底膜，其中 PAS 染色显色更为鲜明、与背景反差更明显、操作更为方便，是一种理想的基底膜染色方法。

Objective: To compare the advantages and disadvantages of Periodic Acid-Schiff (PAS), Grocott Methenamine silver (GMS) and Gomori special staining methods in displaying the basement membranes in corneal and conjunctival carcinoma in situ, and to find the more suitable staining method. Methods: Twenty samples of corneal and conjunctival carcinoma in situ in the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University from January 2012 to September 2017 were stained with three special staining methods of PAS, GMS and Gomori. We observed the staining results of basement membranes under microscope in cornea and conjunctiva carcinoma in situ. Results: The basement membranes in cornea and conjunctiva carcinoma in situ could be showed in all the three special staining methods. They were dark brown in GMS staining with yellow-brown background. They were black in Gomori staining with deposited silver particles in the background. The basement membranes were bright purple in PAS staining with light purple background and good contrast to background. Conclusion: PAS is an ideal method in showing basement membranes in corneal and conjunctival carcinoma in situ with bright color and strong contrast to background in these three special staining methods.

目的：分析比较眼球钝挫伤引起的外伤性晶状体半脱位 I 期与 II 期行经巩膜人工晶状体睫状沟缝线固定术的治疗效果。方法：收集自 2015 年 1 月至 2016 年 12 月在汕头国际眼科中心因眼球钝挫伤所致外伤性晶状体不全脱位行 I 期和 II 期行经巩膜人工晶状体睫状沟缝线固定术的患者 29 例（29眼），其中 I 期 11 例（11眼）、II 期 18 例（18眼）。观察 2 组视力、眼压及并发症发生率。结果：随访 3 ~ 30 个月，I期组术后视力提高达 90.9%，II 期组达94.4%。I 期组术后前房炎性反应发生率明显高于 II 期组，差异有统计学意义（P < 0.05）。2 组长期随访未见远期并发症。结论：I 期与 II 期行人工晶状体睫状沟缝线固定术均是治疗外伤性晶状体半脱位的理想方法。与 I 期手术相比，II 期手术的前房炎性反应发生率较低。

Objective: To compare the safety and efficacy of primary and secondary implantation of suspension intraocular lens (IOLs) in eyes with traumatic lens subluxation after blunt ocular trauma. Methods: A total of 29 eyes of 29 cases with traumatic lens subluxation were collected and analyzed retrospectively. All cases underwent the transscleral ciliary sulcus fixation of IOLs from January 2015 to December 2016 in our hospital. IOLs were implanted primarily in 11 eyes and secondarily in 18 eyes. Visual acuity, intraocular pressure and complications were discussed. Results: Patients were followed up for 3–30 months. The postoperative best corrected visual acuity was improved by 90.9% in phase I group and 94.4% in phase II group. Short-term post-operative anterior chamber inflammation much higher in phase I group than phase II group. No long-term complications occurred in all cases. Conclusion: Primary or secondary ciliary sulcus fixation of IOLs is safe and effective method in eyes with traumatic lens dislocation.

目的：研究雌二醇（estradiol，E2）和丙酸睾酮（testosterone propionate，TP）对兔泪腺上皮细胞凋亡及对MMP-9蛋白表达的影响，探讨雌二醇及丙酸睾酮对干眼的作用机制。方法：体外培养兔泪腺上皮细胞，分别给予雌二醇及丙酸睾酮处理，双氧水（H₂O₂）诱导细胞凋亡，流式细胞仪检测细胞凋亡和免疫细胞化学法检测细胞MMP-9蛋白表达。实验分 4 组：凋亡对照组（AC组）、雌二醇组（E2组）、丙酸睾酮组（TP组）和空白对照组（BC组）。AC组只给予H₂O₂诱导凋亡，E2组给予1×10⁻⁵mol/L雌二醇处理，TP组给予丙酸睾酮处理，BC组未加药物干预及未加H₂O₂诱导凋亡。结果：经H₂O₂诱导细胞凋亡后，泪腺上皮细胞早期凋亡率和MMP-9 蛋白表达累积光密度值与BC组相比，AC组、E2组及TP组均显著增加；同比AC组，E2组及TP组细胞凋亡率和MMP-9蛋白表达量降低；E2组凋亡率及蛋白表达量比TP组明显降低；其差异均具有统计学意义（P<0.01）。结论：雌二醇和丙酸睾酮对H₂O₂诱导兔泪腺上皮细胞凋亡有一定的抑制作用，同时泪腺上皮细胞中MMP-9 表达含量也降低，提示雌二醇和丙酸睾酮抑制兔泪腺上皮细胞凋亡的作用机制可能与MMP-9 有关。

Objective: To investigate the effects of estradiol （E2） and testosterone propionate （TP） on apoptosis and matrix metalloproteinase-9 （MMP-9） expression in rabbit lacrimal gland epithelial cells. Methods: The rabbit lacrimal gland epithelial cells were cultured in vitro. H₂O₂ was used to induce apoptosis in cultured lacrimal gland epithelial cells and then treated with E2 and TP respectively. Cell apoptosis was detected by flow cytometer （FCM） and MMP-9 expression was evaluated by immunocytochemistry. There were four groups: apoptosis control group （AC）, estradiol group （E2）, testosterone propionate group （TP） and blank control group （BC） respectively. The cells of group AC were administrated with H₂O₂ only, group E2 and group TP with 1×10⁻⁵ mol/L E2 and TP respectively and group BC in treated. Statistical analysis were performed with one-way analysis of variance （ANOVA test）using SPSS 16.0, P<0.05 was considered statistically significant. Results: Compared with group BC, the early cells apoptosis rate and integrated optical density of MMP-9 expression of lacrimal gland in group AC, E2 and TP increased significantly after the cells were induced by H₂O₂; Compared with group AC, group E2 and TP reduced; group E2 were significantly lower than group TP; the differences were all statistically significant （P<0.01）. Conclusion: E2 and TP had a certain inhibitory effect on rabbit lacrimal gland epithelial cells apoptosis induced by H₂O₂. Meanwhile, MMP-9 expression of the lacrimal gland cells was decreased. These results indicated that E2 and TP on the apoptosis inhibitory mechanism of lacrimal gland cells may be related with MMP-9. 

目的：探讨翼状胬肉患者手术前后泪膜质量和视力变化。方法：将 50 例（50 眼）鼻侧单头翼状胬肉患者按翼状胬肉面积大小分为大面积组与小面积组，患者均接受翼状胬肉切除联合自体角膜缘移植术。记录并比较各组患者术前、术后1周、术后 1 个月的裸眼视力、矫正视力和泪膜破裂时间。结果：与术前相比，患者术后1周、术后 1 个月裸眼视力、矫正视力均有升高，差异有统计学意义（P<0.01)。术后平均泪膜破裂时间较术前变短，术前和术后1周、术前和术后 1 个月差异有统计学意义（P<0.05），术后1周及术后 1 个月差异无统计学意义（P>0.05）。此外，翼状胬肉面积与术前裸眼视力、矫正视力、平均泪膜破裂时间之间均不存在相关性（P>0.05）。结论：翼状胬肉手术可有效提高患者裸眼视力、矫正视力，使患者获得更清晰的视觉体验；但在术后一段时间内泪膜质量有所下降，术后应积极使用人工泪液维持泪膜稳定性。

Objective: To investigate the variation trend of the tear film quality and visual acuity before and after the pterygium surgery. Methods: Fifty eyes of fifty patients with single nasal pterygium were divided into the large groups and the small groups according to the size of pterygium. All patients were performed the pterygium excision and self-bulbar conjunctiva transplantation. The value of uncorrected visual acuity （UCVA）, corrected visual acuity （CVA） and average tear film rupture time were evaluated before and 1-week after and 1-month after surgery in each group and compared with each other. Results: Compared with preoperative values, the values of UCVA and VCA were significantly improved at 1-week and 1-month after （both P<0.01）. The value of average tear film rupture time was significantly decreased before and 1 week after surgery, and before and 1 month after surgery （both P<0.05）. The values did not significantly differ at 1 week and 1 month after surgery （P>0.05）. Besides, theUCVA, VCA and average tear film rupture time before surgery were not significantly correlated with size of the pterygium （all P>0.05）. Conclusion: Pterygium surgery can improve UCVA, CVA and visual acuity. But the quality of tear film is decreased after the surgery. Consequently, the artificial tears should be used positively to maintain the stability of the tear film.