年龄相关性白内障是全球首位致盲性眼病，手术是治疗白内障唯一有效的手段。白内障手术后视力的良好恢复，除了患者自身的眼部条件外，还有赖于医疗机构的手术技术和质量管理水平。白内障摘除手术的规范操作、人工晶状体屈光力的精准测算和专业的围术期管理是白内障患者复明的关键。国家卫生健康委员会在《加强县医院白内障手术能力建设工作方案（2025—2027年）》中提出，通过加强设备设施建设、帮扶县级医院开展人员培训、建立标准化手术制度等方式，进一步提高县级医院开展白内障手术的能力，就近就便满足人民群众白内障复明需求。因此，为了规范化白内障手术操作、确保手术安全和减少手术并发症，在广东省医学会的领导下，由中山大学中山眼科中心联合广东省内其他21所医疗机构35名权威专家共同起草，在参考国内外白内障手术标准的基础上，结合我省白内障手术的现状，共同讨论并最终确定了本团体标准。本标准系统地描述了年龄相关性白内障手术软件、硬件的基本要求、手术的适应证与禁忌证，制定了白内障手术的标准操作流程及其质量控制标准，并且介绍了并发症或不适的预防及处理，为广东省各级具有资质的医疗机构开展白内障手术以及质量评估提供指导。

Age-related cataract is the leading blinding eye disease in the world, and surgery is the only effective treatment. The good recovery of vision after cataract surgery depends not only on the patients’ ocular conditions but also on the surgical technique and quality management level of medical institutions. Standard surgical procedures, the accurate measurement and calculation of intraocular lens (IOL) power, and professional perioperative management are the keys to restoring the sight of patients. In addition, the National Health Commission proposed in the "Work Plan for Strengthening the Cataract Surgery Capacity Building of County-level Hospitals (2025-2027)" that the ability of county-level hospitals to perform cataract surgery should be further improved by strengthening the construction of equipment and facilities, assisting county-level hospitals in carrying out personnel training, and establishing standardized surgical system. Therefore, in order to standardize cataract surgery procedures, ensure the safety of the surgery and reduce surgical complications, under the leadership of the Guangdong Medical Association, the Zhongshan Ophthalmic Center of Sun Yat-sen University, in conjunction with 21 other medical institutions in Guangdong Province and 35 authoritative experts, jointly drafted this group standard. On the basis of referring to the domestic and international standards for cataract surgery and combining with the current situation of cataract surgery in Guangdong Province, they jointly determined this group standard. This group standard systematically describes the basic requirements for the software and hardware conditions of age-related cataract surgery, the indications and contraindications of the surgery, formulates the standard surgical procedures and quality control standards for cataract surgery, and introduces the prevention and treatment of complications or adverse reactions, providing guidance for all qualified medical institutions at different levels to carry out cataract surgery and quality assessment.

目的：探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法：采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象，所有对象培训周期均为3个月，分为乳化劈核教学组和压核进钩劈核教学组，统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数，培训结束时对学员进行猪眼手术操作考核并记录评分，采用问卷调查对两种教学方式进行评价。结果：压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69（19，50）个，低于乳化劈核教学组的49.86（29，66）个（U=-3.08，P<0.05）；压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13（31，79）个，低于乳化劈核教学组73.14（50，90）个（U=-2.66，P<0.05）；压核进钩劈核教学组一次性完整完成二分核的次数为14.75（9，22）次，高于乳化劈核教学组6.79（3，14）（U=4.02，P<0.05）；压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50（3，5），高于乳化劈核教学组的3.71（2，5）次（U=2.23，P<0.05）；完整手术考核总分平均分为29.00（23，33）分，高于乳化劈核教学组的23.07（19，28）分（U=3.98，P<0.05）。培训结束时，压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31（15，20）分，高于乳化劈核教学组15.07（12，18）（U=3.69，P<0.05）。结论：核进钩劈核技术有助于学员更快地掌握碎核技术，缩短白内障超声乳化摘除手术的学习曲线，增强学习白内障手术的信心，提高超声乳化白内障吸除术的教学效果和满意度。

Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery．

目的：探讨非超声乳化白内障手术两种不同的娩核方式对角膜内皮细胞数量和形态的影响，以及对术后视力恢复情况的影响。

方法：选择在本院手术治疗的40例白内障患者娩核方式分为直接娩出组和半娩出组，并根据 Emery－ little晶状体核硬度分级标准分为软核和硬核，手术方式为白内障非超声乳化手术，术后第3天用角膜内皮镜检查并记录角膜内皮细胞数量和形态。术后随访3个月，比较并观察4组患者术前和术后角膜内皮细胞丢失率、形态变化和视力恢复情况。

结果：术前和术后3个月角膜内皮细胞丢失率比较，硬核直接娩出组与另外三组比较差异有统计学意义(P＜0.01)，而软核直接娩出组、硬核半娩出组与软核半娩出组比较差异无统计学意义(P＞0.05)。术前和术后第二天视力比较硬核半娩出组和软核直接娩出组之间无统计学意义(P＝0.49)，软核半娩出组与这两组比较有统计学意义(P＝0.030)，硬核直接娩出组与这两组之间比较也有统计学意义(P＝0.14)，术后三个月视力比较4组之间均无统计学意义(P＝0.067)。术后 3 个月角膜内皮细胞形态变化不明显。

结论：白内障非超声乳化手术时，硬核直接娩核法对角膜内皮细胞损伤最大，软核半娩核法对角膜内皮损伤最小。若内皮细胞损伤较轻，对手术3个月后视力和角膜内皮细胞形态无明显影响。 

Purpose: To investigate the effect of non-phacoemulsification cataract operation in two different patterns of nucleus delivery on the quantity and morphology of corneal endothelial cells and postoperative visual acuity．

Methods: Forty patients diagnosed with cataract underwent cataract surgery and were assigned into the direct nuclear delivery and semi-nuclear delivery groups. Lens density was measured and divided into the hard and soft lenses according to Emery-little lens nucleus grading system. Non-phacoemulsification cataract operation was performed. At 3 d after surgery, the quantity and morphology of corneal endothelium were counted and observed under corneal endothelial microscope. During 3-month postoperative follow-up, the endothelial cell loss rate, morphological changes and visual acuity were compared among four groups．

Results: Corneal endothelial cell loss rate in the direct delivery of hard nucleus group significantly differed from those in the other three groups before and 3 months after operation (P＜0.01),  whereas no statistical significance was found among the direct delivery of soft nucleus,  semi-delivery of hard nucleus and semi-delivery soft nucleus groups (all P＞0.05).  Preoperative and postoperative 2-d visual acuity did not differ between the semi-delivery of hard nucleus and direct delivery of soft nucleus groups (P＝0.49)，significantly differed from those in the semi-delivery of soft nucleus (P＝0.03) and direct delivery of hard nucleus groups (P＝0.14). Visual acuity at postoperative four months did not differ among four groups (P＝0.067). 
Conclusion: During non-phacoemulsification cataract surgery, direct delivery of hard nucleus caused severe injury to corneal endothelium and semi-delivery of soft nucleus yielded mild corneal endothelial injury. Slight corneal endothelial injury exerted no apparent effect upon visual acuity and corneal endothelial morphology at three months after surgery．

目的：探讨老年性糖尿病性白内障患者治疗及延续护理的措施。

方法：对2014年1月～2014年12月142例老年性糖尿病性白内障患者随机平均分为A组和B组，A组接受常规的出院指导；B组接受常规的出院指导及加强延续护理，根据老年性糖尿病性白内障患者 的具体情况制定护理措施 (眼部的护理、用药指导、饮食护理、心理护理、自我监测指导、定期随访及复查等内容)，并进行跟踪处理。

结果：实施延续护理一年后的患者，体重、空腹血糖、餐后2 h血糖与未实施延续护理的患者相比，差异有显著意义 (P＜0.05)。

结论：护士对老年性糖尿病性白内障患者及家属进行用眼和糖尿病相关的知识宣教、针对性的心理护理、药物治疗护理及日常生活指导等，老年性糖尿病性白内障患者的遵医率提高，减少了因疾病而对生活工作的影响，生活质量有不同程度的提高。

Purpose: To explore the treatment and continuing nursing of patients diagnosed with senile and diabetic cataract．

Methods: In total, 142 patients diagnosed with senile and diabetic cataract admitted to Zhongshan Ophthalmic Center from January to December 2014 were randomly assigned into groups A and B. In group A, patients received conventional instruction after discharge, and those in group B additionally received continuing nursing care after discharge including ocular nursing, use of anti-diabetic drugs, psychological nursing,  diet nursing, self-monitoring guidance,  re-examination and regular follow-up according to the patients’ conditions．

Results: After one year of continuing nursing care, visual acuity of patients in group B was increased without complications. Body mass index, the fasting and 2h postprandial plasma glucose,  and the systolic and diastolic blood pressure were decreased significantly compared with those in group A (all P＜0．05)．

Conclusion: Continuing nursing care, including knowledge education related to ocular use and diabetes mellitus, targeted psychological nursing,  medication nursing and daily life guidance,  play a pivotal role in enhancing the compliance rate of the patients,  reducing the influence upon work and life and enhancing the quality of life to varying extent．

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.

Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.

Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.

Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).

Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.

Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.

Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.

Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).

Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.

目的：探讨3种不同的滴眼液在麻醉小鼠晶状体浑浊中的保护作用。方法：将20只6周龄C57BL/6j小鼠分为4组，A组为自然暴露组(对照组)，B组为滴用透明质酸钠组，C组为滴用甲基纤维素滴眼液组，D组为滴用生理盐水组。分别于麻醉后10，20，30，45和60 min观察小鼠晶状体浑浊情况。结果：与A组相比，3种滴眼液均不同程度地延长小鼠晶状体浑浊的时间；30 min时，4组小鼠浑浊 发生率分别为90%，50%，50%和10%，并延缓晶状体浑浊的进展；60 min时，4组小鼠3级浑浊的发生率为30%，10%，10%和0，其中生理盐水的作用效果最优，可以明显延迟晶状体变浑浊的时间。结论：麻醉小鼠的晶状体浑浊程度可以被相关滴眼液延缓，适用于短时间的眼科检查和处理，又因其经济易得，可广泛应用于小鼠活体的眼科检查中。

Objective: To study the effect of saline, carboxymethylcellulose sodium eye drops and sodium hyaluronate gel to stop the development of cataract in anesthetized mice. Methods: Twenty C57BL/6j mice, aged 6 weeks, were divided into four groups, group A was naturally exposed to air, group B was treated with sodium hyaluronate gel, group C was treated with carboxymethylcellulose sodium eye drops and group D was treated with saline. The lens opacity was observed at 10, 20, 30, 45 and 60 min after the start of the experiment. Results: Compared with group A, the eye drops delayed the development of lens opacity in varying degrees. At 30 min, the incidence rate of cataract in group A, B, C and D was 90%, 50%, 50% and 10%, respectively. At 60 min, the incidence rate of grade 3 cataract in group A, B, C and D was 30%, 10%, 10% and 0 respectively, saline did the best, which can significantly slow the process. Conclusion: Cataract development can be slowed by the protective eye drops. This finding is relevant for those experimental settings in which clear ocular media are required. 

目的：探讨下乡行大批量白内障扶贫手术的手术器械管理方法。方法：对大批量白内障扶贫手术专用的眼科器械实施规范化管理流程，运输过程严格保护，并培训当地护理人员、定人定岗，实行责任制管理，对清洗流程的质量检测及术中严格的无菌操作把控，确保手术安全进行。结果：眼科手术器械得到规范处理和保养，基层护理人员的规范培训提升其对眼科手术器械处理的能力。结论：建立下乡扶贫规范化的手术器械管理流程和培训制度，是大批量白内障扶贫手术顺利完成的基础保障。

Objective: To investigate the methods of management of surgical equipment in large quantities of cataract poverty alleviation surgery for the countryside patients. Methods: The standardized management of cataract poverty alleviation surgery was implented, the ophthalmic equipment on the transport was strictly protected, and nursing training, fixed posts, responsibility system management, cleaning process quality testing and aseptic control were performed to ensure the safety of operation. Results: The processing and maintenance of the surgical equipment were standardized. Nursing training enhanced their ability to manage ophthalmic surgical equipment. Conclusion: A standardized system of surgical equipment management guarantees the successful completion of large quantities of cataract poverty alleviation surgery.

目的：总结大批量白内障扶贫手术的护理安全管理经验。方法：回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况，分析其安全隐患，并在护理过程中采取相应的安全措施。术前充分评估和准备，对患者进行健康指导；术中对手术环境规范管理；指导加强术后患者的自我管理。结果：8批次共1 064例白内障摘除联合人工晶体植入术顺利完成，无1例发生术后感染。结论：建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节，做好术前的评估和准备工作，落实患者的健康教育及术后患者自我管理指导，才能确保手术顺利进行。

Objective: To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: TTis is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. TTe following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1 064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed.Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety.