后极部中心性脉络膜营养不良是一种罕见疾病。本文对 2 例患者进行了荧光素眼底血管造影、眼底自发荧光、相干光层析成像及视觉电生理等检查。眼底检查可见双侧后极部血管弓范围视网膜色素上皮（retinal pigment epithelium，RPE）及脉络膜毛细血管的对称性萎缩。自发荧光可见相应区域的对称性低荧光。光学相干断层成像术（optical coherence tomography，OCT）显示后极部外层视网膜和脉络膜毛细血管的萎缩变薄。

Posterior polar central choroidal dystrophy is a rare disease. Clinical data of two patients with posterior polar central choroidal dystrophy fluorescein angiography, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT), and electrophysiological tests were reported. Fundus examination showed bilateral symmetric atrophy of the retinal pigment epithelium and choriocapillaris in the posterior polar areas between vascular arcades. FAF imaging showed clearly defined hypoautofluorescent areas that corresponded to the aforementioned lesions. Atrophy of the choriocapillaris and outer retinal layer were detected by optical coherence tomography.

强直性瞳孔在临床工作中较为少见，容易被误诊，典型的强直性瞳孔为单侧，随着病程的进展，逐渐转变为双侧。新发双侧强直性瞳孔更是极为罕见，应当引起重视。其典型的临床表现包括瞳孔散大、瞳孔运动迟钝、节段性瞳孔麻痹、无其他眼部器质性病变。依据病因可以分为继发于急性眼内肌麻痹、合并有全身疾病以及特发性三类。目前治疗方面多以病因治疗为主。

Tonic pupil is rare in clinical work and likely to be misdiagnosed. The typical tonic pupil is unilateral, which gradually turns to bilateral with the progress of disease. Newly bilateral tonic pupil is extremely rare, which captivates widespread attention. Typical clinical manifestations include dilated pupils, slow pupil movement, segmental pupillary palsy, and no other ocular diseases. On this basis, the causes can be divided into three categories, including secondary to acute intraocular myoparalysis, complicated with systemic disease and idiopathic type. At present, etiological treatment is the main treatment.

目的：探讨眼外伤门急诊与住院病房一体化管理模式下，眼外伤患者的护理方法。方法：对2018年4月中山大学中山眼科中心 109 例眼外伤急诊手术患者采取有效的护理措施，通过交谈、示范、发放宣传资料等方法，对患者实施心理护理、术前护理、术后护理、出院指导及延续护理。结果：109 例患者均顺利接受手术，其中门急诊患者 43 例当天行手术治疗并于第 2 天眼外伤急诊专科门诊复诊，收入院患者 66 例行手术治疗均治愈出院。结论：在门急诊与住院病房一体化的管理模式下，对患者做好心理护理、术前术后护理及出院指导，使患者安心接受手术，得到相应的健康指导，提高了患者的满意度，值得推广。

Objective: To explore the nursing methods for ocular traumatic patients in the integrated management mode of ocular trauma emergency room and ward. Methods: We took effective nursing measures for the patients who treated with surgeries in our ocular traumatic emergency room, including comprehensive conversation, demonstration, distribution of detailed propaganda, discharge guidance as well as preoperative, postoperative, and discharge psychological nursing, from 1st April, to 30th April, 2018. Results: A total of 109 patients were included in this study. Forty-three of them underwent the emergency surgery on the day of admission and reviewed in the outpatient at postoperative 2 days. The other 66 patients were hospitalized, recovered and discharged. Conclusion: In this integrated management mode, comprehensive psychological nursing, perioperative nursing and discharged guidance would help to comfort patient and improve the degree of satisfaction, which is worthy of widespread application.

目的：探讨以护士为主导的按术式排程手术日模式在眼整形病区的应用与成效。方法：采用便利抽样法，选择实施以护士为主导的按术式排程手术日模式后的 2018年1至6月作为试验组，实施该模式前的 2017年1至6月作为对照组。统计并比较该模式实施前后平均每周手术量、病区关闭时长、水电费用、医务人员对工作的满意度及患者的满意度。结果：该模式实施后平均每周的手术台数由实施前的 26 台升至 31.8 台，关区时长由实施前的 4.5 h 升至 33.2 h，水电费由实施前的 625.3 元降至 518.5 元，差异有统计学意义（t＝2.61，3.94，4.22，P < 0.05）；医护人员对工作的满意度由实施前的 80% 上升至 90%，患者满意度由实施前的 83.3% 上升至 93.3%，差异有统计学意义（χ2＝4.61，5.01，P < 0.05）。结论：以护士为主导的按术式排程手术日模式在眼整形病区切实可行，在保障医疗、护理安全性的同时，可节省医院的运营成本，亦可提高护士、医生、患者的满意度，值得在临床推广。

Objective: To explore the effect of the mode of nurse-led surgery scheduling based on procedure in ocular plastic ward. Methods: Convenience sampling method was adopted, the nurse-led surgery performed from January to June 2018 was assigned in the experimental group, and those conducted from January to June 2017 were assigned into the control group. The average number of operations per week, the length of the ward closure, utilities, medical staff and patients' satisfaction were calculated and compared. Results: After the implementation of this mode, the average number of operations per week increased, the length of the ward closure increased, utilitiesdecreased, and the difference was statistically significant (t=2.61, 3.94, 4.22, P<0.05). The degree of satisfaction of medical staff and patients was significantly improved (χ²=4.61, 5.01, P<0.05). Conclusion: The mode of nurse-led surgery scheduling based on procedure can save hospital operating costs and improve the satisfaction of nurses, doctors and patients, which is worthy of clinical promotion.

目的：检测四川地区脉络膜黑色素瘤患者GNAQ，GNA11基因的突变情况。方法：对 22 名脉络膜黑色素瘤患者行眼球剜除术，眼球组织用甲醛固定，石蜡包埋保存。从肿瘤石蜡切片中提取 DNA 进行 PCR 扩增反应，并对 GNAQ，GNA11 突变位点进行测序分析。结果：在 16 名患者的肿瘤组织中检测到 GNAQ 或 GNA11 基因突变，总突变率为 72.73％，其中 GNAQ 突变率为 45.45％，GNA11 突变率为 27.28％。结论：GNAQ，GNA11 基因在四川地区脉络膜黑色素瘤患者中的突变率较高。

Objective: To sequence the GNAQ and GNA11 mutation in patients with uveal melanoma from Sichuan Province. Methods: A total of 22 samples were collected from uveal melanoma patients. DNA was extracted from formalin-fixed paraffin-embedded tissue. Primers of GNAQ and GNA11 were synthesized. Polymerase chain reaction was performed and the products were sent to sequencing. Results: A total of 16 cases among the patients with uveal melanoma were found with GNAQ or GNA11 mutation. The overall mutation rate was 72.73％. And the mutation rates for GNAQ and GNA11 were 45.45％ and 27.28％, respectively. Conclusion: The patients with uveal melanoma in Sichuan province have a high level of GNAQ /GNA11 mutation rate.

目的：比较学生在不同散光欠矫下使用C字视力表和E字视力表所测的视力差别并分析其原因。

方法：选取 30 名 15~18 岁的学生，在完全矫正屈光度 MPMVA（maximum plus to maximum visual acuity）状态下，附加相应不同散光轴向的柱镜造成相应的散光度数后，比较使用两种不同的视力表测出的视力值。同时根据两种视力表不同的设计原理及记录方法，分析造成数值差异的可能原因。

结果：与 E 字视力表组相比，C 字视力表组附加各个轴向 +0.25 DC 柱镜组测得视力值均值差异较小，附加 +0.50 DC 差异较大，其中斜轴方向上的差异更大，差异有统计学意义（F = 23.141，P < 0.01）。在各个附加度组别中使用 C 字视力表测得视力平均值小于 E 字视力表测得视力平均值，其中斜轴方向的附加组差值更大。C 字视力表在各散光轴位测得视力值差异无统计学意义（F = 1.446，P = 0.231）；E 字视力表组在各散光轴位测得视力值相差明显，在斜轴散光中数值与非斜轴散光数值差异有统计学意义。

结论：散光患者使用 C 字视力表更加优异，不同轴向的散光测出来的视力值更加稳定。对于非斜轴散光患者来说，使用 C 字视力表比 E 字视力表更难，用小数记录法记录视力值可能相差 3 ~ 4 行，原因为散光眼在各个方向上的屈光度不一致及 C 字视力表和 E 字视力表的视标形状及排列不同导致。

Objective: To compare the differences of visual acuity measured by C-chart and E-chart under different astigmatism and analyze the reasons for the differences.

Methods: Thirty students aged 15–18 years were selected. Under the condition of fully corrected refractive MPMVA (maximum plus to maximum visual acuity)，the corresponding astigmatism was caused by adding corresponding columnar lenses with different astigmatism axes. The corresponding visual acuities measured by two different visual charts. According to the design principle and recording methods of two kinds of visual acuity charts, the possible reasons for the different values are analyzed.

Results: Compared with the E-type visual acuity chart, the average difference of visual acuity measured by adding each axis +0.25 DC columnar lens group was smaller, and the difference between adding +0.50 DC group was larger, especially in the oblique axis direction（F = 23.141，P < 0.01）。The average visual acuity measured by the C-type visual acuity chart in each additional degree group was smaller than that measured by the E-type visual acuity chart, and the difference of the additional group in the oblique axis direction was greater than that measured by the E-type visual acuity chart. There was no significant difference in the visual acuity measured by C-type chart at different astigmatism axes（F = 1.446，P = 0.231）；there was a significant difference in the visual acuity values measured by E-type chart at different astigmatism axes, and there was a significant difference in the values of oblique astigmatism and non-oblique astigmatism.

Conclusion: Astigmatism patients with C-type chart obtain more accurate results, and the visual acuity values measured by different axes of astigmatism are more stable. For patients with non-oblique astigmatism, it is more difficult to use C-type chart than E-type chart. The difference of visual acuity recorded by decimal recording method may be 3–4 rows. The reasons are the inconsistency of diopter in different directions of astigmatism and the different shape and arrangement of visual icons between C- and E-type charts.

目的：探讨眼科显微器械清洗固定架在临床的应用效果。方法：将研究对象分为实验组与对照组，用于同类手术。实验组显微器械用眼科显微器械清洗固定架固定后进行机械清洗；蓝色对照组 40 把显微器械采用手工清洗方法，对器械的清洗效率、清洗质量及损耗情况进行比较。结果：实验组清洗效率、清洗质量、器械完好率均优于对照组。结论：眼科显微器械清洗固定架的应用可提高眼科显微器械的清洗质量、减少器械损坏、提高工作效率、降低工作人员职业暴露风险。

Objective: To explore the effect of cleaning fixture to clean ophthalmic micro-instruments. Methods: The ophthalmic micro instruments from the same surgery were divided into the exPerimental group and control group. The micro instruments of the experimental group were fixed with the cleaning fixture and cleaned mechanically. Those micro-instruments of the control group were cleaned by manual method. The cleaning efficiency, cleaning quality and damages of the instruments were analyzed in two groups. Results: The experimental group obtained a better cleaning efficiency, cleaning quality and less damages than the control group. Conclusion: Using cleaning fixture to clean ophthalmic micro-instruments is conducive to improve the cleaning efficiency, cleaning quality and reduce the damages of the instruments.

目的：分析目前滴眼剂中防腐剂的添加情况，为眼科临床针对不同疾病选择合适的滴眼剂提供参考，倡导合理用药。方法：对临床使用的 194 种滴眼剂说明书中防腐剂成分标注进行统计分析，并对防腐剂的种类、新型防腐剂、眼表毒性研究情况进行归纳综述。结果：滴眼剂中防腐剂大致可分为 5 类，如季铵盐类、醇类、羟苯酯类、有机汞、纯氯氧复合物等。进口滴眼剂的防腐剂以苯扎氯铵为主。国产滴眼剂中新药多以苯扎氯铵为防腐剂，老药则以羟苯乙酯防腐为主；国产药说明书中，有 20.83% 未注明所含防腐剂种类。目前防腐剂中苯扎氯铵抗菌活性虽强，但引起眼表损害的报道也最多，新型防腐剂的研发及无防腐剂滴眼剂可减少眼表的损害。结论：滴眼剂中防腐剂种类繁多、标准不统一，临床医生应熟悉每种眼用制剂防腐剂成分和含量，尤其对青光眼及中重度干眼症使用含防腐剂的滴眼剂时，应关注其对眼表的损害，尽量选择新型防腐剂或不含防腐剂的滴眼剂以减少不良反应的发生。

Objective: To provide guidance for ophthalmologist to choose suitable eye drops for different eye diseases and promote rational drug use by analyzing present situation of preservatives in eye drops. Methods: According to the instructions of 194 kinds of eye drops, statistical analysis was retrospectively carried out on the types, new type, and ocular surface toxicity of preservatives in eye drops. Results: The preservatives of eye drops could be basically divided into 5 categories, such as quaternary ammonium salts, alcohols, hydroxyphenyl esters, organic mercury compounds, pure chlorine oxygen complexes, etc. Besides, most of the preservatives in imported eye drops were benzalkonium chloride, and the new categories of domestic eye drops also utilized benzalkonium chloride as the preservative. However, ethylparaben was used to be considered as preservatives in old-brand domestic eye drops.Moreover, 20.83% domestic drugs’ instructions failed to describe its preservatives. In addition, benzalkonium chloride yielded stronger antibacterial activities compared with other preservatives, but a huge number of animal and in vitro studies demonstrated that benzalkonium chloride may cause or enhance harmful consequences on the eye structures of the anterior segment. Fortunately, preservative-free formulations and new categories would provide clinically benefits. Conclusion: Owing to the various kinds of preservatives and lacking of unified standard of application, clinicians should master the types and content of each preservative in ophthalmic drugs, especially in glaucoma, moderate, and severe dry eyes. Besides, considering ocular surface damage, ophthalmologists should choose new types or preservative-free eye drops to reduce the occurrence of adverse reactions.

目的：观察猪脱细胞角膜基质进行人板层角膜移植术后角膜植片上皮化的临床过程。方法：收集 2017 年 1 月至 2018 年 1 月在佛山市第二人民医院经药物治疗无效的感染性角膜炎患者 5 例。采用脱细胞角膜基质（商品名：艾欣瞳）行板层移植术，以对侧眼为对照。术后 3 d，7 d，1 个月，3 个月，6 个月对患者进行随访，在裂隙灯显微镜下观察移植后植片上皮化完成过程。术后 1，3，6 个月共聚焦显微镜观察植片上角膜上皮细胞密度及上皮下神经纤维修复情况。结果：脱细胞角膜基质板层角膜移植术后 3 d 开始出现上皮化，术后 10 d 上皮化逐步完成，但角膜上皮排列疏松，荧光素染色仍有点状染色。激光扫描共聚焦显微镜检查结果显示：术后 1，3，6 个月角膜上皮细胞排列规则、紧密，与对侧眼比较角膜上皮细胞密度差异无统计学意义（P > 0.05）。结论：应用脱细胞角膜基质行板层角膜移植术后植片上皮化过程能够顺利完成。

Objective: To observe the epithelization process of grafts after human lamellar keratoplasty with acellular porcine corneal stroma (APCS). Methods: Five patients with infectious keratitis who were unresponsive to medication treatment were enrolled from January 2017 to January 2018 at the Second People’s Hospital of Foshan. Corneal lamellar transplantation was performed with APCS (product name: Acornea) as grafts and the contralateral eyes as control. Patients were followed up at postoperative 3 d, 7 d, 1 month, 3 months and 6 months. The morphology and density of corneal epithelial cells and subepithelial neural fibers were examined by laser confocal microscope at 1, 3 and 6 months after surgery. Results: Epithelization of grafts was seen at postoperative 3 daysand gradually completed at 10 days after surgery, while the corneal epithelial cells were still loosely arranged with punctate fluorescein staining. Results of confocal laser scanning microscopy showed that corneal epithelial cells were regularly and tightly arranged at 1, 3 and 6 months after surgery without statistically significant difference compared with those in the contralateral eyes (P > 0.05). Conclusion: Complete epithelialization of corneal grafts can be successfully achieved after lamellar keratoplasty with acellular corneal stroma.

目的：探讨珠海地区早产儿视网膜病变（retinopathy of prematurity，ROP）的患病情况及临床特点。方法：回顾分析珠海市妇幼保健院2009年5月至2018年12月 5 473 例（10 946 只眼）早产儿的眼病筛查资料。结果：共筛查出 185 例（370 眼）患有不同程度的 ROP，患病率为 3.38%。33 例（66 眼）需要治疗，占 17.84%。低出生体重组出生孕周为 26～31，32～33，34～36的 ROP 患儿分别为 133，13，9 例，ROP 发病率分别为 14.9%，1.4%，1.3%，差异具有统计学意义（P < 0.05）。高出生体重组出生孕周为 26～31，32～33，34～36 的 ROP 患儿分别为 1，5，24例，ROP 发病率分别为 7.1%，1.1%，1.0%，差异无统计学意义（P > 0.05）。33 例严重 ROP 患儿（需要干预治疗的 ROP）中，低出生体重组出生孕周为 26～31，32～33，34～36 的严重ROP患儿分别为 29，3，1 例，发病率分别为 3.2%，3%，0.1%，差异具有统计学意义（P < 0.05）。高出生体重组无严重 ROP 患儿。结论：珠海地区近十年的早产儿 ROP 患病率为 3.38%，出生体重和胎龄是 ROP 发病的危险因素。严重ROP患儿的出生体重均 <2 000 g。

Objective: To investigate the clinical characteristics of retinopathy of prematurity (ROP) in Zhuhai. 

Methods: The eye screening data for 5,473 (10,946 eyes) premature infants born from May 2009 to December 2018 in the Maternal and Child Health Hospital of Zhuhai were retrospectively analyzed.

Results: In the 5 473 premature babies examination, 185 cases (3.38%) were detected with different degrees of ROP. The number of cases requiring treatment was 33 (17.84%). In the low birth weight group, the ROP patients with 26–31, 32–33, and 34–36 weeks were 133 (14.9%), 13 (1.4%), and 9 (1.3%), respectively; the difference was statistically significant (P < 0.05). In the high birth weight group, the ROP patients with birth weeks of 26–31, 32–33, and 34–36 were 1 (7.1%), 5 (1.1%), and 24 (1.0%), respectively; the difference was not statistically significant (P > 0.05). Among the 33 children with severe ROP (requiring intervention treatment), there were 29 (3.2%), 3 (3%), and 1 (0.1%) with birth weeks of 26–31, 32–33, and 34–36, respectively, in the low birth weight group; the difference was statistically significant (P < 0.05). The severe ROP was 0 in the high birth weight group.

Conclusion: The prevalence of ROP in premature infants is 3.38% in the past decade in Zhuhai. Birth weight and gestational age are risk factors for ROP. The birth weight of infants with severe ROP is less than 2 000 g.