应用超声生物显微镜检查及诊断眼部睫状体脱离

Diagnosis and analysis of cyclodialysis by ultrasound biomicroscopy

目的探讨眼部睫状体脱离的形态学改变及其临床意义。方法应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ，ＵＢＭ）对１７３例睫状体脱离的患眼与健眼的形态进行观察，并对其测量的相关参数进行统计学分析。结果所有睫状体脱离眼均为３６０°全周脱离，而非某一象限的脱离。ＵＢＭ探查睫状体脱离的特征性表现：巩膜与睫状体间存在无回声区，睫状突位置前移、前旋，睫状体平坦部向玻璃体中轴部位移动，部分患者可见睫状体平坦部呈层间分离。部分患者可显示虹膜、睫状体与巩膜附着点完全脱离，形成睫状体离断，离断的范围可为眼球的某一象限而非眼球全周，致使前房与睫状体上腔之间形成完全沟通的瘘口。脱离眼的前房深度（２１１５±５８９）μｍ较未脱离眼的前房深度（２７３６±４４１）μｍ浅（ｔ＝４．４９，Ｐ＜０．００１），前房变浅的原因是睫状突前移、前旋导致虹膜根部膨隆。结论应用ＵＢＭ检查可以明确地诊断睫状体脱离，且不受屈光间质条件的限制，将为临床治疗提供可靠的依据。

Objective To determine the morphologic changes and their clinical significance of cyclodialysis. Methods 173 eyes of 173 patients with cyclodialysis were examined by ultrasound biomicroscopy (UBM) for the morphologic changes, and the measurements of relative parameters were analyzed statistically. Results The cyclodialysis in all the cases was 360. The characteristic manifestations of cyclodialysis found by UBM were as follows: no echoes between sclera and ciliary body, anterior displacement and rotation of ciliary process and displacement of pars plana toward the centre of eyeball. Superciliary effusion could be observed in some cases. In some patients, the ciliary body may be completely disintegrated from the scleral spur, but the disintegration may be quadrantal instead of 360, resulting in a fistula between anterior chamber and superciliary cavity. The anterior chamber depth of the affected eye (2 115589) m was markedly shallower than that of the normal eye (2 736441) m (t=4.49, P<0.001). The shallowing of anterior chamber was caused by the anterior displacement and rotation of ciliary processes and the resulting anterior bulging of the iris root. Conclusions UBM can be used to make a correct diagnosis of cyclodialysis irrespective of optic media condition, and can provide evidences for treatment.