超声生物显微镜联合前房角镜在前房角异物取出术中的应用

Application of ultrasound biomicroscopy combined with gonioscope in extraction of foreign body in anterior chamber

目的探讨超声生物显微镜(UBM)联合前房角镜在前房角异物取出术中的应用。方法回顾性分析唐山市眼科医院2013年9月—2017年9月收治的前房角异物患者32例(32只眼)在UBM联合前房角镜下行前房角异物取出术。术前及术后检查并记录术眼的最佳矫正视力(BCVA)及眼压数据,并在术后统计手术成功率及手术并发症。结果(1)BCVA:术前平均为(0.26±0.11),与术后(0.15±0.10)比较,差异有统计学意义(t=18.940,P=0.000)。(2)眼压:术前平均为(21.74±1.44)mm Hg,与术后(15.81±2.14)mm Hg比较,差异有统计学意义(t=19.931,P=0.000)。(3)成功率:32例(32只眼)的前房角异物全部取出,取出物均为栗刺,手术成功率100%。(4)并发症:虹膜小范围脱色素2例;取出异物时前房出血1例;术后无晶状体损伤、眼内炎发生,并发症的发生率为9.37%。结论UBM能及时、尽早发现并定位植物性前房角异物,联合前房角镜行异物取出术,手术成功率高,并发症少,可提高BCVA,降低眼压。

OBJECTIVE To investigate the application of ultrasonic biological microscope(UBM)combined with gonioscope in the removal of foreign body in anterior chamber Angle.METHODS A Retrospective analysis was performed on 32 patients(32 eyes)with anterior chamber foreign body who were treated in Tangshan Eye Hospital from September 2013 to September 2017 and underwent foreign body removal under ultrasonic biological microscope(UBM)combined with gonioscope.The best corrected visual acuity(BCVA)and intraocular pressure of the operated eyes were recorded preoperatively and postoperatively,and the success rate and complications were recorded postoperatively.RESULTS(1)BCVA:The preoperative mean value was(0.26±0.11),and the postoperative mean value was(0.15±0.10),the difference was statistically significant(t=18.940,P=0.000).(2)Intraocular pressure:The preoperative mean value was(21.74±1.44)mmHg,and the postoperative mean value was(15.81±2.14)mm Hg and their difference was of statistical significance(t=19.931,P=0.000).(3)The success rate:All the foreign bodies(chestnut thorns)in the anterior chamber horn of 32 cases(32 eyes)were removed.The success rate of the operation was 100%.(4)Complications:Small iris depigmentation happened in two cases;Anterior chamber hemorrhage happened in one case when foreign body was removed;No lens injury or endophthalmitis occurred,and the incidence rate of complications was 9.37%.CONCLUSIONS UBM can detect and locate botanical foreign body in anterior chamber early and timely.There are many advantages of removal of foreign body with gonioscope,such as high success rate,less complications,improving BCVA and reducing intraocular pressure.