A 74-year-old man presented with a three-year history of foreign body sensation in the right eye after cataract surgery. He underwent uneventful trabeculectomy with mitomycin C (MMC) in the right eye seven years ago. Slit-lamp examination revealed a large avascular filltration bleb overhanging on the cornea with a thin base connected to the conjunctiva. Preoperative ultrasound biomicroscopy (UBM) impressions were confirmed by leakage of aqueous from the incision intraoperatively. Surgical dissection and revision of the bleb was performed with satisfactory outcome. Histopathologic evaluation showed proliferation of fibrous tissue under the conjunctival epithelia with irregular cystoids change. The current case may be the first report of a post-trabeculectomy overhanging filtration bleb related to cataract surgery. The possible mechanism may be related to microleakage of the surgical wound after phacoemulsiff cation which initiated the healing and scarring process.

A 74-year-old man presented with a three-year history of foreign body sensation in the right eye after cataract surgery. He underwent uneventful trabeculectomy with mitomycin C (MMC) in the right eye seven years ago. Slit-lamp examination revealed a large avascular filltration bleb overhanging on the cornea with a thin base connected to the conjunctiva. Preoperative ultrasound biomicroscopy (UBM) impressions were confirmed by leakage of aqueous from the incision intraoperatively. Surgical dissection and revision of the bleb was performed with satisfactory outcome. Histopathologic evaluation showed proliferation of fibrous tissue under the conjunctival epithelia with irregular cystoids change. The current case may be the first report of a post-trabeculectomy overhanging filtration bleb related to cataract surgery. The possible mechanism may be related to microleakage of the surgical wound after phacoemulsiff cation which initiated the healing and scarring process.

目的：通过光学相干断层扫描技术(optical coherence tomography，OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化，评价治疗效果。方法：选择明确诊断为PACG患者46例50眼，其中 急性闭角型青光眼临床前期及缓解期眼26例27眼，慢性闭角型青光眼20例23眼，行LPI治疗，通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离，采用配对t检验。结果：急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05)；慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论：急性闭角型青光眼LPI术后前房角开放距离增加，治疗效果较好；慢性闭角型青光眼LPI术后前房角开放距离增加不明显，术后仍存在前房角闭塞趋向。

Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.

      青光眼(glaucoma)是一组具有特征性视神经损害和视野缺损的眼病,在临床上常常表现为视力减退、眼部胀痛伴头痛等症状，是一种致盲率居第二位的不可逆性眼病。青光眼视神经损伤有一定 的遗传倾向，造成视神经凹陷性萎缩及视野不同程度缺损这两种结局的危险因素有多种,其中致盲的主要原因包括进行性视神经节损害、病理性眼压升高等。所以在青光眼的治疗中一方面要考虑降低眼压，另一方面还要保护好视神经。本文将从视神经损害的机制、影响因素、分级方法、视神经相关检测指标及其在临床上相关仪器应用、治疗等方面进行综述。

Glaucoma is an irreversible eye disease with the characteristic of optic nerve damage and visual ?eld defect, the clinical manifestation is behaved for vision loss, eye pain with symptoms such as headache, which rate of blindness ranks second place. The optic nerve injury of glaucoma has a certain genetic predisposition. There are many risk factors result in optic nerve atrophy and visual ?eld defect, one of the major causes of blindness including optic ganglion damage, pathological elevation of intraocular pressure. So on the one hand in the treatment of glaucoma should be considered to reduce intraocular pressure, on the other hand, to protect the optic nerve. This article will reviews the mechanism, influencing factors, classification methods, optic nerve related detection indexes and clinical application and treatment of optic nerve injury. 

青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。

青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。

暴发性脉络膜上腔出血(subchoroidal expulsive hemorrhage，SEH)是内眼手术中罕见且严重的并发症，广东省人民医院眼科收治1名因晶状体完全脱位继发青光眼的女性患者，73岁，其手术过程中发生SEH，现报告如下。通过回顾病例，讨论及分析SEH的原因、危险因素及治疗。

Subchoroidal expulsive hemorrhage (SEH) is one of the rarest and worst complications of intraocular surgery. We treated one patient with secondary glaucoma due to complete dislocation of the lens, who developed SEH during the surgery. In this case report, the causes, risk factors and treatment of subchoroidal expulsive were discussed and analyzed by reviewing the case.

青光眼是一组以视盘萎缩凹陷、视野缺损以及视力下降为共同特征的视神经退行性疾病，也是世界首位不可逆性致盲眼病，导致患者生活质量降低、引起极大卫生经济负担。但其发病机制尚不明确，促进房水排出从而降低眼内压力仍是目前减缓疾病进展的唯一治疗手段。房水排出的主要途径是经由小梁网进入Schlemm’ s管最后汇入巩膜外静脉，因此小梁网在调节房水排出以及平衡眼内压力方面发挥重要作用。近年以来体内以及体外房水排出测量技术和小梁网成像技术不断突破，众多研究表明小梁网存在压力依赖的节律性搏动，在房水的脉冲式排出中起到关键作用，但在青光眼中这种搏动随疾病的进展减弱甚至消失。文章将以小梁网的泵理论为核心，总结青光眼中房水排出的最新研究进展，并从恢复小梁网功能的角度出发探索可能有效的治疗策略，为青光眼的临床诊治提供新的思路。

青光眼是一组以视盘萎缩凹陷、视野缺损以及视力下降为共同特征的视神经退行性疾病，也是世界首位不可逆性致盲眼病，导致患者生活质量降低、引起极大卫生经济负担。但其发病机制尚不明确，促进房水排出从而降低眼内压力仍是目前减缓疾病进展的唯一治疗手段。房水排出的主要途径是经由小梁网进入Schlemm’ s管最后汇入巩膜外静脉，因此小梁网在调节房水排出以及平衡眼内压力方面发挥重要作用。近年以来体内以及体外房水排出测量技术和小梁网成像技术不断突破，众多研究表明小梁网存在压力依赖的节律性搏动，在房水的脉冲式排出中起到关键作用，但在青光眼中这种搏动随疾病的进展减弱甚至消失。文章将以小梁网的泵理论为核心，总结青光眼中房水排出的最新研究进展，并从恢复小梁网功能的角度出发探索可能有效的治疗策略，为青光眼的临床诊治提供新的思路。

       “锌”在青光眼研究舞台上正扮演着越来越重要的角色。糖皮质激素，作为人体内重要的激素之一，其对锌的调控已在诸多系统中被证实。研究发现，在糖皮质激素的影响下，小梁网中的锌离子转运受阻，导致细胞外基质降解失衡，从而干扰小梁网正常流出道功能，加重青光眼的病情。而视神经损伤后，锌离子在神经突触间的异常传递、不平衡分布与胞内异常累积影响视网膜神经节细胞存活和轴突的再生能力，进而损害视功能，可能成为青光眼视神经损伤发病及进展的关键因素。这些研究进展为视神经保护策略提供了新的视角，“锌”作为治疗靶点的潜力正在被逐步挖掘，通过调节锌水平来干预青光眼病理进程成为可能治疗手段。
       本期封面中将汉字“锌”设计为飞天舞者，其超越时空的永恒美感，呼应了“锌”在青光眼研究中突破传统、开辟新程的角色。轻盈与自由的飞天舞者，象征着“锌”在细胞内外穿梭，精妙调控生理功能，维系细胞的和谐与平衡，为青光眼患者带来新的治疗希望。

       “锌”在青光眼研究舞台上正扮演着越来越重要的角色。糖皮质激素，作为人体内重要的激素之一，其对锌的调控已在诸多系统中被证实。研究发现，在糖皮质激素的影响下，小梁网中的锌离子转运受阻，导致细胞外基质降解失衡，从而干扰小梁网正常流出道功能，加重青光眼的病情。而视神经损伤后，锌离子在神经突触间的异常传递、不平衡分布与胞内异常累积影响视网膜神经节细胞存活和轴突的再生能力，进而损害视功能，可能成为青光眼视神经损伤发病及进展的关键因素。这些研究进展为视神经保护策略提供了新的视角，“锌”作为治疗靶点的潜力正在被逐步挖掘，通过调节锌水平来干预青光眼病理进程成为可能治疗手段。

       本期封面中将汉字“锌”设计为飞天舞者，其超越时空的永恒美感，呼应了“锌”在青光眼研究中突破传统、开辟新程的角色。轻盈与自由的飞天舞者，象征着“锌”在细胞内外穿梭，精妙调控生理功能，维系细胞的和谐与平衡，为青光眼患者带来新的治疗希望。

青光眼是一种以视网膜神经节细胞(retinal ganglion cell, RGC)及其轴突的进行性变性和丢失为主要特征的眼病，是导致视力丧失的最常见原因。尽管其具体的发病机制尚未完全明确，但众所周知，眼内压升高是青光眼进展的主要危险因素。目前，通过药物和手术治疗降低眼内压是控制疾病进展的主要手段。他氟前列素因其能有效长期稳定地降低眼内压，且不良反应轻微、患者依从性高、无明显全身不良反应，已成为治疗原发性开角型青光眼及眼高压症的一线治疗药物。近年来的研究表明，他氟前列素除了具有降低眼内压的效果外，还可能具有神经保护作用。文章对他氟前列素的药理作用及其在神经保护方面的潜在效益进行综述，为开发更有效的治疗青光眼药物提供理论依据和科研基础。然而，目前缺乏充分的临床研究证据支持其神经保护效应，未来研究应进一步探索这一领域，以促进针对视神经保护的药物开发和基于视神经再生的视觉功能重建。

Glaucoma is characterized by the progressive degeneration and loss of retinal ganglion cells (RGC) and their axons,making it one of the most common causes of vision loss. Although the exact underlying mechanisms remain unclear, it is well known that elevated intraocular pressure (IOP) is a major risk factor for the progression of glaucoma. Currently, the primary means of controlling glaucoma involves reducing IOP through medication and surgery. Tafluprost, due to its effective and long-term ability to lower IOP, minimal side effects, high patient compliance, and absence of significant systemic side effects, has become the first-line treatment for primary open-angle glaucoma and ocular hypertension. Recent studies suggest that tafluprost may also have neuroprotective effects beyond its IOP-lowering effects. This article aims to review the pharmacological and potential neuroprotective effects of tafluprost, providing a theoretical basis and research foundation for developing more effective drugs for glaucoma treatment. However, there is still a lack of sufficient clinical evidence to support the neuroprotective effects of tafluprost, and further investigations are required to explore in this field to furnish critical theoretical backing for the development of drugs that target optic nerve protection and facilitate vision restoration through optic nerve regeneration.

糖皮质激素(glucocorticoid, GC)由于其抗炎特性被广泛用于治疗眼部炎症，而G C诱导性青光眼(glucocorticoid-induced glaucoma, GIG) 作为一种常见并发症，其发病机制长期受到关注。文章综述了锌在GIG中的关键作用及其调控机制，揭示了锌在青光眼发病机制中的重要角色。锌作为人体中含量第二丰富的过渡金属，对蛋白质结构、酶催化和细胞信号调节至关重要。GC对锌分布的调控作用在不同组织和细胞类型中表现出复杂性，影响锌的摄取和释放，进而参与青光眼的病理过程。锌通过影响小梁网细胞外基质(extracellular matrix, ECM)的降解和重塑，以及视网膜神经节细胞的存活和轴突再生，在GIG的发病机制中发挥着复杂的作用。文章同时介绍了体内锌调控的现有途径，包括补充锌和减少锌的策略，提供了潜在的治疗途径。未来的研究应深入探索锌在青光眼中的作用机制以及与GC的相互作用，评估锌补充或螯合在青光眼治疗中的安全性和有效性，以及开发新型锌递送和螯合系统，有助于全面揭示锌在青光眼中的作用及治疗潜力，以实现更加精准的防治方案，改善患者预后。

Glucocorticoid (GC) is widely used in the treatment of ocular inflammation for its anti-inflammatory propery. However, glucocorticoid-induced glaucoma (GIG) is a common complication, and its pathogenesis has been extensively studied. This review summarizes the crucial role of zinc in GIG and its regulatory mechanisms, highlighting zinc's significant involvement in the pathogenesis of glaucoma. Zinc, the second most abundant transition metal in the human body, is essential for protein structure, enzyme catalysis, and cell signaling regulation. The effects of GC on zinc distribution vary across different tissues and cell types, affecting zinc uptake and release, which may contribute to the pathological processes of glaucoma. Zinc influences the degradation and remodeling of the trabecular meshwork extracellular matrix and the survival and axonal regeneration of retinal ganglion cells, playing complex roles in the pathogenesis of GIG. We discuss available strategies for regulating zinc in vivo, including zinc supplementation and reduction strategies, providing potential therapeutic approaches. Future research should explore the mechanisms of zinc's role in glaucoma and its interaction with glucocorticoids, evaluate the safety and efficacy of zinc supplementation or chelation in glaucoma treatment, and develop novel zinc delivery and chelation systems. These efforts will help fully elucidate the role of zinc in glaucoma and its therapeutic potential, enabling more precise prevention and treatment strategies to improve patient outcomes.