Table of Content

22 February 2026, Volume 50 Issue 1

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Clinical applications of ophthalmic surgical robots: from stable manipulation to artificial intelligence integration

Yao Haipei, Huang Jiannan

2026, 50(1):  1-7.  doi:10. 3760/cma.j.cn115500-20250911-26101

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Ophthalmic surgery, characterized by its delicate operations and low tolerance for error, places extremely high demands on the precision and stability of surgical instruments. As a new technology, ophthalmic surgical robots may assist ophthalmologists in performing more refined surgical procedures. Through the design of Remote Center of Motion (RCM) mechanisms, these robots achieve micron-level operational precision, significantly reducing the impact of physiological hand tremors. Currently, ophthalmic surgical robots have been applied in various fields, including orbital surgery, corneal surgery, cataract surgery, and vitreoretinal surgery. Representative systems such as MICRON, the Preceyes Surgical System, and IRISS have demonstrated excellent performance in laboratory or clinical trials. Future development trends of ophthalmic surgical robots include the integration of intraoperative OCT and femtosecond laser technologies to enhance surgical visualization and stability, the expansion of medical accessibility through 5G telesurgery, and the deep integration of artificial intelligence to advance autonomous surgical strategies. Although ophthalmic surgical robots hold great promise, challenges remain, such as miniaturization design, real-time feedback delays, clinical validation, and surgeon training.

Effect of particulate matter on the eye

Liu Tong, Gao Wen

2026, 50(1):  8-14.  doi:10.3760/cma.i.cnl15500-20251020-26102

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Particulate matter (PM) pollution is a severe public health issue. As an organ directly exposed to the environment, the eye is highly susceptible to damage. PM induces a range of pathological changes in different ocular tissues through multiple mechanisms such as oxidative stress, inflammatory responses, and modes of cell death. On the ocular surface, PM can lead to meibomian gland dysfunction and conjunctivitis, disrupting tear film stability. In the cornea, PM can directly impair the barrier function of the corneal epithelium.As the lesion progresses, PM can interfere with the outflow of aqueous humor through pathways such as activating inflammatosomes, increasing the risk of glaucoma. It can also trigger ferroptosis to cause cataracts and break through the blood-retinal barrier to cause damage to the structure and function of the retina.PM exposure causes comprehensive damage to the eye from the ocular surface to the fundus through multiple mechanisms and targets. Attention should be paid to the component-specific toxicity of PM, and personal and public protective measures should be strengthened to reduce the risk of eye-related diseases.

Structural characteristics, effector functions, and research advances of IgG N-glycosylation in ocular diseases

Liao Haibing, Zhang Mingzhi

2026, 50(1):  15-21.  doi:10.3760/cma.i.cn115500-20251009-26103

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Immunoglobulin G (IgG) N-glycosylation is a critical post-translational modification whose structural diversity significantly influences the effector functions of IgG. The biosynthesis of IgG N-glycosylation involves the coordinated action of multiple enzymes in the endoplasmic reticulum and Golgi apparatus. With advances in glycomics analysis techniques, research on IgG N-glycosylation in ocular diseases has attracted considerable attention. In diabetic retinopathy, decreased levels of IgGgalactosylation, fucosylation, and sialylation may contribute to microvascular damage and neuroretinopathy by enhancing complement activation and inflammatory responses. In age-related macular degeneration, disease progression is accompanied by dynamic changes in glycosylation patterns, with immunomodulatory alterations observed in early stages and pronounced pro-inflammatory features in advanced disease. In neuromyelitisoptica spectrum disorders, reduced IgGgalactosylation is associated with disease severity during acute phases, and specific glycoform alterations in the Fc and Fab regions of IgG can effectively differentiate neuromyelitisoptica spectrum disorders from multiple sclerosis. IgG N-glycosylation not only provides a new perspective for understanding the immune-inflammatory mechanisms underlying ocular diseases but also demonstrates potential as a biomarker for disease diagnosis, staging, and differential diagnosis.

Microsporidial keratitis: pathogenesis, risk factors, diagnosis, and treatment

Jiang Hanyu, Jiang Yang, Li Ying, and Sun Xuguang

2026, 50(1):  22-28.  doi:10.3760/cma.i.cn115500-20251203-26104

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Microsporidial keratitis is an infectious corneal disease caused by microsporidial infection. Its clinical manifestations are non-specific and often resemble conditions such as Thygeson's superficial punctate keratitis, viral keratitis, or fungal keratitis, leading to high rates of misdiagnosis and underdiagnosis. The disease can occur in both immunocompetent and immunocompromised individuals. Major risk factors include exposure to soil or contaminated water, pet ownership, contact lens wear, and the use of topical corticosteroids.Based on clinical features, the disease is primarily classified into two types: microsporidial keratoconjunctivitis, which tends to be self-limiting with a favorable prognosis, and microsporidial stromal keratitis, which is more refractory, often requires corneal transplantation surgery, and carries a poorer prognosis. Diagnosis relies mainly on laboratory tests such as corneal scraping stains and polymerase chain reaction (PCR). Regarding treatment, topical fluoroquinolones may be tried for microsporidial keratoconjunctivitis, while microsporidial stromal keratitis responds poorly to traditional anti-infective agents. Topical fumagillin eye drops could represent a promising new therapeutic approach. Enhancing awareness of this disease, achieving early diagnosis, and implementing appropriate treatment are crucial for improving patient outcomes.

Comparison of myopia-control mechanisms of simultaneous competing defocus and diffusion optics technology lenses

Zhen Yi, Huang Yan

2026, 50(1):  29-38.  doi:10.3760/cma.i.cn115500-20251107-26105

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The onset and progression of myopia are closely related to the visual signals received by the retina, including optical defocus and contrast signals. This review systematically integrates evidence from optical modeling, animal studies, and clinical trials on myopia control lenses based on Simultaneous Competing Defocus (SCD) and Diffusion Optics Technology (DOT), and proposes a cascaded regulatory framework of “retinal ON/OFF pathway rebalancing → choroidal response → slowed scleral remodeling.” At the optical level, SCD lenses weaken mid-high spatial frequency input via myopic defocus in the spatial domain, whereas DOT lenses implement a mild, wide-field reduction of contrast in the signal-intensity domain while striving to preserve central clarity. At the physiological level, both types of lenses are characterized by reduced OFF-pathway activity, relatively enhanced ON-pathway activity, concomitant choroidal thickening, and a decreased rate of scleral remodeling. At the clinical level, prospective and randomized controlled studies suggest that their inhibitory effects on refractive progression and axial elongation are of a similar magnitude, and that the effect size is associated with treatment adherence and daily wearing time.

Application of visual stimulation and training techniques in functional rehabilitation of optic nerve diseases

Liu Xiaotian, Wu Yinan, Xu Xiaoping

2026, 50(1):  39-46.  doi:10.3760/cma.i.cn115500-20250925-26106

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Optic nerve diseases are among the leading causes of irreversible vision loss, with traditional treatments primarily focusing on etiology control rather than functional recovery. In recent years, visual training and stimulation techniques based on neuroplasticity theory have brought new hope for optic nerve disease rehabilitation. Transcorneal electrical stimulation (TcES) shows promising applications in Leber hereditary optic neuropathy and glaucoma; repetitive transorbital alternating current stimulation (rtACS) with individualized electrode positioning technology can significantly improve patient's visual field and visual acuity; 40Hz light flicker stimulation promotes optic nerve regeneration by activating microglia; virtual reality visual training demonstrates sustained visual function improvement in glaucoma patients; cortical visual prosthesis technology achieves letter recognition function in humans for the first time. These techniques provide new treatment options for optic nerve disease patients by activating neuroplasticity, promoting neuroprotection and regeneration, and improving visual function. With continuous technological development and refinement, the introduction of predictive rehabilitation intervention strategies has further optimized treatment outcomes, offering hope for rehabilitation to more patients.

The role of lipid metabolism-related composite indicators in the diagnosis of blinding eye diseases

Zhang Jinjin, Zhang Mingzhi

2026, 50(1):  47-53.  doi:10.3760/cma.i.cn115500-20251128-26107

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Lipid metabolism-related composite indicators, by integrating basic blood lipid parameters and relevant variables, offer a more sensitive quantification of systemic insulin resistance, oxidative stress, and endothelial function, thereby overcoming the limitations associated with single lipid parameters. In the context of blinding ocular diseases, these indicators demonstrate distinct pathological implications. The triglyceride-glucose (TyG) index, functioning as a surrogate marker for insulin resistance, is positively correlated with the severity of diabetic retinopathy and the extent of microvascular injury. The apolipoprotein B/non-high-density lipoprotein cholesterol (ApoB/non-HDL-C) ratio, reflecting ectopic lipid deposition and local inflammation, aids in predicting the risk of neovascular age-related macular degeneration. Elevated non-HDL-C levels indicate lipid metabolic dysregulation within the optic nerve and its microenvironment in glaucoma. And the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio exhibits superior diagnostic efficacy and a significant association with visual prognosis in non-arteritic anterior ischemic optic neuropathy. Despite current challenges such as the lack of unified diagnostic thresholds and the need to further elucidate causal mechanisms, risk assessment systems based on these composite indices are emerging as pivotal tools for facilitating early diagnosis, stratified screening, and precise prevention and treatment of ophthalmic diseases.

Mechanism of lipid metabolism in the development of age-related macular degeneration

Gao Yumin, Liu Dongcheng, Qin Bo, Liu Jingwen, Lu Yijie

2026, 50(1):  54-60.  doi:10.3760/cma.i.cn115500-20251016-26108

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Age-related macular degeneration (AMD) is a leading cause of global blindness and currently remains incurable. Accumulating evidence suggests that alterations in lipid homeostasis may contribute to the pathogenesis of AMD. Lipid metabolism supplies energy to the retina, contributes to cellular structure, and maintains cellular homeostasis. Specifically, imbalances in circulating lipoproteins have been implicated in the onset of AMD. Lipid metabolism influences AMD progression through mechanisms such as lipofuscin accumulation, mitochondrial dysfunction, and neovascularization.Among lipid metabolism genes,the protective allele of the ATP-binding cassette transporter A1 can enhance cholesterol excretion and reduce lipid deposition, while the risk variant weakens this function. The ε4 allele of apolipoprotein E is an important protective factor for AMD and may be related to the promotion of lipid clearance. The ε2 allele is usually associated with an increased risk. There are also opposite-effect loci for the cholesterol ester transfer protein and liver lipase C genes. By understanding the role of lipids in the development and maintenance of AMD, developing treatment methods targeting lipid metabolism-related AMD can provide new solutions for the treatment of AMD related to lipid metabolism.

Surgical methods for idiopathic macular hole

Liu Jiyin, Liu Jiandong, Gao Rongyu, Sun Xianyong

2026, 50(1):  61-67.  doi:10.3760/cma.i.cn115500-20250923-26109

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The surgical concept for idiopathic macular holes has evolved from "relieving traction" to an individualized and precise era of "structural reconstruction". To enhance the hole closure rate and postoperative visual quality, various modified techniques of internal limiting membrane (ILM) peeling have emerged: expanded ILM peeling aims to completely relieve tangential traction, ILM peeling with preservation of the fovea is designed to minimize iatrogenic damage to the fovea, ILM inversion and coverage or filling (using autologous ILM or human Amniotic Membrane, hAM) provide mechanical support to actively promote hole healing and closure, flapless ILM transposition achieves coverage by horizontal transposition of a pedicled inner membrane flap. The core of modern surgical strategies lies in selecting the best technique based on the specific characteristics of the hole, with the ultimate goal of achieving high-level anatomical closure and maximizing the repair of photoreceptor microstructure, thereby significantly improving long-term visual quality for patients.

Mechanism of endoplasmic reticulum stress and mitophagy in regulating the development of cataract

Yue Peilin, Wang Zhenyu, Song Xudong

2026, 50(1):  68-75.  doi:10.3760/cma.i.cn115500-20251009-26110

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The disruption of lens epithelial cell homeostasis is a critical event in cataract pathogenesis. Endoplasmic reticulum stress and mitophagy, as essential quality control mechanisms for maintaining lens homeostasis, become dysregulated under pathological conditions such as aging and oxidative stress. Their dysfunction creates a vicious cycle, jointly triggering lens epithelial cell apoptosis and lens opacification. Targeted regulation of key nodes in these processes may provide novel pharmaceutical strategies for the prevention and treatment of cataract.

Application of trypan blue in capsular staining for cataract surgery

Li Ruofan, Li Xuemin

2026, 50(1):  75-80.  doi:10.3760/cma.i.cn115500-20250725-26111

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In cataract surgery, continuous curvilinear capsulorhexis (CCC) is a critical step. However, with certain cataract types where the red reflex is absent and there's poor contrast between the anterior capsule and cortex, the capsulorhexis path becomes difficult to visualize, often leading to CCC failure. To address this, Trypan blue (TB) has been widely adopted as a capsular staining agent. Since its first application in cataract surgery staining in 1999, TB has been commonly used at concentrations ranging from 0.04% to 0.1%, with 0.06% recognized globally as a safe and effective concentration. Various staining techniques have been developed, including injection under an air bubble, subcapsular injection, injection under an ophthalmic viscosurgical device, and one-step intracameral injection. Studies have confirmed that low-concentration TB does not cause significant corneal endothelial toxicity, elevated intraocular pressure, or inflammatory reactions. By enhancing surgical visualization, it effectively improves both the safety and efficiency of the procedure.