眼科内镜微创技术存在的问题与规范化发展

Problems related to ophthalmic endoscopic surgery and some strategies for its systematicdevelopment into a precise procedure

随着内镜医学的发展，内镜微创技术在眼科迅速拓展，内镜下经鼻视神经管减压术、经蝶筛径路眶减压术等相继被开发和不断完善，赋予了视神经、眼眶及泪道疾病全新的诊疗理念与内涵。但随着该项技术的推广，亦暴露出不少问题，如未经严格培训即在“自学”中摸索开展、手术适应证选择不当、缺乏统一诊疗规范与客观疗效评价体系等。因此，建立一套科学、先进的专业技术规范化培训、考核管理与准人制度，积极开展该领域的基础与应用基础研究，对促进该项技术的良性、快速、健康、规范、可持续发展具有重要意义。

With the rapid development of mini-invasive endoscopic techniques, in recent years many ophthalmic endoscopic surgeries such as endoscopic transnasal optic canal decompression and endoscopic transethmeid orbital decompression have been developed and extensively used in clinics. Good results have been achieved and many new findings have been exploited for physiopathology and treatment of a variety of optic nerve diseases, orbital diseases and lacrimal disorders. However, along with its increasingly extensive application, many problems have arisen due to relatively poor surgical conditions and equipment at the medical institutes, performance of surgery without experience and training in ophthalmic endoscopic techniques, improper surgical indications and the lack of an objective system for evaluating surgical outcomes. Therefore, it is necessary and important to establish strict and regular training programs, to develop a guide for regular diagnosis and treatment, and to carry out basic and clinical research for the systematic and precise development of this advanced technique.