目的：探讨近视与双眼视功能状态以及用眼时间的关系。方法：对广州市花都区 219 名 10~12 岁学生进行纵向队列研究，研究对象均于2016年基线检查时进行了眼部生物测定、散瞳下自动验光、主观验光、配镜，并在戴镜2周后测量散瞳验光结果，2017年11月再次重复上述检查。同时做调查问卷收集户外、户内活动时间，进一步比对。结果：219 名学生1年后近视度数加深值为 -1.05±0.44（P < 0.001），眼轴长度1年后增长 0.44±0.31，两者呈正相关（P < 0.001）；近视度数与调节滞后、调节幅度有相关性，同时与周一至周五户外活动时间呈负相关。结论：近视加深速度与调节滞后、调节幅度有关。在用眼时间方面，户外活动时间越短，近视加深越快；户内活动时间越长，近视加深越快。

Objective: To evaluate the relationship between myopia progression and binocular vision functions and the relationship between myopia progression and outdoor/indoor activities. Methods: A 1-year longitudinal study was carried out and 219 subjects were included. Subjects lived in Huadu District, Guangzhou, China. Binocular functions measurements, ocular biometry measurements and cycloplegic refraction were done at the first visit in 2016. Cycloplegic refraction were done 2 weeks after dispensing. The measurements were repeated in November 2017 and information about outdoor activities and indoor activities was gathered by questionnaires for comparison. Results: The myopia progression was measured to be -1.05±0.44 (P < 0.001) in 219 subjects, which was positively correlated with axial length elongation for 0.44±0.31 (P < 0.001) and correlated with accommodative lag and accommodative amplitude. Myopia progression was observed to be negatively related to outdoor activitytime. Conclusion: Myopia progression rate is related to accommodative lag and accommodative amplitude. Outdoor activities could be a protective factor for myopia progression.

目的：观察可折叠人工晶体单襻悬吊术在处理白内障超声乳化术中后囊膜破裂的临床应用效果及安全性。方法：回顾性分析 2015 年 1 月至 2016 年 12 月在南京医科大学附属无锡人民医院行白内障超声乳化术并出现后囊膜破裂的 64 例（64 眼）白内障患者，分为试验组（33 例 33 眼）和对照组。试验组行可折叠人工晶体单襻悬吊术；对照组（31 例 31 眼）行硬片式人工晶体双襻悬吊术。手术当天记录疼痛评分，并分别于术后 1 d、术后 1 周及术后 1 个月记录术眼视力、眼压、前房反应、晶体位置及并发症发生情况。结果：试验组的疼痛反应较对照组显著减轻（P < 0.05）。术后第 1 天，两组视力、眼压、前房反应差异均无统计学意义（P > 0.05）。术后 1 周试验组前房反应较对照组小（P < 0.05），两组视力、眼压差异均无统计学意义（P > 0.05）。术后 1 个月两组视力、眼压、前房反应差异均无统计学意义（P > 0.05）。试验组中 1 例（3.03%）术后第 1 天出现前房积血，2例（6.06%）出现人工晶体轻度偏位；对照组 1 例患者（3.33%）术后第 1 天出现一过性眼压增高，未发现其余并发症。结论：改良折叠型人工晶体上方悬吊术是处理白内障超声乳化术中后囊膜破裂安全可行的手术方式。

Objective: To evaluate the safety and effectiveness of foldable intraocular lens single loop suspension in the treatment of posterior capsule rupture in the phacoemulsification. Methods: Sixty-four patients (64 eyes) with posterior capsular rupture during cataract surgery from January 2015 to December 2016 were selected and divided into an experimental group (33 patients, 33 eyes) and a control group (31 patients, 31 eyes). The experimental group received foldable intraocular lens single loop suspension, and the control group received hard plate intraocular lens suspension. Pain score was recorded on the day of operation; visual acuity, intraocular pressure, anterior chamber response, crystal location and other complications were recorded separately on the dayafter operation, 1 week and 1 month after operation. Results: Patients felt less painful in the experimental group (P < 0.05). There was no significant difference in visual acuity, intraocular pressure and anterior chamber response between the two groups the day after operation (P > 0.05). But the anterior chamber reaction in the control group was more serious than in the experimental group when observed one week and one month after operation (P < 0.05), and there was no significant difference in visual acuity, intraocular pressure and anterior chamber response between the two groups. In the experimental group, 1 patient (3.03%) had hyphema, and 2 patients (6.06%) had a slight tilt of the intraocular lens. In the control group, 1 patient (3.33%) had transient intraocular hypertension. Conclusion: Foldable intraocular lens single loop suspension is a safe and feasible operation to treat posterior capsular rupture in phacoemulsification.

10% 水合氯醛是最常用的小儿镇静药之一，广泛应用于眼科小儿检查和治疗前。对于年龄小、不配合的患儿，如何合理、安全使用水合氯醛，提高其镇静效果，减少其并发症发生，笔者总结护理心得如下：使用前对小儿进行全身的评估和家长的准备，使用时要掌握口服或灌肠的操作技巧，使用后要注意观察小儿的全身反应、用药效果和做好家长的宣教。

10% chloral hydrate is one of the most commonly used pediatric sedatives, which is widely used before ophthalmic pediatric examination and treatment. For young uncooperative children, how to use chloral hydrate reasonably and safely to improve their sedative effect and reduce the occurrence of complications, we summarized the nursing experiences, including evaluating child’s whole body and the preparation of parents before its use; mastering operative techniques of oral or enema route of admission in its use; paying attention to observe the child's systemic response and efficacy of drug, and patient education

目的：研究准分子激光原位角膜磨镶术(laser in situkeratomileusis，LASIK)前后角膜滞后量(corneal hysteresis，CH)和角膜阻力因子(corneal resistance factor，CRF)变化量，对其相关因素进行多元线性回归分析。方法：前瞻性研究。纳入行LASIK手术的近视眼及近视散光患者70眼(38例)，术前与术后6个月各项参数分别由眼反应分析仪(ocular response analyzer，ORA)、非接触眼压仪、超声角膜测厚仪及Pentacam眼前节分析仪测量。分析LASIK手术前后△CH，△CRF与术前、手术设计等参数的相关性，并对相关参数进行多元线性回归分析。结果：手术前后CH分别为(10.05±1.36)，(8.15±0.90) mmHg(1 mmHg=0.133 kPa)，CRF分别为(9.91±1.38)，(6.92±0.88) mmHg，差异均有统计学意义(P<0.01)；△CH与△CRF分别为(1.90±1.15)，(2.99±1.23) mmHg。△CH与术前CH，CRF，眼压(intraocular pressure，IOP)，预计切削深度(ablative depth，AD)以及AD/CCT呈正相关；△CRF与术前CH，CRF，IOP，AD，AD/CCT，术前等值球镜(spherical equivalent，SE)以及预计基质床厚度(residual stromal bed’s thickness，RSBT)有相关性。采用多元线性回归对LASIK手术前后△CH，△CRF与术前、手术设计等各相关参数进行分析，回归方程为：△CH=?6.182+0.658CH_术前+8.421AD/CCT (R2=0.639，P<0.01)，△CRF=?0.007+0.725CRF_术前?0.014RSBT (R2=0.689，P<0.01)。结论：LASIK术前后CH与预计AD和角膜厚度比值密切相关，CRF变化量与预计角膜RSBT密切相关，在设计手术时应慎重考虑预计AD与预计RSBT。

Objective: To discuss the change of corneal hysteresis and corneal resistance factor before and after laser in situkeratomileusis (LASIK), and to analyze their related factors by multivariate linear regression. Methods: In this prospective study, 70 eyes (38 patients) with myopia and myopic astigmatism undergoing LASIK were included. Related factors were measured preoperatively and at 6 months postoperatively by ocular response analyzer, noncontact tonometer (NCT), ultrasonic pachymeter, and Pentacam system. TTe correlation was analyzed between △CH, △CRF and preoperative and operative design’s parameters, and correlative factors analyze. △CH and △CRF were analyzed by the multiple linear regression. Results: CH before and after LASIK were (10.05±1.36) and (8.15±0.90) mmHg, and CRF before and affer LASIK were (9.91±1.38) and (6.92±0.88) mmHg. TTere was signiffcant difference between preoperative and postoperative CH and CRF (P<0.01). △CH and △CRF were (1.90±1.15) and (2.99±1.23) mmHg. Preoperative CH, CRF, intraocular pressure (IOP), ablative depth (AD) and AD/CCT were positive correlated with △CH. Preoperative CH, CRF, IOP, AD, AD/CCT, preoperative spherical equivalent (SE) and predicted residual stromal bed’s thickness (RSBT) were correlated with △CRF. TTe regression equation of △CH and △CRF and influencing factors were △CH =?6.182 + 0.658CH_preoperative + 8.421AD/CCT (R2 =0.639, P<0.01), △CRF =?0.007 + 0.725CRF_preoperative ? 0.014RSBT (R2 =0.689, P<0.01). Conclusion: The change of CH before and after LASIK is correlative with AD/CCT. The change of CRF before and after LASIK is correlative with predicted residual stromal bed’s thickness. Ablative depth and predicted residual stromal bed’s thickness should be considered carefully during the surgical design.

目的：观察 1 g/L 玻璃酸钠滴眼液（不含防腐剂）对圆锥角膜患者配戴硬性透气性角膜接触镜（rigid gas permeable，RGP）相关性干眼的疗效。方法：选择 2016 年 1 月至 2017 年 5 月来沈阳何氏眼科医院门诊就诊的 90 例透气性角膜接触镜相关性干眼圆锥角膜患者，随机分为 3 组，每组 30 例（60 眼）：A 组使用 1 g/L 玻璃酸钠滴眼液（不含防腐剂），4 次/d，1 滴/次；B 组使用舒润液（博视顿），4 次/d，1 滴/次；C 组在使用舒润液（博视顿）（4 次/d，1 滴/次）后 10 min 再用 1 g/L 玻璃酸钠滴眼液（不含防腐剂）（4 次/d，1 滴/次）。观察各组用药前 1 d 与用药后第 1、2、4 周的眼部症状评分、Schirmer I 试验（Schirmer I test，SIT）、泪膜破裂时间（break-up time，BUT）、角膜荧光染色评分变化。结果：3 组在用药 1 周时的干眼症状、BUT 和角膜荧光染色均较治疗前有明显改善（P < 0.05），3 组 SIT 值治疗前后差异均无统计学意义（P > 0.05）。各组各项指标在治疗第 1、2、4 周时差异无统计学意义（P > 0.05）。A 组与 B 组对干眼症状、SIT 和 BUT 的改善作用差异无统计学意义（P > 0.05）；A 组较 B 组在改善角膜荧光染色的作用上更明显，差异有统计学意义（P < 0.05）。C 组对改善干眼症状上优于 A 组（P < 0.05）。C 组对改善干眼症状和角膜荧光染色作用优于 B 组（P < 0.05）。结论：1 g/L 玻璃酸钠滴眼液（不含防腐剂）能够稳定泪膜，促进角膜上皮损伤修复，改善圆锥角膜患者配戴 RGP 所致干眼症状，具有一定的临床应用价值。

Objective: To investigate the clinical efficacy of sodium hyaluronate eye drops in the treatment of dry eye in keratoconus patients wearing rigid gas permeable (RGP) contact lens. Methods: Ninety keratoconus cases of dry eye related to wearing RGP contact lens from January 2016 to May 2017 were enrolled and divided into 3 groups randomly, including 30 cases (60 eyes) in each group. In group A, preservative-free sodium hyaluronate eye drops (EUSAN GmbH, German, specifications: 10 mL) were administered, 1 drop each time, 4 times daily; In group B, rewetting drops (BOSTON), 1 drop each time, 4 times daily; In group C, rewetting drops were initially given, followed by sodium hyaluronate eye drops 15 min later. All patients were evaluated by subjective symptoms of dry eye, Schirmer I test (SIT), break-up time (BUT) and corneal fluorescent staining, at pre-therapy and 1, 2, 4 weeks after treatment. Results: The subjective symptoms of dry eye, BUT and corneal fluorescent staining of three groups were significantly improved at 1 week after therapy than the data before therapy (all P < 0.05), SIT of three groups did not significantly differ before and after therapy (P > 0.05). Each index when measured after 1, 2 and 4 weeks had no significant difference in each group (all P > 0.05). There was no significant difference in subjective symptoms, SIT and BUT between group A and group B (all P > 0.05), whereas corneal fluorescent staining in group A was superior to group B (P < 0.05). The subjective symptoms of dry eye were significantly better than those in group A (P < 0.05). The subjective symptoms of dry eye and corneal fluorescent staining in group C were significantly better than those in group B (both P < 0.05). Conclusion: Administration of sodium hyaluronate eye drops (preservative-free) at a dose of 1 g/L can stabilize the tear film, promote the repair of corneal epithelial defects and significantly improve dry eye symptoms and signs in keratoconus patients wearing RGP contact lens, which has application value in clinical practice.

目的：探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法：通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗，对其疗效进行回顾性分析。结果：术后修复皮瓣均成活，眼睑功能良好，随访 4 个月~10 年，期间无复发及转移病例。结论：对于眼睑部的基底细胞癌，采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率，同时最大限度地保留了眼睑的正常组织，达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

目的：探索适合本地实际情况的屈光发育档案管理模式。方法：总结本区屈光发育档案推行数据，采用鱼骨图系统分析影响屈光发育档案在基层医院推行的关键因素。结果：影响屈光发育档案在基层医院推行的关键因素包括家庭因素、个人因素、学校因素、医院因素。建议通过与学校加强合作，进行健康教育，加强与学生、家长的沟通，开发简易技术，加强医院信息化建设，逐步建立适合本地实际情况的屈光发育档案管理模式。结论：在基层医院建立青少年屈光发育档案受多种因素影响，需平衡家庭、学校、医院的关系，加强数字化平台建设。

Objective: To explore an appropriate management model of refractive development archives suitable for local conditions. Methods: The main influencing factors of refractive development archives in primary hospitals were analyzed by using fishbone diagram. Results: The influencing factors included family factors, personal behavior, school and medical factors. It was recommended to improve the cooperation with school and strengthen communication with students and parents. The hospital should develop simple technologies to strengthen the construction of information technology. An appropriate model of refractive development archives was established according to the local situation. Conclusion: The establishment of adolescent refractive development archives in primary hospitals is affected by many factors. It is necessary to balance the relationship among families, schools and hospitals, and strengthen the construction of digital platforms.

目的：观察后房型有晶体眼人工晶体(implantable collamer lens，ICL)V4c植入术后2年的有效性、安全性和稳定性，评估ICL V4c矫正屈光不正的中远期临床疗效。方法：回顾性病例研究。收集在河 北省沧州市中心医院眼一科行ICL V4c手术治疗的屈光不正患者，观察并记录术前至术后2年的裸眼视力、最佳矫正视力、屈光状态、对比敏感度、高阶像差、眼压、人工晶体拱高、角膜内皮细胞 计数、不良反应、主观视觉质量等临床资料，进行统计学分析。结果：完成随访的96例术眼，术后2年的平均裸眼视力(LogMAR)为0.021±0.065，平均最佳矫正视力(LogMAR)为0.002±0.041，优于术前最佳矫正视力，有效性指数为1.05，安全性指数为1.09，等效球镜数值稳定，对比敏感度提升，高阶像差有所增加，但主观视觉质量良好，眼压基本稳定，内皮细胞丢失率为1.6%，平均拱高为(549.6±50.0) μm，随访期间未发现眼内感染、继发性青光眼、晶状体混浊、黄斑水肿、视网膜脱离等并发症。结论：ICL V4c植入术矫正屈光不正具有良好的中远期临床效果。

Objective: To assess the medium-long term efffcacy, safety and stability of a newly developed posterior chamber phakic intraocular lens (model V4c Visian Implantable Collamer Lens) to correct refractive errors. Methods: Retrospective case series. This study evaluated eyes that had implantation of ICL V4c to correct ametropia for at least two years. Uncorrected and corrected distance visual acuities, refraction, contrast sensitivity, high-order aberration, quality of life, intraocular pressure, endothelial cell density, pIOL vault, and adverse events were evaluated to assess the efffcacy, safety and stability of V4c. Results: The study comprised 96 eyes of 50 patients. At 2 years postoperatively, the mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.021±0.065 logMAR and 0.002±0.041 logMAR, which were better than preoperative CDVA. The efffcacy and safety indices were 1.05 and 1.09, respectively. The spherical equivalent was stable with improved contrast sensitivity and increased high-order aberrations, but the subjective visual quality was well. The IOP remained stable over time. The mean vault was (549.6±50.0) μm and the mean endothelial cell loss was 1.6%. No eye developed intraocular infection, secondary glaucoma, lens opacity, macular edema or retinal detachment.Conclusion: The good medium-long term outcomes support the use of ICL V4c for the correction of myopia. 

目的：观察健康中老年人群中心凹视觉敏感度阈值(foveal threshold，FT)及光相干断层扫描血管成像(optical coherence tomography angiography，OCTA)的双眼对称性。方法：横断面观察性研究。纳入33例66眼，测量并比较眼灌注压(ocular perfusion pressure，OPP)，FT，黄斑区3 mm × 3 mm范围内中心凹无血管区面积(non-flow area，NFA)，浅层视网膜血管密度(superior vessel density，SVD)和深层视网膜血管密度(deep vessel density，DVD)的双眼对称性；分析各指标双眼差值、均值及其比值与年龄、性别的相关性。结果：配对样本t检验结果显示除FT(t=?2.118，P=0.042)外，左右眼OPP，NFA，SVD和DVD差异均无统计学意义(P>0.05)；Pearson相关性分析和同类相关系数(intra-class correlation coefficient，ICC)检验结果显示5项指标左右眼测量值相关强度由强到弱为OPP>FT>NFA>DVD>SVD；Bland-Altman分析结果提示5项指标双眼间一致性良好。5项指标的双眼对称性不随性别、年龄改变。结论：健康中老年人群FT、黄斑区NFA，SVD及DVD的测量值具有双眼对称性。

Objective: To observe the interocular symmetry of foveal threshold (FT) and optical coherence tomography angiography (OCTA) parameters in healthy middle-aged and elderly subjects. Methods: Cross-sectional observational study. Sixty-six eyes from thirty-three subjects were enrolled to compare binocular ocular perfusion pressure (OPP), FT, non-flow area (NFA), superior vessel density (SVD) and deep vessel density (DVD) in a 3 mm × 3 mm OCTA scan of macula. The interocular symmetry of all the parameters was analyzed; the correlations of the differences (△), mean value (m) and the ratio of all the parameters with age and gender were analyzed. Results: There was no significant interocular difference revealed by paired-samples t-tests in all the parameters (P>0.05) except FT (t=?2.118, P=0.042), while the rank of Pearson’s correlation index and intraclass correlation coefffcient (ICC) from strong to weak was OPP > FT > NFA > DVD > SVD. The interocular symmetry of all the parameters was proved to be good with Bland-Altman plots, and it changed little with the variations of age and gender. Conclusion: Interocular symmetries of FT and OCTA parameters are observed in healthy middle-aged and elderly subjects.