超声生物显微镜联合前房角镜在前房角非金属异物诊断中的应用

Ultrasound biomicroscopy combined with gonioscopy in the diagnosis of non-metallic foreign body in anterior chamber angle

目的探讨超声生物显微镜（UBM）联合前房角镜在前房角非金属异物诊断中的作用。方法回顾性分析2009年12月至2014年10月在我院治疗的前房角非金属异物10例（10眼）。术前进行了裂隙灯显微镜、检眼镜、前段照相、彩超、眼眶CT、UBM、前房角镜等检查。UBM检查结合前房角镜检查确诊并定位前房角非金属异物。结果10例UBM检查确诊并定位后手术摘出非金属异物，其中植物性异物（栗子刺）8例，石屑1例，煤渣1例。术后未出现感染、继发性青光眼、低眼压、睫状体脱离、脉络膜脱离或视网膜脱离。结论UBM联合前房角镜检查诊断、定位前房角非金属异物有重要临床价值，能及时、尽早发现前房角非金属异物，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） combined with gonioscopy in the diagnosis of non-metallic foreign body in anterior chamber angle. Methods Retrospective study on 10 eyes of 10 patients who were diagnosed as anterior chamber angle non-metallic foreign bodies from October 2010 to December 2014. The routine clinical examination was performed before the surgery including slit lamp microscopy, ophthalmoscopy, anterior segment photograph, color Doppler imaging（CDI）, computed tomography（CT） , UBM and gonioseopy. UBM was used to diagnose and locate suspicious anterior chamber angle foreign bodies, which were comfirmed as non-metallic foreign bodies by CT, gonioscopy and surgical operation. Results Anterior chamber angle foreign bodies of all cases were extracted successfully, and all foreign bodies were non-metallic. Eight cases were planted foreign bodies （chestnuts thorns）, one case was tiny stone and one case was coal clinder. No postoperative infection, secondary glaucoma, low intraocular pressure, ciliary body detachment, choroid or retinal detachment occurred. Conclusion UBM and gouioscopy have great practical value for diagnosing non-metallic foreign bodies in anterior chamber angle. UBM could find non-metallic foreign bodies in time, alleviate intraocular infection and decrease misdiagnosis and missed diagnosis.