外伤性白内障术前检查的研究进展

Research progress in preoperative evaluation of traumatic cataract

外伤性白内障的手术是一项复杂的手术。严重的眼外伤后,角膜水肿或瘢痕、虹膜后粘连、血性或炎性房水等使得裂隙灯显微镜很难对晶状体及玻璃体情况进行观察。外伤性白内障术前对患眼进行特殊检查并评估,有助于手术医师制定手术方案,避免术中并发症,预估术后视觉质量。术前以CT排除眼内异物,以B超及彩色超声多普勒成像了解眼球整体情况,20 MHz B超评估晶状体后囊的完整性,以超声生物显微镜(UBM)观察晶状体悬韧带的情况。随着光学仪器发展,眼前节光相干断层扫描仪(AS-OCT)、扫频源光相干断层扫描仪(SS-OCT)、Scheimpflug成像也在一定程度上对外伤性白内障眼术前评估提供帮助。本文将对外伤性白内障术前评估作一综述。

The operation of traumatic cataract is a complicated operation.After severe ocular trauma,corneal edema or scar,posterior synechia of iris,bloody or inflammatory aqueous humor make it difficult to observe the lens and vitreous body under slit lamp microscope.Special examination and evaluation of the affected eyes before traumatic cataract surgery is helpful for surgeons to formulate surgical strategies,avoid intraoperative complications and predict postoperative visual quality.CT are used to exclude intraocular foreign bodies before operation,B-Scan and color doppler ultrasound are used to understand the overall condition of the eyeball,20 MHz B-Scan is used to evaluate the integrity of the posterior capsule of the lens,and ultrasound biomicroscopy(UBM)is used to observe the condition of the lens zonule.With the development of optical instruments,anterior segment optical coherence tomography(AS-OCT),swept source optical coherence tomography(SS-OCT)and Scheimpflug imaging are also helpful to the preoperative evaluation of traumatic cataract.This article will review the preoperative evaluation of traumatic cataract.