目的：分析肺炎克雷伯菌导致内源性眼内炎在糖尿病患者中的临床特征，总结治疗经验及评估其预后。方法：回顾性病例分析2019年1月至2022年3月期间就诊于山东中医药大学附属眼科医院的肺炎克雷伯菌导致的内源性眼内炎糖尿病患者7例(8眼)。分析其年龄、性别、感染灶来源、就诊时间、治疗前后视力、眼压、裂隙灯检查、眼底检查、眼科B超、治疗方式、感染控制及复发情况。结果：7例患者年龄(63±17.6)岁。男性5例(71.4%)，女性2例(28.6%)。术后7眼(87.5%)视力NLP，1眼(12.5%)LogMAR视力0.2。视力与患者就诊时间及就诊时视力有关。6例(85.7%)就诊前发热。8眼(100%)结膜混合充血，1眼(12.5%)前房积脓。7眼(87.5%)行玻璃体切割术联合玻璃体腔注药术，1眼(12.5%)行单纯玻璃体腔注药术。8眼感染均控制，无眼球摘除。随访期间眼压正常，无感染复发。结论：肺炎克雷伯菌是内源性眼内炎的主要致病菌，易在糖尿病人群中发生。发病迅速进展快，早期临床表现不典型易被误诊，其预后和病程的长短及治疗的时机密切相关，尽早地治疗可挽回部分视力。

Objective: To analyze the clinical characteristics of endogenous endophthalmitis caused by Klebsiella pneumoniae in diabetic patients, and summarize the treatment experience and evaluate its prognosis. Methods: A retrospective case analysis was performed on 7 patients (8 eyes) with endogenous endophthalmitis caused by Klebsiella pneumoniae, who were admitted to the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to August 2022. The age, gender, origin of infection, time of treatment, visual acuity before and after treatment, intraocular pressure, slit lamp examination, fundus examination, ophthalmic B-mode ultrasound, treatment methods, infection control and recurrence were analyzed. Results: The mean age of the seven patients was (63±17.6). There were five males (71.4%) and 2 females (28.6%). Postoperative visual acuity was NLP in seven eyes (87.5%) and LogMAR visual acuity was 0.2 in one eye (12.5%). Visual acuity was related to the patient’s visit time and the visual acuity at visit. Six cases (85.7%) had fever before treatment. Fever was a risk factor for Klebsiella pneumoniae endophthalmitis infection. Eight eyes (100%) had mixed conjunctival congestion, and one eye (12.5%) had abscess in the anterior chamber. Seven eyes (87.5%) underwent vitrectomy combined with intravitreal drug injection, and one eye (12.5%) underwent intravitreal drug injection alone. Infections were controlled in all eight eyes without enucleation. Intraocular pressure was normal during the follow-up period, and there was no infection recurrence. Conclusions: Klebsiella pneumoniae is the main pathogen of endogenous endophthalmitis and is prone to occur in people with diabetes. The onset of the disease progresses rapidly. The early clinical manifestations are not typical, and the prognosis is closely related to the duration of the disease and the timing of treatment. Early treatment can restore some vision.

Purtscher样视网膜病变是一种少见的视网膜血管性疾病，该文分析了13例Purtscher样视网膜病变的临床特征。典型的眼底表现包括 Purtscher斑22眼、棉絮斑22眼、视网膜出血13眼、黄斑水肿22眼、视盘水肿12眼和假樱桃红斑10眼。荧光素血管造影异常表现包括毛细血管无灌注区21眼，毛细血管前闭塞22眼。13例患者中有9例使用糖皮质激素、免疫抑制剂，4例使用改善循环、营养神经等治疗。随访2周至5年，4例患者(6眼)在随访期间出现神经上皮萎缩并持续低矫正视力(<0.1)。基于文献回顾，讨论了Purtscher样视网膜视力恢复不佳可能与黄斑水肿及无灌注区形成有关。

Purtscher-like retinopathy is a rare retinal vascular disease. In this study,the clinical characteristics of 13 cases of Purtscher-like retinopathy were analyzed. Typical fundus abnormalities included Purtscher flecken (22 eyes), cotton-wool spots (22 eyes), retinal hemorrhages (13 eyes), macular edema (22 eyes), swelling of optic disk (12 eyes), and falsecherry red spots (10 eyes). The abnomal manifestations of fluorescein angiography included non perfusion area of capillaries (21 eyes), and precapillary occlusion (22 eyes). Among 13 patients, 9 patients were treated with glucocorticoids and immunosuppressive drugs, and 4 patients were treated with circulation-improving and neurotrophic drugs. During the follow-up period of two months to five years, four patients (six eyes) experienced neuroepithelial atrophy and persistent low vision (<0.1). Based on literature review, we proposed that the prognosis of vision in Purtscher-like retinopathy may be associated with macular edema and the formation of capillary non-perfusion.

目的：中重度甲状腺相关眼病内下壁骨性减压联合脂肪减压术的临床疗效观察。方法：回顾性分析25例(31眼)在浙江大学医学院附属第二医院眼科行内下壁骨性减压联合脂肪减压术治疗的甲状腺相关眼病患者，观察时间为2020年1月至2022年1月。术前所有患者均进行了眼眶CT检查，并对双眼视力、眼球突出、复视及双眼外观形态进行了测量。手术效果评价指标为：术后眼球突出度、视力和复视程度，并对相关数据进行统计和分析。结果：术后眼球突出度回退2~6 mm，平均回退(3.45±0.93)mm，切除眶内脂肪1.4~3.6 mL，平均切除(2.33±0.66)mL，外观恢复满意。4例患者术前存在复视，2例患者术后新发复视，术前已存在复视的患者，术后复视程度并未加重，新发的2例复视患者均为轻度复视。术后CT检查显示眼眶减压效果良好。结论：内下壁骨性减压与脂肪减压术联合，可以有效扩大眼眶容积，对眼球进行回纳，减少眼球突出程度，改善容貌外观，且手术切口隐蔽美观，具有较好的临床疗效果。

Objective: To observe the clinical efficacy of medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe thyroid associated ophthalmopathy (TAO). Methods: A retrospective analysis was performed on 25 patients (31 eyes) with moderate-to-severe TAO from January 2020 to January 2022 in Eye Hospital of Zhejiang University, who were treated with medial-inferior wall orbital decompression combined with fat decompression. All of patients were given orbital computed tomography to measure visual acuity, exophthalmos, diplopia and ocular appearance before operation. The preoperative and postoperative exophthalmos, visual acuity and diplopia before and after operation were taken as efficacy evaluating indicators. The related data was counted and analyzed statistically. Results: After operation, the reduction of exophthalmos was 2-6 mm, with an average of (3.45±0.93) mm, the volume of intrazonal fat-removal was 1.4-3.6 mL, with an average of (2.33±0.66) mL, with a satisfactory appearance. There were 4 cases of preoperative diplopia and 2 cases of new diplopia after operation, all of which were mild diplopia. Diplopia did not exacerbate after operation in the patients who had diplopia before operation. Conclusion: Medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe TAO can effectively expand orbital volume, reduce exophthalmos, improve appearance with a concealed beautiful surgical incision, showing its good clinical efficacy.

系统性红斑狼疮(systemic lupus erythematosus, SLE)是一类累及多种器官的结缔组织病，且SLE的发病机制十分复杂，常引起关节炎、脑病、肾病、皮肤损害，眼部病变亦是SLE常见疾病，且常引起视力障碍，甚至致盲、致残。该文通过整理文献，浅谈SLE相关眼病的类型、病因、眼部表现，以及SLE常用的中医辨证论治。

Systemic lupus erythematosus (SLE) is a class of connective tissue diseases that affect a variety of organs. Moreover, the pathogenesis of SLE is very complex, often causing arthritis, encephalopathy, kidney disease and skin damage, ocular lesions are also common diseases of SLE, and it can often cause visual impairment, and even blindness and disability. By collating the literature, this paper discusses the types, etiology, and ocular manifestations of SLE-related eye diseases, as well as the dialectical treatment of SLE commonly used in traditional Chinese medicine.

目的：探讨多发性大动脉炎的全身表现及眼部临床表现，提高眼科医生对大动脉炎的诊治能力。方法：采用回顾性病例系列研究。收集2018年3月至2022年5月山东第一医科大学附属省立医院风湿免疫科确诊后、经眼科会诊或治疗的大动脉炎患者14例，总结患者的全身表现、眼部临床表现及治疗结果。结果：14例多发性大动脉炎患者中，男性1例、女性13例，年龄(35.57±9.77)岁。其中，Ⅰ型头臂动脉型7例(50%)，Ⅱ型胸腹主动脉型2例(14.3%)，Ⅲ型肺动脉型0例，Ⅳ型广泛型5例(35.7%)。85.7%病例累及头臂动脉干。患者全身表现多样，最常见的是上肢低血压相关表现，4例发生严重的心脑血管并发症(28.6%)。5例(35.6%)患者以眼部症状为首发表现，3眼曾误诊为“白内障”(21.4%)。患者最佳矫正视力为无光感~1.0，其中，21眼最佳矫正视力为1.0(占75%)，4眼最佳矫正视力<0.1(占14.3%)。眼部检查正常者4眼(14.3%)，其余24眼(85.7%)均存在眼部异常。晶体异常、结膜巩膜血管扩张充血及瞳孔散大是最常见的眼前节表现。眼底表现以低灌注性视网膜病变为主(20眼，71.4%)，高血压视网膜病变4眼(14.3%)。与Ⅱ型患者比较，Ⅰ型患者更容易发生低灌注性视网膜病变。缺血导致的异常动静脉交通及视盘旁花冠状血管是最典型的眼底表现，严重者导致新生血管形成、增殖性玻璃体视网膜病变和视网膜脱离。所有患者经糖皮质激素和免疫抑制剂治疗，眼部行视网膜光凝及抗血管内皮生长因子(anti-vascular endothelial growth factor,anti-VEGF)药物治疗后，3眼视网膜病变仍有进展，其余患者病情稳定。结论：多发性大动脉炎是一种临床相对比较少见的慢性血管炎性阻塞性病变，年轻女性多发。本组病例以累及头臂动脉干为主，眼部受累概率高，缺血性眼前节表现是较容易被识别的体征，低灌注性视网膜病变是最典型的眼底表现，并可能引发严重的眼部并发症。眼科医生应提高对多发性大动脉炎的认识和诊断能力，并重视对大动脉炎患者的详细眼部检查。

Objective: To discuss the systemic and ocular manifestations of patients with multiplex Takayasu arteritis (TA) and improve the ability of ophthalmologists to diagnose and treat TA. Methods: Retrospective case series study was used. From March 2018 to May 2022, a total of 14 TA patients were admitted to the Department of Rheumatology and Ophthalmology in Shandong Provincial Hospital Affiliated to Shandong First Medical University. They were diagnosed by ophthalmology consultation and treated in the Department of Rheumatology and Immunology. Their systemic manifestations, ocular clinical manifestations, and treatment outcomes were summarized. Results: There were 13 female patients and 1 male patient in our TA cohot. Mean age was (35.57±9.77) years. The most common classification of TA was 7 cases of type I (50%). Others were type II (2 cases of Abdominal aorta and/or renal arteries involved, 14.3%) and 5 cases of type IV (combination of type I and type II, 35.7%), 0 cases of type III. The most common location of involvement was brachiocephalic arterial trunk (85.7%). TA patients had a variety of systemic manifestations, the most common was upper extremity hypotension-related manifestations. Severe cardiovascular and cerebrovascular complications occurred in 4 patients (28.6%). Ocular abnormal was the initial manifestation in 5 patients (35.6%), and 3 eyes were misdiagnosed as cataract (21.4%). Best corrected visual acuity (BCVA) of the TA patients was -1.0 with no light perception, among with 21 eyes had 1.0 (75%) and 4 eyes had a BCVA less than 0.1 (14.3%). Only 4 eyes were totally normal (14.3%) and the remaining 24 eyes (85.7%) had ocular abnormalities. Lens opacity, chronic scleral hyperemia and dilated pupil were the most frequent manifestations in ocular anterior segment. Fundus manifestations were dominated by hypoperfusion retinopathy (20 eyes, 71.4%) and 4 eyes suffered from hypertensive retinopathy (14.3%). Patients with Type I had a higher prevalence for developing hypoperfusion retinopathy than type II patients. Ischemia-induced fiscrete arteriovenous shunt and wreath-like anastomosis around the optic disc were the most typical fundus manifestations. Retinal neovascularization, proliferative vitreoretinopathy and retinal detachment were the most serious retinal complications. Corticosteroids and immunosuppressive agents were administered in all the patients. Most of the patients remained stable, while progression of retinopathy still could be seen in 3 eyes even after pan-retinal photocoagulation and intravitreal injection of anti-VEGF drug treatemnt. Conclusions: TA is a relatively rare chronic vasculitic obstructive lesion that occurs more often in young women. This group of cases mainly involved brachiocephalic artierial trunk. TA has a high possibility of ocular involvement and may lead to various ocular abnormalities. Anterior segment manifestations secondary to ischemia were the relative recognizable signal for diagnosis of TA. Hypoperfusion retinopathy was the most common fundus manifestations, and might cause serious ocular complications. Ophthalmologists should improve awareness and diagnostic capacity for multiple TA and value the detailed eye examination of TA patients.

眼可受全身系统性疾病的累及，通过眼部表现可对心血管系统性疾病、神经系统疾病、自身免疫性疾病、感染性疾病及药物相关眼病等全身疾病进行评估、协助诊断和随访观察。重视全身疾病在眼部的表现，对于眼科及相关专业临床诊疗水平的提升具有重要意义。

Eyes can be affected by systemic diseases. Ocular manifestations can be used to evaluate, help to diagnose and observe systemic diseases including cardiovascular diseases, neurological disorders, autoimmune diseases, infectious diseases and drug-related eye diseases. Paying attention to the manifestations of systemic diseases in the eye is of great significance for the improvement of clinical diagnosis and treatment in ophthalmology and related specialties.

目的：应用Cirrus HD-OCT 5000对正常眼黄斑及视盘血流参数进行血管成像测量，评估其可重复性及再现性。方法：纳入40只正常眼进行前瞻性研究。操作者A于一周内3天的同一时段(T1，T2，T3)对正常受试者的同一眼黄斑及视盘进行3次血管成像扫描，扫描过程中均开启FastTrac^TM图像跟踪功能，操作者B在T 2时间点再次对受试者同一眼进行相同程序扫描，使用Angio PlexMetrix^TM量化软件(版本10.0)自动测量黄斑和视盘的血管长度密度(vessel length density，VD)和血管灌注密度(vascular perfusion density，PD)。应用单因素方差分析或非参数检验比较3次扫描的VD、PD是否有差异。采用组内相关系数(intraclass correlation coefficient，ICC)、变异系数(coefficient of variation，CV)评价操作者A的可重复性，采用一致性相关系数(consistent correlation coefficient，CCC)、重复性系数(repeatability coefficient，CR)、C V评价操作者间的再现性。结果：操作者A对黄斑及视盘各区域3次扫描的V D、P D之间差异无统计学意义(P >0.05)。操作者A对黄斑和视盘V D、PD 3次扫描的ICC值分别为0.260~0.517、0.362~0.898，黄斑及视盘各区域V D、P D的C V值均<8.1%。黄斑和视盘V D、P D的操作者间CCC值分别为0.3130~0.5665、0.5149~0.7801；黄斑VD和PD的CR值分别为3.2212~4.6399、0.0574~0.0832；视盘VD和PD的CR值分别为2.0675~4.0630、0.0447~0.0730。黄斑CV值均<9.0%，视盘CV值均<6.9%。结论：非同日的同一时段视盘浅层血流参数具有较好的重复性及再现性，黄斑浅层血流参数的重复性及再现性相对较差。

Objective: To evaluate the repeatability and reproducibility of quantification of macular and peri-papillary superficial capillaries in normal eyes using Cirrus HD-OCT 5000 angiography. Methods: Forty normal eyes were included in this prospective study. Angiography 3 mm × 3 mm scan protocol centered on the disc or macula of the same eye was repeated 3 times by operator A in the same period on 3 days (T1, T2, T3) within 1 week,and the FastTrac^TM image tracking function was turned on during the scan. Operator B repeated the same scan independently at T2 after operator A. Angio Plex Metrix^TM quantification software (version 10.0) was used to automatically measure the vessel length density (VD) and vascular perfusion density (PD) of macular and peri-papillary superficial capillaries. One-way analysis of variance or nonparametric test was used to compare the VD and PD measurements of the 3 scans. The intraclass correlation coefficient (ICC) and coefficient of variation (CV)were calculated to evaluate the intra-operator repeatability. Consistent correlation coefficient (CCC), repeatability coefficient (CR), and CV were calculated to evaluate the inter-operator reproducibility. Results: There was no statistically significant difference in the measurements of VD and PD between the 3 scans of the macular and peri-papillary superficial capillaries by operator A (P>0.05). The ICC values for the 3 scans of VD and PD of the macular and peri-papillary superficial capillaries by operator A were 0.260–0.517 and 0.362~0.898, respectively.The CV values of the VD and PD of the macular and peri-papillary superficial capillaries were all <8.1%. The inter-operator CCC values of the macular and peri-papillary superficial capillaries were 0.3130–0.5665 and 0.5149~0.7801,respectively; the CR values of the VD and PD of macula were 3.2212–4.6399 and 0.0574–0.0832, respectively; the CR values of the VD and PD of optic disc were 2.0675–4.0630 and 0.0447–0.0730, respectively. The CV values of macular were all <9.0%, and the CV values of optic disc were all <6.9%. Conclusion:The macular and peri-papillary superficial capillaries parameters in the same period on different days have a good repeatability and reproducibility,while the superficial macular blood flow parameters have relatively poor repeatability and reproducibility.

目的：探讨原发性慢性闭角型青光眼(chronic primary angle-closure glaucoma，CPACG)患者的视网膜血流密度(vessel density，VD)与视野缺损程度的相关性。方法：光学相干断层血管成像技术(optical coherence tomography angiography，OCTA)测量89例(112眼)视野缺损的CPACG患者的黄斑区VD、视盘旁VD，分析VD与视野缺损程度的相关性。结果：视盘旁VD与视野缺损程度成负相关(r>–0.728，P<0.05)。黄斑浅层总VD的受试者工作曲线(receiver operating characteristic，ROC)及曲线下面积(area under the curve，AUC)为0.874。在控制年龄、眼压及视力的情况下，黄斑总浅层VD每降低1%，视野平均缺损(mean deviation，MD)值增加–0.639 dB。结论：CPACG患者VD与视野缺损呈线性负相关，OCTA可以方便无创地观察青光眼患者眼底血流情况，在视野缺损前发现视网膜VD降低，从而可以作为CPACG早期诊断的参考指标。

Objective: To investigate the correlation between the retinal vessel density (VD) and the degree of visual field loss in chronic primary angle-closure glaucoma (CPACG). Methods: Eighty-nine CPACG patients (112 eyes)with different degrees of visual field loss were measured with optical coherence tomography angiography (OCTA) for macular VD and para-optic microcirculation VD, and the correlation between them and the degree of visual field defect were analyzed. Results: There was a negative correlation between the VD of the microcirculation in each zone next to the optic disc and the degree of visual field loss (r>–0.728, P<0.05). The receiver operating characteristic (ROC) and area under the curve (AUC) of the total VD of the superficial macula is 0.874. Under the condition of controlling age, intraocular pressure and vision, for every 1% decrease in the total superficial macular VD, the average visual field defect mean deviation (MD) value increases –0.639 dB. Conclusion: The VD of CPACG patients is linearly negatively correlated with visual field defects. OCTA can conveniently and non-invasively observe the blood flow of the fundus in patients with glaucoma. It is found that the retinal VD is reduced before visual field defects, which can be used as a reference index for early diagnosis of CPACG.

目的：了解原发性开角型青光眼(primary open angle glaucoma，POAG)患者视野缺损的进展情况，探讨其发生进展的相关危险因素。方法：回顾性分析2014年1月至2018年7月就诊于北京大学第三医院眼科并有至少4次视野检查的POAG患者。按照患者首次视野检查的平均偏差或平均缺损进行分期。将历次随访视野检查的平均偏差或平均缺损与时间进行线性回归分析，取其斜率(dB/年)。根据平均偏差或平均缺损的斜率将患者分为进展组与无进展组。分析患者视盘周围视网膜神经纤维层(retinal nerve fiber layer，RNFL)厚度损害位置、平均随诊间隔时间、基线视野分期等因素与青光眼视野缺损进展的关系。结果：共纳入128例患者(252只眼)，其中129眼使用Octopus视野计检查随访，基线视野缺损值为(10.91±5.76) dB；123眼使用Humphrey视野计，基线视野偏差值为(–10.62±6.89) dB。视野缺损早、中、晚期的比例分别为26.19%、36.51%和37.30%。进展组31只眼(12.30%)，无进展组221只眼(87.70%)。上下方RNFL都存在重度损害的患者，其视野缺损更易进展(P<0.001)。平均随诊间隔时间≤4个月的患眼，发生进展的比例高于平均随诊间隔时间>4个月的患眼(P=0.058)。基线视野分期、年龄、性别、总随访时间与视野缺损进展未见显著相关性。结论：青光眼患者的视功能损害出现恶化是普遍存在的。上下方RNFL均存在重度损害、随诊间隔时间短与视野缺损进展相关。视神经结构的改变与功能损害具有相关性，结构改变的方位对功能损害进展有提示功能。规律随诊对病情监测有重要意义，对于可能快速进展的患者，应缩短随诊间隔时间。

Objective: To investigate the progression of visual field defect in primary open angle glaucoma (POAG), and to explore the related risk factors for its progression. Methods: A retrospective analysis was performed on patients with POAG who had at least 4 visual field examinations in the Department of Ophthalmology, Peking University Third Hospital from January 2014 to July 2018. The visual field was staged according to the mean deviation or mean defect of the first visual field examination. Linear regression analyses of mean deviation or mean defect were performed against time, and corresponding regression slopes (in decibels per year) were calculated. Patients were divided into progressive and non-progressive groups according to the mean deviation slope or mean defect slope. The relationship between retinal nerve fiber layer (RNFL) thickness lesion location, mean follow-up interval, baseline visual field staging, and the progression of visual field defect in glaucoma were analyzed. Results: A total of 128 patients (252 eyes) were included. Among them, 129 eyes were followed up with an Octopus perimeter, and the average mean defect value of the baseline visual field was 10.91±5.76 dB; while the other 123 eyes were followed up with a Humphrey perimeter, and the average mean deviation value of the baseline visual field was –10.62±6.89 dB. The proportion of early, middle and late visual field defects was 26.19%, 36.51% and 37.30%. There were 31 eyes (12.30%) in the progressive group and 221 eyes (87.70%) in the non-progressive group. Patients with severe damage to both the upper and lower RNFLs had more visual field defects (P<0.001). Patients with an average follow-up interval ≤4 months had a higher rate of progression than those with an average follow-up interval >4 months (P=0.058).There were no significant differences in baseline visual field stage, age, gender, and total follow-up time between the progression and progression-free groups. Conclusion: Deterioration of visual function impairment is common in glaucoma patients. The progression of visual field defects is associated with severe impairments which are present both in the upper and lower RNFLs, and short follow-up intervals. Optic nerve structure changes are related to functional impairment, and the location of structural changes is suggestive of functional impairment progression.Regular follow-up visits are of great significance for disease monitoring. For patients who may progress rapidly, the follow-up interval should be shortened.

目的：观察并分析慢性闭角型青光眼患者小梁切除术后早期眼前节及屈光状态变化。方法：采用前瞻性研究方法，收集青光眼小梁切除手术病例20例20只眼，分别测定术前、术后1周、1个月及3个月的球面镜度数、角膜曲率、眼轴长度、前房深度，并进行统计学分析。结果：小梁切除术后1周球面镜度数较手术前差异均具有统计学意义(P<0.05)，差值为(?1.20±0.55) D；术后1个月、3个月球面镜度数较手术前差异无统计学意义(P>0.05)。术前、术后1周、1个月垂直方向角膜曲率分别为(44.89±1.20) D、(45.72±1.54) D、(45.65±1.35) D，术后1周、1个月垂直方向角膜曲率较手术前显著性增加，差异具有统计学意义(P<0.05)；术后3个月垂直方向角膜曲率较术后1个月差异无统计学意义(P>0.05)。术前眼轴长度(22.49±0.43) mm和前房深度(2.75±0.45) mm与术后1周眼轴长度(21.60±0.59) mm和前房深度(2.25±0.34) mm比较差异具有统计学意义 (P<0.01)；术后1个月和3个月前房深度、眼轴长度较手术前差异无统计学意义(P>0.05)。结论：小梁切除术后早期(术后1个月)可发生球面镜度数增加，前房变浅、眼轴变短、垂直方向曲率增加的眼前节和屈光改变。从而发生近视飘移、而影响术后视力。随时间推移(术后3个月)，前房加深、眼轴长度逐渐增加、垂直散光和近视飘移度数逐渐减少，眼前节和屈光变化逐渐趋于稳定，术后视力逐渐恢复。

Objective: To observe and analyze the changes of anterior segment and refractive state in patients with chronic angle closure glaucoma after trabeculectomy. Methods: It was a prospective study. A total of 20 cases with 20 eyes that have met the inclusion criteria undergoing trabeculectomy were collected. The diopter of spherical power,corneal curvature, axial length (AL) and anterior chamber depth (ACD) were measured before the surgery and 1 week, 1 month, and 3 months after the surgery respectively. Results: There was significant difference (P<0.05)for the diopter of spherical power before and 1 week after the trabeculectomy, the difference was (?1.20±0.55) D.After 1 month and 3 months, the diopter of spherical power was not statistically significant (P>0.05). The corneal curvature in the vertical direction was (44.89±1.20) D, (45.72±1.54) D, (45.65±1.35) before, 1 week and 1 month after operation. The corneal curvature in the vertical direction increased significantly at 1 week and 1 month after operation (P<0.05), and there was no significant difference (P>0.05) after 3 months. The preoperative mean ocular axis length (22.49±0.43 mm) and mean anterior chamber depth (2.75±0.45 mm) compared with postoperative mean ocular axis length (21.60±0.59 mm) and mean anterior chamber depth (2.25±0.34 mm) were statistically significant (P<0.01). Comparing 1 month and 3 months after operation, there was no significant difference in the depth of the anterior chamber and the length of the eye axis (P>0.05).Conclusion: In the early stage after trabeculectomy (1 month after operation), the diopter of spherical power can be increased. The ACD became shallower, the eye axis became shorter, and the curvature of vertical direction increased resulting in myopic drift,which affected postoperative visual acuity. Over time (3 months after operation), the anterior chamber deepened,the axial length gradually increased, the vertical astigmatism and myopia drift degree gradually decreased, the anterior segment and refractive changes gradually stabilized, and the postoperative visual acuity gradually recovered.