超声生物显微镜在巩膜栗子刺诊断中的应用

Ultrasound biomicroscopy in the diagnosis of chestnut thorn in sclera

目的探讨超声生物显微镜检查（Ultrasound biomicroscopy，UBM）在巩膜栗子刺诊断中的应用。方法回顾性分析巩膜栗子刺刺伤65例（65眼）。术前进行裂隙灯显微镜、前段照相、UBM等检查。由UBM检查确诊并定位栗子刺，手术均摘出栗子刺异物。结果65例UBM确诊并定位后手术取出栗子刺异物，其中5例巩膜糜烂变薄，1例因巩膜过薄行自体巩膜板层移植修补术，1例出现细菌性眼内炎，进行晶状体玻璃体切除术，术后抗生素治疗控制了感染，挽救了眼球。结论UBM诊断定位巩膜栗子刺有重要临床意义，能及时、尽早发现巩膜栗子刺，减少误诊、漏诊及感染发生。它弥补了常规临床检查和影像学检查的不足。

Objective To investigate the application of ultrasound biomicroscopy （UBM） in the diagnosis of sclera chestnuts thorns. Methods Retrospective study of 65 eyes of 65 cases which were diagnosed as scleral chestnuts thorns. Before operation, clinical examination was performed, including slit lamp microscopy and anterior segment photograph. Chestnuts thorns were localized using UBM were confirmed by surgical operation. Results Seleral chestnuts thorns of all cases were extracted successfully after being localized by UBM. Five eyes have local sclera erosion and thinning. Among which 1 eye get autologous sclera transplantation for its sclera was too thin. One eye was suffering from bacterial endophthalmitis after operation. His eye ball was saved after vitrectomy and lensectomy combined with postoperative antibiotic therapy. Conclusion UBM is highly significant and has great practical value for diagnosing chestnuts thorns in sclera. And UBM can find chestnuts thorns in time, alleviate introcular infection, decrease misdiagnosis and missed diagnosis. It makes up for the dificiency of routine clinical examination and imaging examination.