目的：探讨睑结膜乳头切除联合自体游离结膜瓣移植术治疗春季角结膜炎的临床效果。方法：在显微镜下对11例(22眼)春季角结膜炎患者行睑结膜乳头切除联合自体游离结膜瓣移植术，观察治疗效果。结果：术后随访36~48个月，11例(22眼)春季角结膜炎患者中，治愈19眼(86.36%)，有效2眼(9.09%)，无效1眼(4.55%)，总有效率95.45%。结论：睑结膜乳头切除联合自体游离结膜瓣移植术是治疗春季角结膜炎安全、有效的方法。

Objective: To evaluate the efficacy and safety of surgical resection of conjunctival papillae combined with autologous conjunctival graft in the treatment of vernal keratoconjunctivitis (VKC). Methods: All 11 cases (22 eyes) with VKC were treated with surgical resection of conjunctival papillae in combination with autologous conjunctival graft. Clinical efficacy and safety were evaluated. Results: After 36 to 48 months of follow-up, 19 eyes were cured (86.36%), 2 eyes were improved (9.09%), and 1 eye was ineffective (4.55%). The total effective rate

was 95.45%. Conclusion: Surgical resection of conjunctival papillae combined with autologous conjunctival graft is efficacious and safe in the treatment of VKC.

目的：比较硬膜外导管辅助双路置硅胶管术与传统双路置硅胶管术在泪小管断裂吻合术中的疗效。方法：随机将连云港市第二人民医院52例(52眼)行泪小管断裂吻合术的患者分成两组，使用硬膜外导管辅助双路置硅胶管术为A组(30例)；使用传统手术方式(双路置硅胶管术)为B组(22例)。比较两组患者术中置管时间、平均手术时间、鼻腔出血率、术中疼痛评分、一次性吻合成功率的差异。结果：在术中置管时间方面，A组为(11.20±3.80) min，B组为(21.50±12.60) min；在平均手术时间方面，A组为(42.70±5.50) min，B组为(62.20±15.20) min；在术中疼痛评分方面，A组为(3.10±0.80)分，B组为(4.60±1.25)分；在鼻腔出血率方面，A组为3.33%(1/30)，B组为18.2%(4/22)，以上差异均有统计学意义(均P<0.05)；但在一次性吻合成功率方面，A组有效率为93.3%(28/30)，B组有效率为86.4%(19/22)，差异无统计学意义(P>0.05)。结论：在泪小管断裂吻合术中，应用硬膜外导管辅助双路置硅胶管术较传统双路置硅胶管术，在术中置管时间、手术平均时间、鼻腔出血率、患者疼痛程度等方面具有优势，2种置管一次性成功率的差异无统计学意义，硬膜外导管辅助双路置硅胶术方法安全、可靠、优势明显，值得临床手术推广。

Objective: To compare the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional bicanalicular silicone intubation in the anastomosis of lacrimal canaliculus rupture. Methods: Fifty-two patients (52 eyes) were randomly divided into two groups. Patients in group A (30 cases) were treated by bicanalicular silicone intubation assisted with epidural catheters, while patients in group B (22 cases) were treated with conventional operation (bicanalicular silicone intubation). The intubation time, average operation time, nasal bleeding rate, intraoperative pain score and one-time success rate were compared between the 2 groups. Results: Intubation time in group A was (11.20±3.80) min and that in group B was (21.50±12.60) min(P<0.05). The mean operation time of group A was (42.70±5.50) min and that of group B was (62.20±15.20) min(P<0.05). Intraoperative pain score was 3.10±0.80 in group A and 4.60±1.25 in group B (P<0.05). The rate of nasal hemorrhage was 3.33% (1/30) in group A and 18.2% (4/22) in group B (P<0.05). With respect to one-time anastomosis success rate assessment, the effective rate was 93.3% (28/30) in group A, and 86.4% (19/22) in group B (P>0.05). Conclusion: During lacrimal canalicular anastomosis, bicanalicular silicone intubation assisted with epidural catheters is superior to bicanalicular silicone intubation in intubation time, average operation time, nasal bleeding rate and pain degree. There is no significant difference between the two methods in one-time success rate. Bicanalicular silicone intubation assisted with epidural catheters is safe, reliable, and worthy of promotion.

目的：观察黏膜瓣泪小点成形术用于治疗慢性泪小管炎的疗效。方法：回顾性病例系列研究。收集2018年1月至2020年12月中山眼科中心眼整形科就诊的44例慢性泪小管炎患者的临床资料，分析其性别、年龄、患病眼别、临床症状、泪道冲洗结果等临床特点。采用黏膜瓣泪小点成形术进行治疗，术后随访评估其疗效。结果：44例慢性泪小管炎患者以女性为主(男女比例1:3.9)，单侧发病，多累及下泪小管(上下泪小管比例1:3)，主要表现为分泌物增多、溢泪以及内眦部位红肿，结石阳性率为95.7%，病原微生物检查结果显示以放线菌感染为主(78.3%)。大部分患者术后1周内症状得到明显改善，其中1例上下泪小管炎患者于术后2个月出现上泪小管炎复发。总体治愈率为97.8%，随访时间为(20.7±10.9)个月。结论：黏膜瓣泪小点成形术治疗慢性泪小管炎的临床疗效确切，方法可靠。

Objective: To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis. Methods: In this retrospective serial case study, the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020. Demographic data such as gender, age, affected eye, clinical presentations and lacrimal duct irrigation results were analyzed. The efficacy of the procedure, symptom resolution and complications were assessed. Results: Of the 44 patients, most (male:female 1:3.9) were female, and the disease most often (upper:lower 1:3) involved the lower lacrimal canaliculus of only one eye. Main symptoms included increased secretion, tearing, and swelling of the inner canthus. Stones were present in 95.7% of patients and Actinomyces israelli was found to be the most common pathogen (78.3%). Most patients’ symptoms improved significantly within 1 week after surgery. Only one patient, who had infections in both the upper and lower canaliculi, had recurrence of upper canaliculitis 2 months after the surgery. The overall cure rate was 97.8%, and the follow-up time was (20.7±10.9) months. Conclusion: Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.

目的：观察和评价改良联合筋膜鞘(combined fascial sheath，CFS)悬吊术治疗复发性上睑下垂的可行性和临床效果。方法：纳入2017年3月至2020年3月于河北省眼科医院眼整形门诊就诊的26例复发性重度上睑下垂患者(32只眼)，均采用改良CFS悬吊术予以矫正。术后随访1年，分别于术后1个月、3个月、6个月及1年时复诊，对患者术后上睑缘中点到角膜反光点的距离(marginal reflex distance-1，MRD1)、眼皮折皱深度、长度、弧度和并发症等情况为主要观察指标给予记录和效果评估。结果：26例患者共32只患眼，临床治愈27只眼(84.4%)，改善4只眼(12.5%)，无效1只眼(3.1%)，对1只无效眼术后6个月进行再次调整，调整后达到临床治愈标准。1例出现结膜脱垂，经过药物与加压包扎治疗后结膜脱垂症状消失，无暴露性角膜炎或其他并发症发生病例。结论：改良CFS悬吊术矫正复发性重度上睑下垂，具有操作简单、创伤小、治疗效果确切、并发症少等优点，值得临床推广与应用。

Objective: To observe and evaluate the feasibility and clinical effect of modified combined fascial sheath (CFS) suspension on the treatment of recurrent severe blepharoptosis. Methods: A total of 26 patients (32 eyes) with recurrent severe ptosis treated in Hebei Eye Hospital from March 2017 to March 2020 were included. All patients were corrected by modified CFS suspension. The patients were followed up for 1 year, and returned to the hospital at 1 month, 3 months, 6 months and 1 year respectively. The marginal reflex distance-1 (MRD1), eyelid crease depth, length, radian, and complications were recorded as the main observation indexes and the effect was evaluated. Results: In the 32 eyes of 26 patients, 27 eyes (84.4%) were completely corrected, 4 eyes (12.5%) were improved, while 1 eye (3.1%) had no improvement, the invalid eye was adjusted again 6 months after operation, and reached the effective standard after adjustment. Conjunctival prolapse occurred in 1 case, and the symptoms of conjunctival prolapse disappeared after the treatment with drugs and pressure dressing, and no case of exposure keratitis or other complications occurred. Conclusion: Modified combined fascial sheath suspension is an effective method on the treatment of recurrent severe blepharoptosis with the advantages of simple operation, less trauma, definite therapeutic effect, and fewer complications, which is worthy of clinical promotion and application.

目的：评价上睑下垂矫正术后并发上睑内翻倒睫的手术治疗效果，并分析其发生原因。方法：回顾性分析2015年1月1日至2020年6月30日因上睑下垂矫正术后并发上睑内翻倒睫在中山大学中山眼科中心接受手术治疗，随访时间6个月以上的患者资料。患者的内翻倒睫矫正手术方案根据有无合并上睑下垂过矫或者欠矫，以及原上睑下垂矫正的矫正方式进行设计。评价术前、术后患者的睑裂高度、眼睑闭合不全程度、上睑睑缘弧度、内翻倒睫矫正状态和角膜荧光素染色评分。结果：本研究共收录上睑下垂术后并发上睑内翻倒睫患者19例(20眼)，其中额肌肌瓣悬吊术后17例(18眼：上睑过矫8眼，欠矫6眼，睑裂高度正常4眼)，提上睑肌缩短术后2例(2眼：上睑过矫1例，欠矫1例)。所有患者的上睑内翻倒睫经手术治疗均完全矫正，角膜上皮荧光素染色评分显著降低(P<0.05)。上睑下垂过矫或欠矫术后均矫正满意，术前睑裂高度正常的患者矫正内翻倒睫没有改变睑裂高度。总结术中探查所见，上睑下垂矫正术后发生上睑内翻倒睫可能与多个因素相关：上睑皮肤切口位置过低；睑缘眼轮匝肌去除过多；额肌肌瓣分离不佳；额肌肌瓣在睑板上的固定位置过高；术中对睑裂高度评估不准确引起上睑下垂过矫等。结论：上睑下垂矫正术后并发上睑内翻倒睫再次手术可以达到满意的治疗效果，但手术操作较为棘手。为降低此类并发症的发生和患者多次手术的风险，应规范上睑下垂矫正手术操作，总结教训。

Objective: To evaluate the surgical treatment outcome of upper eyelid entropion after ptosis correction and analyze the complicated causes. Methods: A retrospective analysis was performed on patients who underwent surgical treatment for complicated upper eyelid entropion after ptosis correction and were followed up for more than 6 months at Zhongshan Ophthalmic Center from January 1, 2015 to June 30, 2020. Pre- and postoperative lid height, lagophthalmos, upper lid margin curvature, eyelid entropion and corneal fluorescein staining scores

were evaluated. Results: A total of 18 cases (19 eyes) were included, among which 17 cases (18 eyes: 8 eyes of ptosis overcorrection, 6 eyes of ptosis undercorrection, and 4 eyes with normal eyelid height) were post-frontalis flap suspension, and 2 cases (2 eyes: 1 eye of ptosis undercorrection, 1 eye of ptosis overcorrection) post-levator resection. All patients had a complete correction of upper eyelid entropion and a significant reduction in corneal epithelial fluorescein staining score (P<0.05). Both the complicated ptosis undercorrection and overcorrection were treated with satisfactory outcome. Correction of entropion did not change the eyelid height in patients with preoperative normal height. The intraoperative findings showed that several factors related to original ptosis surgery may be involved in complicated upper eyelid entropion, including: the skin incision too close to the upper lid margin, excessive resection of the orbicularis oculi muscle along the eyelid margin, poor separation of the frontalis muscle flap, inappropriate eyelid plate fixation site of the frontalis muscle flap, and ptosis overcorrection caused by inaccurate evaluation of the intraoperative eyelid height, etc. Conclusion: Surgical treatment of the upper eyelid entropion secondary to ptosis correction is safe and effective, but is complicated and difficult. Skillful ptosis surgery and appropriate surgical techniques are crucial to reduce its occurrence.

目的：分析复发与初发睑板腺囊肿患者的睑板腺组织形态学改变在活体共聚焦显微镜(in vivo confocal microscope，IVCM)下的表现及特点。方法：采用横断面研究方法，选取2018年10月至2019年4月在汕头大学·香港中文大学联合汕头国际眼科中心门诊就诊的10例复发性睑板腺囊肿患者、10例初发性睑板腺囊肿以及10例对照组作为观察对象。所有对象行眼科常规检查及IVCM检查。IVCM检测指标包括睑板腺开口面积、开口最短径、开口最长径、睑板腺开口附近腺管形态、睑板腺腺泡样结构形态，分析比较三组的计量指标。结果：复发性睑板腺囊肿组睑板腺开口短径(109.08±49.96) μm，开口长径(144.95±68.10) μm，开口面积为11 621.62 (3 976.49~24 828.82) μm² ；初发性睑板腺囊肿组睑板腺开口短径(101.53±29.55) μm，开口长径(130.08±45.21) μm，开口面积10 615.07(5 813.29~18 275.44) μm² ；对照组睑板腺开口短径(44.14±14.37) μm，开口长径(55.98±13.46) μm，开口面积2 233.29(1 437.72~2 945.65) μm2 。与对照组相比，复发性、初发性睑板腺囊肿组睑板腺开口短径、开口长径及开口面积均明显扩大，差异有统计学意义(P<0.05)；复发与初发睑板腺囊肿组之间差异不具有统计学意义(P>0.05)。复发性睑板腺囊肿组睑板腺腺管扩张，周边腺泡样结构纤维组织增生，伴有炎症细胞浸润。初发性睑板腺囊肿组睑板腺腺管扩张，周边腺泡样结构未见明显纤维组织增生。结论：IVCM可在活体下观察睑板腺囊肿患者睑板腺形态学上的微观改变，复发性睑板腺囊肿睑板腺腺泡样结构形态与初发性睑板腺囊肿表现有差异。

Background: To analyze the morphological changes of meibomian glands in patients with recurrent and primary meibomian gland cyst under in vivo confocal microscope (IVCM). Methods: A cross-sectional study was performed in Shantou International Eye Center from September 2018 to April 2019. Ten patients with recurrent meibomian cyst, 10 patients with primary meibomian cyst and 10 control subjects were selected in this clinical trial. All subjects received routine ophthalmologic examination and IVCM examination. IVCM examination parameters included open area of meibomian gland, and the maximum and minimum diameter of meibomian gland opening. Relevant parameters were analyzed and statistically compared among different groups. Results: The average minimum diameter of meibomian glands opening in the recurrent meibomian gland cyst group was (109.08±49.96) μm, the average maximum diameter of meibomian glands opening was (144.95±68.10) μm, and the median open area of meibomian gland was 11 621.62 (3 976.49–24 828.82) μm² . In the primary meibomian gland cyst group, the average minimum diameter of meibomian glands opening was (101.53±29.55) μm, the average maximum diameter of meibomian glands opening was (130.08±45.21) μm, and the median open area of meibomian gland was 10 615.07 (5 813.29–18 275.44) μm² . The opening of meibomian glands in both the recurrent and primary meibomian gland cyst groups was enlarged, which significantly differed from that in the control group (both P<0.05). No statistical significance was noted between the recurrent and primary meibomian gland cyst groups (P>0.05). The acinus structure around the gland tube was manifested with serious hypertrophic scar complicated with inflammatory cell infiltration. Conclusion: IVCM can detect the morphological changes of meibomian glands in meibomian gland cyst patients. The IVCM findings of recurrent and primary meibomian gland cyst are different.

目的：利用儿童Glasgow受益调查问卷(Glasgow Children’s Benefit Inventory，GCBI)评估先天性上睑下垂手术后儿童健康相关生活质量(health-related quality of life，HRQOL)的受益，并探索受益的影响因素。方法：验证GCBI中文版评估先天性上睑下垂矫正术后长期患儿生活质量的信效度，并用其评估术后儿童HRQOL受益与性别、手术年龄、术后随访时间等相关性。结果：共178名先天性上睑下垂接受下垂矫正术后儿童完成问卷，结果显示不同性别、年龄均有正性受益，术后短期(<1年)受益更明显(P<0.05)。结论：GCBI中文版具有良好的信度和效度，适用于评估先天性上睑下垂儿童术后受益结果。先天性上睑下垂儿童接受下垂矫正术后不同性别均有正性受益，术后短期(<1年)受益更明显。

Objective: To explore the benefits of children’s HRQOL after congenital ptosis surgery using the Glasgow Children’s Benefit Inventory (GCBI) and the factors influencing the benefits. Methods: To verify the reliability and validity of the Chinese version of GCBI in evaluating the long-term life quality of children after correction of congenital ptosis, and to evaluate the correlation between the HRQOL benefit of children after surgery and gender, surgical age, postoperative follow-up time, etc. Results: A total of 178 children after congenital ptosis surgery completed the questionnaire. Different genders or ages of children with congenital ptosis both showed positive benefit after ptosis correction, and the short-term (<1 year) benefit was more obvious after surgery (P<0.05). Conclusion: The Chinese version of GCBI has good reliability and validity,and is suitable for evaluating the postoperative benefit results of children with congenital ptosis. All the children with congenital ptosis received positive benefit after ptosis correction, and the short-term benefit (<1 year) was more obvious.

上睑下垂是眼整形科最常见的疾病之一，由于儿童处于生长发育阶段的特殊性，不规范的诊疗不仅会影响外观，同时可能会导致视功能发育迟缓。目前关于儿童先天性上睑下垂的手术时机和手术方式的选择尚无统一的标准和共识，本文通过对儿童先天性上睑下垂分类细化，阐明合并不同原因导致弱视的患者手术时机的选择；对比不同手术方式，分析其原理及优缺点，进一步明确矫正重度儿童先天性上睑下垂的手术方式，以期规范儿童先天性上睑下垂手术时机和手术方式的选择，提高手术的成功率，减少弱视的发生。

Blepharoptosis is one of the most common diseases in oculoplastics. Due to the particularity of children in the stage of growth and development, non-standard diagnosis and treatment not only affect the appearance,but also lead to the retardation of visual function development. Currently, there are no uniform standards and consensus on the choice of surgical timing and methods for pediatric congenital blepharoptosis. Here through refined classification of congenital blepharoptosis, we try to elucidate the choice of surgical timing for congenital blepharoptosis patients combined with amblyopia caused by a variety of reasons. By comparing different surgical methods, we analyze their mechanisms and advantages, and illustrate the surgical indication for severe congenital blepharoptosis, so as to standardize the choice of surgical timing and methods for pediatric congenital ptosis,improve the surgical success rate, and reduce the occurrence of amblyopia.

为使眼科手术铺巾方法更安全、便捷、利于操作，本研究团队在原有眼科手术铺巾基础上，增加不同规格尺寸、标识定位、背胶等功能，发明了一种眼科手术铺巾[专利号：国家实用新型专利(ZL 201921410018.3)]。该种眼科手术铺巾采用一次性防水无纺布为主要制作材料，具有规格多样、结构简单、便于操作、无菌屏障功能更强等特点，能更好地满足眼科手术术前消毒铺巾的使用要求。

In order to make ophthalmic surgical draping safer, more convenient and easier to operate, this research team invented an ophthalmic surgical drape [patent number: National Utility Model Patent (ZL 201921410018.3)] based on the original ophthalmic surgical drape, adding functions such as various sizes, marking and positioning,and glutinosity. This kind of ophthalmic surgical drape is made of disposable waterproof non-woven fabric, which has the characteristics of various specifications, simple structure, easy operation and strong function of aseptic barrier, which can better meet the requirements of disinfection drape before ophthalmic surgery than the original drape.

为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求，又能合理利用有限空间，本研究团队在原有的眼科日间病房座椅的基础上，增加玻璃体手术后体位护理等功能，发明了一种护理座椅[专利号：国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料，其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单，操作方便，安全使用，既能保证临床体位护理需求，又能节省空间，便于病房环境管理。

To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.