超声生物显微镜对外伤眼晶状体悬韧带异常的观察

Assessment of zonules after blunt trauma using ultrasound biomicroscopy

目的通过超声生物显微镜对闭合性外伤眼的晶状体悬韧带状态进行观察,为晶状体手术方式的选择提供帮助。方法对196例闭合性眼钝伤患者207只眼进行超声生物显微镜检查并记录晶状体悬韧带损伤情况和范围。超声生物显微镜检查前裂隙灯观察晶状体推测晶状体悬韧带损伤。结果超声生物显微镜检查207只眼中,悬韧带发生异常的有67只眼(32.4%)。晶状体悬韧带异常表现有:晶状体悬韧带的断裂以及悬韧带的延长,其中46只眼(68.7%)晶状体悬韧带发生断裂,15只眼(22.4%)晶状体悬韧带发生延长,6只眼(9.0%)同时存在晶状体悬韧带断裂和延长。晶状体悬韧带断裂范围从1个象限以内到360°不等,晶状体悬韧带异常区域还表现有睫状体变平和晶状体赤道部变圆。裂隙灯检查35只眼(16.9%)发生虹膜震颤和晶状体偏位。结论超声生物显微镜能对晶状体悬韧带等眼前段结构进行准确观察,对于晶状体手术方式的选择及预后有重要意义。

Objective To evaluate the role of ultrasound biomicroscopy （UBM） as a method for assessing the zonules after eye blunt trauma, in order to help the selection of the surgical technique and improve the outcomes of traumatic cataract surgery. Methods Two hundred and seven eyes with eye blunt trauma were examed using UBM with a 50 MHz transducer. The degree and extent of the zonular defects were recorded. All patients also had the slit-lamp examination before the UBM. Results Examined using UBM,zonular defects were identified in 67 of 207 eyes （32.40%）. Zonular abnormalities include broken zonules and stretched zonules. Fortysix eyes （68.70/00） had broken zonules,15 eyes （22.40/00） had stretched zonules, 6 eyes （9.0%） had both broken and stretched zonules. The extent of broken zonules ranged from under one quadrant to 360°. Increased lenticular sphericity and ciliary body flattening were seen in the area of zonular defects on UBM. Examined using slit-lamp, 35 of 207 eyes （16.9%） had phacodonesis and iridodonesis. Conclusions UBM is an effective method for identifying zonular defects in patients with anterior segment trauma. Diagnosing zonular defects preoperatively is of helpful in surgical planning and reduce complications.