Vault predicting after implantable collamer lens implantation using random forest network based on different features in ultrasound biomicroscopy images

AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images were collected from the Lixiang Eye Hospital to provide the patient’s preoperative parameters as well as the vault of the ICL after implantation.The vault was set as the prediction target,and the input elements were mainly ciliary sulcus shape parameters,which included 6 angular parameters,2 area parameters,and 2 parameters,distance between ciliary sulci,and anterior chamber height.A random forest regression model was applied to predict the vault,with the number of base estimators(n_estimators)of 2000,the maximum tree depth(max_depth)of 17,the number of tree features(max_features)of Auto,and the random state(random_state)of 40.0.RESULTS:Among the parameters selected in this study,the distance between ciliary sulci had a greater importance proportion,reaching 52%before parameter optimization is performed,and other features had less influence,with an importance proportion of about 5%.The importance of the distance between the ciliary sulci increased to 53% after parameter optimization,and the importance of angle 3 and area 1 increased to 5% and 8%respectively,while the importance of the other parameters remained unchanged,and the distance between the ciliary sulci was considered the most important feature.Other features,although they accounted for a relatively small proportion,also had an impact on the vault prediction.After parameter optimization,the best prediction results were obtained,with a predicted mean value of 763.688μm and an actual mean value of 776.9304μm.The R²was 0.4456 and the root mean square error was 201.5166.CONCLUSION:A study based on UBM images using random forest network can be performed for prediction of the vault after ICL implantation and can provide some reference for ICL size selection.

Comparison of anterior section parameters using anterior segment optical coherence tomography and ultrasound biomicroscopy in myopic patients after ICL implantation

AIM：To compare the agreement of anterior chamber depth（ACD）and central vault measurements obtained by anterior segment optical coherence tomography（AS-OCT）and ultrasound biomicroscopy（UBM）of post surgical high myopic eyes with posterior chamber phakic intraocular lens（Visian ICL;STAAR Surgical）implantation.·METHODS：Fifty-two phakic eyes of 28 high myopic patients who underwent implantable Collamer lens（ICL）surgery for the correction of high myopia were studied.The postoperative ACD,the distance between the corneal endothelium and the anterior surface of ICL（cornea-ICL）and the central vault were measured with the AS-OCT system and the UBM system.Intraclass correlation coefficient（ICC）and the Bland-Altman plot were used to evaluate the repeatability and agreement of two devices.·R ESULTS：The mean ACD,cornea-ICL and central vault in the 52 phakic eyes after ICL surgery was 3.19±0.28 mm,2.47±0.28 mm,0.50±0.19 mm by AS-OCT and3.13±0.25 mm,2.49±0.25 mm,0.44±0.19 mm by UBM,respectively.Pairwise comparison of ACD and central vault measurements showed significant differences between AS-OCT and UBM（〈0.05）.However,no statistically significant difference was found between these imaging techniques in cornea-ICL（〉0.05）.The Pearson correlation coefficient（）between AS-OCT and UBM measurements for ACD,cornea-ICL and vault was0.88,0.80 and 0.89,respectively（〈0.001）.The ICC was0.89-0.94 for the measurements of AS-OCT and UBM.Bland-Altman analysis showed the 95%limits of agreement of ACD,cornea-ICL,central vault measurements between these two devices were-0.20 to 0.32 mm,-0.36to 0.32 mm and-0.12 to 0.24 mm,respectively.58·CONCLUSION：Central ACD and vault measurements using AS-OCT demonstrated a slight significantly higher value than using UBM in phakic eyes after ICL surgery.These two devices should not be used interchangeably for measurements of central ACD and vault in patients after phakic intraocular lens implantation.

Gonioscopy and Ultrasound Biomicroscopy in the Detection of Angle Closure in Patients with Shallow Anterior Chamber

Objective To assess the agreement between gonioscopy and ultrasound biomicroscopy(UBM) in detecting angle closure in Chinese patients with shallow anterior chamber. Methods An observational comparative study of the two different examination methods was conducted. Patients with normal intraocular pressure and temporal peripheral anterior chamber depth less than a quarter of corneal thickness based on slit lamp examination were included in this study from December 2007 to May 2009 in the outpatient clinic of First Hospital of Tsinghua University. Gonioscopy was performed with a Goldman goniolens in dark room first and followed by full beam light and indentation. If the filtering trabecular meshwork was invisible or any peripheral anterior synechia was found, that quadrant of the angle was considered closed. UBM was first undertaken in a darkened room then repeated with normal room lighting. If iridotrabecular apposition was showed, that quadrant of the angle was considered closed. The status of angle closure of each quadrant with different methods was recorded. Results 85 eyes of 46 patients were included in this study. The agreement between gonioscopy and UBM was poor(κ<0.4) with Kappa analysis in both dark and light conditions in each quadrant. The accordance of agreement between gonioscopy and UBM was hardly affected by age or sex, while in dark condition, eyes with deeper anterior chamber(P=0.005) or plateau iris configuration tended to produce different results(P=0.075) in the 2 methods. Conclusion Gonioscopy and UBM are both indispensable methods for detecting angle closure, neither can completely replace the other.

Diagnosis of lacrimal canalicular diseases using ultrasound biomicroscopy: a preliminary study

· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·METHODS: Sixty cases(63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included32 patients(32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients(12eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case(1 eye, 1 canaliculus)of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.· RESULTS: UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2(2 eyes, 2canaliculi) of the 9 patients(12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14patients(14 eyes, 14 canaliculi).·CONCLUSION: UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.

Simultaneous follow-up of mouse colon lesions by colonoscopy and endoluminal ultrasound biomicroscopy

AIM:To evaluate the potential use of colonoscopy and endoluminal ultrasonic biomicroscopy(eUBM)to track the progression of mouse colonic lesions.METHODS:Ten mice were treated with a single azoxy-methane intraperitoneal injection(week 1)followed by seven days of a dextran sulfate sodium treatment in their drinking water(week 2)to induce inflammationassociated colon tumors.eUBM was performed simultaneously with colonoscopy at weeks 13,17-20 and21.A 3.6-F diameter 40 MHz mini-probe catheter was used for eUBM imaging.The ultrasound mini-probe catheter was inserted into the accessory channel of a pediatric flexible bronchofiberscope,allowing simultaneous acquisition of colonoscopic and eUBM images.During image acquisition,the mice were anesthetized with isoflurane and kept in a supine position over a stainless steel heated surgical waterbed at 37℃.Both eUBM and colonoscopic images were captured and stored when a lesion was detected by colonoscopy or when the eUBM image revealed a modified colon wall anatomy.During the procedure,the colon was irrigated with water that was injected through a flush port on the mini-probe catheter and that acted as the ultrasound coupling medium between the transducer and the colon wall.Once the acquisition of the last eUBM/colonoscopy section for each animal was completed,the colons were fixed,paraffin-embedded,and stained with hematoxylin and eosin.Colon images acquired at the first time-point for each mouse were compared with subsequent eUBM/colonoscopic images of the same sites obtained in the following acquisitions to evaluate lesion progression.RESULTS:All 10 mice had eUBM and colonoscopic images acquired at week 13(the first time-point).Two animals died immediately after the first imaging acquisition and,consequently,only 8 mice were subjected to the second eUBM/colonoscopy imaging acquisition(at the second time-point).Due to the advanced stage of colonic tumorigenesis,5 animals died after the second time-point image acquisition,and thus,only three were subjected to the third eUBM/colonoscopy imaging acquisition(the third time-point).eUBM was able to detect the four layers in healthy segments of colon:the mucosa(the first hyperechoic layer moving away from the mini-probe axis),followed by the muscularis mucosae(hypoechoic),the submucosa(the second hyperechoic layer)and the muscularis externa(the second hypoechoic layer).Hypoechoic regions between the mucosa and the muscularis externa layers represented lymphoid infiltrates,as confirmed by the corresponding histological images.Pedunculated tumors were represented by hyperechoic masses in the mucosa layer.Among the lesions that decreased in size between the first and third time-points,one of the lesions changed from a mucosal hyperplasia with ulceration at the top to a mucosal hyperplasia with lymphoid infiltrate and,finally,to small signs of mucosal hyperplasia and lymphoid infiltrate.In this case,while lesion regression and modification were observable in the eUBM images,colonoscopy was only able to detect the lesion at the first and second time-points,without the capacity to demonstrate the presence of lymphoid infiltrate.Regarding the lesions that increased in size,one of them started as a small elevation in the mucosa layer and progressed to a pedunculated tumor.In this case,while eUBM imaging revealed the lesion at the first time-point,colonoscopy was only able to detect it at the second time-point.All colonic lesions(tumors,lymphoid infiltrate and mucosal thickening)were identified by eUBM,while colonoscopy identified just76%of them.Colonoscopy identified all of the colonic tumors but failed to diagnose lymphoid infiltrates and increased mucosal thickness and failed to differentiate lymphoid infiltrates from small adenomas.During the observation period,most of the lesions(approximately67%)increased in size,approximately 14%remained unchanged,and 19%regressed.CONCLUSION:Combining eUBM with colonoscopy improves the diagnosis and the follow-up of mouse colonic lesions,adding transmural assessment of the bowel wall.

Comparison of 25 MHz and 50 MHz ultrasound biomicroscopy for imaging of the lens and its related diseases

AIM： To compare the results of 25 MHz and 50 MHz ultrasound biomicroscopy（UBM） regarding the image characteristics of the lens and its related diseases and to discuss the application value of 25 MHz UBM in ophthalmology. METHODS： A total of 302 patients（455 eyes） were included in this study from November 2014 to May 2015. Patient ages ranged from 5 to 89 y（mean±SD： 61.0±17.7 y）. Different cross-sectional images of the lens were collected to compare and analyze the image characteristics and anterior segment parameters using 25 MHz and 50 MHz UBM in axial and longitudinal scanning modes, respectively. SPSS 19.0 for Windows, paired t-tests and B＆A plot analysis were used for data analysis, and a value of P〈0.05 was considered statistically significant. RESULTS： The 25 MHz UBM images displayed the lens shape more clearly than 50 MHz UBM images. Particularly for cataracts, the whole opacity of the lens was shown by 25 MHz UBM, but 50 MHz UBM only showed part of the lens. The means of the anterior segment parameters obtained using 25 MHz and 50 MHz UBM were as follows： central corneal thickness： 0.55±0.03 and 0.51±0.04 mm, respectively; central anterior chamber depth： 2.48±0.54 and 2.56±0.56 mm, respectively; and central lens thickness： 4.26±0.62 and 4.15±0.56 mm, respectively. A statistically significant difference was found between the results obtained with 25 MHz UBM and those obtained with 50 MHz UBM. The two devices had a good agreement in measuring the anterior segment parameters. CONCLUSION： The 25 MHz UBM had an obvious advantage in showing the lens shape. It can provide reliable imaging of the lens and its related diseases and has a high application value for ophthalmology.

Comparison of Anterior Segment Optical Coherence Tomography and Ultrasound Biomicroscopy for Iris Parameter Measurements in Patients with Primary Angle Closure Glaucoma

Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure glaucoma. Methods: Twenty-two patients (38 eyes) with primary angle closure glaucoma,including 5 eyes with acute angle closure glaucoma,10 fellow eyes of acute angle closure glaucoma, and 23 eyes with chronic angle closure glaucoma, were recruited consecutively in our hospital. All subjects underwent anterior scanning by AS-OCT and UBM. Peripheral iris thickness (PIT) and iris curvature (IC) in the anterior segment image obtained by AS-OCT and UBM were measured twice. The reproducibility of these two scans was evaluated by the intraclass correlation coefficient (ICC). A paired t-test was used to compare the difference between the two scans and the 95% limits of agreement (LoA) were calculated. Results:The ICCs of PIT and IC measured by UBM were 0.892 and 0.936 respectively, while for AS-OCT these values were 0.629 and 0.859, respectively. UBM had a higher reproducibility in both PIT and IC measurements as compared with AS-OCT.Differences in PIT measurement between AS-OCT and UBM(P=0.331).were not statistically significant, the 95% LoA (-0.178～0.156) mm was 36.1～41.2% of the mean. The IC was 0.053 mm smaller when measured by UBM than by AS-OCT (P=0.017), with the 95% LoA (-0.100～0.206) mm, or 36.2～74.6% of the mean.Conclusion:UBM had a higher reproducibility in measuring iris parameters than AS-OCT. The consistency between AS- OCT and UBM in measuring iris parameters was low in primary angle closure glaucoma patients. (Eye Science 2013; 28:1-6)

Functional evaluation of the filtering bleb by ultrasound biomicroscopy after trabeculectomy with mitomycin C

AIM： To study the role of ultrasound biomicroscopy（UBM） in the assessment of the bleb function after trabeculectomy with mitomycin C（MMC）. METHODS： This was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3 min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure（IOP） was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mmHg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36 mo after trabeculectomy（13.6±9.7 m o）. RESULTS： This study included 33 trabeculectomy filtering blebs of 25 patients（9 males and 16 females）. The mean age of patients was 53.2±14.2 y（range 25-71y）. We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs（IOP ≤18 mmHg without antiglaucoma medications）, others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings（intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts） and cases with different grades of clinical functional success（P〈0.01）.CONCLUSION： UBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.

Evaluation of the Changes in Anterior Segment Morphology with Ultrasound Biomicroscopy after Vitrectomy without Use of Tamponade in Pseudophakic Eyes

Aim: In this study we investigated the changes in anterior segment morphology in pseudophakia patients that underwent ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Method: Pseudophakic patients who undergo PPV were enrolled in this prospective study between October 2012 and April 2015. Study included patients in whom intraocular tamponade was not used during PPV operation. UBM measurements were performed both before and 10 days after the operation. Anterior chamber depth (ACD) was measured using axial images of anterior segment. Trabecular meshwork-iris angle (TIA), ciliary body thickness (CBT), sclera thickness (ST), trabecular meshwork-ciliary process distance (T-CPD), iris-ciliary processes distance (I-CPD), and iris thickness (IT) were measured at temporal quadrant based on radial section images of the angle. Values measured before and after the operation were statistically compared with each other. Results: This study included 30 patients (18 females, 12 males) that underwent an operation ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Mean age was 69.6 ± 9.1 (55 - 85) years. Eighteen operations occurred on the left eye whereas twelve operations occurred on the right eye. CBT1, CBT2, CBT Max, T-CPD, and I-CPD were significantly decreased after operation when compared with the values of baseline (before) (p = 0.018, p = 0.012, p = 0.001, p = 0.033, p = 0.015, respectively). Other evaluated parameters did not show statistically significant changes after the operation (p > 0.05). Discussion: PPV results in significant changes in ciliary body morphology together with changes in anterior segment parameters in pseudophakic cases.

Predictors of angle widening after laser iridotomy in Chinese patients with primary angle-closure suspect using ultrasound biomicroscopy

AIM:To assess the predictive value of baseline parameters of ultrasound biomicroscopy(UBM) for angle widening after prophylactic laser peripheral iridotomy(LPI) in patients with primary angle-closure suspect(PACS).METHODS:Angle-opening distance(AOD),trabecular iris angle(TIA),iris thickness,trabecular-ciliary process angle,and trabecular-ciliary process distance were measured using UBM performed before and two weeks after LPI.Iris convexity(IC),iris insertion,angulation,and ciliary body(CB) size and position were graded.Uni-and multivariate regression analyses were used to determine factors predicting the change in AOD(ΔAOD500,calculated as an angle width change before and after LPI) in all quadrants and in subgroup quadrants based on IC.RESULTS:In 94 eyes of 94 patients with PACS,LPI led to angle widening with increases in AOD500 and TIA(P<0.01).Multivariable regression analysis showed that IC(P<0.001),CB position(P=0.007) and iris insertion(P=0.049) were significantly predictive for ΔAOD500.All quadrants were categorized into extreme IC(27.8%),moderate IC(62.3%),and absent IC(9.9%) subgroups.The AOD500 increased by 220% and no other predictive factor was found in the extreme IC quadrants.The AOD500 increased by 55%,and baseline iris angulation was predictive for smaller changes in ΔAOD500 in the moderate IC quadrants.CONCLUSION:In PACS patients,quadrants with greater iris bowing predict substantial angle widening after LPI.Quadrants with a flatter iris,anteriorly positioned CB,and basal iris insertion are associated with less angle widening after LPI.Quadrants with iris angulation as well as a flatter iris configuration predict a smaller angle change after LPI.

改良Van Herick前房角宽度评估法的临床观察

目的:探讨在Van Herick法基础上更方便准确评估前房角宽度的方法。方法:纳入2021-01/12于我院就诊的年龄相关性白内障患者58例69眼,参考Van Herick法分为房角宽度≥1/2颞侧角膜厚度(CT)组(37例44眼)和<1/2CT组(21例25眼),应用超声生物显微镜测量中央前房深度和周边房角度数。结果:房角宽度≥1/2CT组和<1/2CT组患者中央前房深度有明显差异(2.64±0.27 mm vs 2.23±0.29 mm,P<0.01),且两组间上方、颞侧、下方和鼻侧象限房角度数均有明显差异(P<0.01)。房角宽度≥1/2CT组患者上方与下方象限房角度数无显著差异(P>0.05),其余各象限房角度数均有差异(P<0.05);房角宽度<1/2CT组患者上方与鼻、颞侧象限,下方与颞侧象限房角度数均有差异(P<0.05)。结论:裂隙灯下采用Van Herick法评估颞侧房角宽度,同时评估下方象限房角宽度,可以更简单、快速、准确地评估前房角的整体情况。

超声生物显微镜在儿科常见眼病中的应用进展

超声生物显微镜(UBM)是对复杂虹膜-睫状复合体进行高分辨率成像的一种非侵入性超声技术,尤其适用于角膜混浊及其他屈光介质不清的眼前段疾病。UBM成像现已广泛应用于成人,而在儿科人群中,因绝大部分眼前节疾病伴有角膜混浊,且无法提供详细病史,检查依存性差,因此UBM在小儿眼科中显得至关重要。本文就UBM在儿科常见眼病中的应用进展进行综述。

原发性闭角型青光眼患者一级亲属眼前节结构特点

目的:研究原发性闭角型青光眼(PACG)患者一级亲属的眼前节结构特点。方法:选择2020-09/2022-10于南昌大学附属眼科医院就诊的40-60岁PACG一级亲属48例48眼作为观察组,同时纳入同年龄段、无青光眼及青光眼家族史的健康体检者40例40眼为对照组,按年龄分为低龄组(40-49岁)和高龄组(50-60岁)。所有研究对象均行超声生物显微镜(UBM)检查,使用camera measure测量软件进行测量,主要测量指标包括前房深度(ACD)、前房面积(ACA)、前房宽度(ACW)、眼前节深度(ASD)、房角开放距离(AOD 500)、小梁虹膜夹角(TIA)、小梁虹膜间面积(TISA_(500))、晶状体拱高(LV)、虹膜曲率(IC)、虹膜厚度(IT 500)、巩膜睫状突夹角(SCPA)及虹膜睫状突距离(ICPD)。比较两组各指标。结果:观察组ACD、ACA、AOD 500、TISA_(500)、TIA均比对照组小,LV、IC均比对照组大(均P<0.05)。高龄观察组ACD、ACA、AOD 500、TISA_(500)、TIA明显小于同龄对照组,LV、IC大于同龄对照组(均P<0.05);低龄观察组ACD、AOD 500、TISA_(500)、TIA明显小于同龄对照组,LV、IC显著大于同龄对照组(均P<0.05)。高龄观察组的ACD、ACA、AOD 500、TISA_(500)、TIA均显著小于低龄观察组,LV、IC显著大于低龄观察组(均P<0.05)。观察组与对照组ACD分布有差异(P<0.05),其中中重度浅前房的占比约为对照组的10倍。相关性分析表明,TISA_(500)与ACD、ACA呈正相关,与LV、IC呈负相关,TISA_(500)主要受LV影响。IC与LV呈正相关,与ACD、ACA呈负相关。结论:正常眼轴的PACG一级亲属存在房角关闭的高风险性。PACG一级亲属的眼前节结构较正常人拥挤,晶状体前移可能是导致房角狭窄的始动影响因素。

超声生物显微镜(UBM)辅助下的改良睫状沟缝线固定人工晶状体植入术

目的评价超声生物显微镜(ultrasound biomicroscopy,UBM)辅助下的改良睫状沟缝线固定人工晶状体植入术的临床疗效。方法收集2015年1月至2016年12月于我院就诊的行睫状沟缝线固定人工晶状体植入术的患者21例(21眼)。术前行UBM检查,了解睫状沟位置结构,选择睫状沟固定位点。在固定位点旁制作口袋样板层巩膜隧道。行晶状体摘出及人工晶状体悬吊术,结扎缝线关闭巩膜隧道,同时将线结埋藏于隧道内。观察术前和术后1周、1个月、3个月、12个月的裸眼视力,术中及术后并发症。通过Pentacam检查及Image Pro Plus软件分析人工晶状体的位置。结果患者术后裸眼视力除2眼外(1眼为高度近视视网膜病变、1眼为老年性黄斑变性)均有一定程度的提高。术中及术后均未见严重并发症发生。线结埋藏切口闭合满意。术后1 d人工晶状体偏心量为(0.61±0.26) mm,术后1 d、1周、1个月、3个月偏心量无明显差异,术后12个月偏心量增大,为(0.64±0.27) mm,与其他时间点相比差异均有统计学意义(均为P <0.05)。术后1 d倾斜度为5. 71°±2. 05°,术后1周、1个月,3个月、12个月倾斜度明显减小,与术后1 d时相比差异均有统计学意义(均为P<0.05)。结论 UBM术前检查能够提高手术安全性,能够辅助选择合适的缝合位点从而提高术后视觉质量。改良的口袋样板层巩膜隧道埋线法,关闭切口及埋线同时完成,操作简便,并发症少。

超声生物显微镜(UBM)在闭角型青光眼手术前后的应用

目的探讨超声生物显微镜在闭角型青光眼手术前后的应用价值。方法回顾740例(963眼)闭角型青光眼患者的临床资料,分析UBM应用在本组患者术前诊断、手术方式选择、术后疗效评价方面的作用。结果所有患者术前诊断明确,术式选择正确,术后眼压有不同程度的下降,术后20例前房及脉络膜脱离。结论UBM在闭角型青光眼诊治过程中发挥重要作用。

超声生物显微镜在术前评估先天性上睑下垂眼睑解剖结构中的应用

目的初步探究超声生物显微镜(UBM)作为先天性上睑下垂(CP)术前眼睑解剖结构评估工具的可行性,并分析患侧眼提上睑肌及腱膜的病理改变。方法前瞻性病例研究。选取10例单眼先天性上睑下垂的初诊患者入组,根据病情的严重程度分为中度组(5例)和重度组(5例)。利用UBM(SW-3200L,35MHz)对患者双侧上眼睑进行观察并成像。将患侧眼的UBM图像与其术中所见及术后病理相对照,进一步比较患侧眼提上睑肌(提肌)及腱膜的免疫组化结果并作初步定量分析。结果UBM能对包括眼轮匝肌、腱膜、睑板和提上睑肌-Müller肌复合体在内的眼睑结构清晰成像。术前UBM成像发现的腱膜变薄、腱膜后退及腱膜劈裂在术中观察得以印证;术前UBM成像发现的脂肪浸润在术中观察和术后病理中均得以证实。关于脂肪的浸润,中度组中,脂肪组织在腱膜中的浸润密度高于在提肌中(P<0.05),重度组中亦然(P<0.01);脂肪组织在重度组提肌中的浸润密度稍高于中度组提肌(P<0.05),而重度组腱膜中脂肪组织的浸润密度显著高于中度组腱膜(P<0.01)。关于胶原纤维的增生,中度组中,胶原纤维在提肌和腱膜中的增生没有明显统计学差异(P>0.05);重度组中,胶原纤维在腱膜中的增生相比于提肌显著增高(P<0.01);此外,重度组提肌中胶原纤维的增生程度稍高于中度组提肌(P<0.05),而重度组腱膜中胶原纤维的增生程度显著高于中度组腱膜(P<0.01)。结论UBM可作为先天性上睑下垂患者术前眼睑解剖结构评估的有效无创检查,重度患者腱膜的组织结构比提肌更为紊乱。

眼前段微小异物UBM定位及异物摘出联合手术

目的 探讨眼前段微小异物的超声生物显微镜 (UBM )定位的意义及异物摘出联合白内障摘出等手术的效果。方法 应用其他检查方法未能确定的 12例眼前段微小异物 ,同时合并铁质沉着症 ,通过UBM检查 ,明确异物位置并采取异物摘出联合白内障囊外摘出、玻璃体切除、晶状体切除和 /或人工晶状体植入手术。结果 12眼均顺利摘出异物 ,同期植入人工晶状体 9眼中的 8眼获得 0 5以上良好视力。结论 高度怀疑眼前段微小异物 ,UBM检查是一种极好的定位方法 ;

非穿透性小梁切除术后UBM随访观察

目的研究超声生物显微镜（UBM）在非穿透性小梁切除术（NPTS）后随访的意义。方法对21例28～51岁开角型青光眼患者进行NPTS联合丝裂霉素C（MMC）及羊膜植入治疗，在术后1～18个月，UBM观察滤过泡的形态、形成液间腔的大小、剩余小梁膜的厚度及羊膜的变化。结果所有病例UBM下均形成前部的液间腔，随访18个月，其边缘逐渐钝化不规则，体积逐渐缩小，差异有统计学意义。角巩膜小粱带逐渐粗糙，其厚度测量差别较大。羊膜术后9个月左右融解，无明显后部液间腔存在。结论NPTS联合MMC及羊膜植入能有效降低眼压，远期效果良好。UBM适合于NPTS的随访，羊膜在NPTS中无明显的抑制纤维增生作用。

蒸馏水及泪然在UBM检查中对角膜上皮影响的对比研究

目的探讨两种不同超声介质在超声生物显微镜(ultrasound biomicroscopy,UBM)检查中对角膜上皮的影响。方法采用前瞻性研究方法将2012年1-4月在我院行超声生物显微镜的患者随机分为2组,蒸馏水组(30例46眼,采用蒸馏水作为超声介质)和泪然组(33例37眼,采用泪然作为超声介质),两组均于检查后10 min及24 h行角膜荧光素染色(cornealfluorescein staining,CSF)评分,评估角膜上皮缺损情况。结果检查后10 min泪然组角膜荧光素染色评分明显低于蒸馏水组(P<0.05),差异有统计学意义;24 h后两组角膜上皮荧光素染色均较前明显好转,差异无统计学意义(P>0.05)。结论UBM检查有损伤角膜上皮的风险,采用泪然作为超声介质能有效保护角膜上皮,缓解检查后不适症状。

眼挫伤后睫状体脱离的UBM观察

目的:超声生物显微镜(ultrasound biomicroscopy,UBM)观察眼挫伤后睫状体脱离的特点,并评价UBM指导下睫状体缝合手术治疗眼挫伤后睫状体脱离的临床效果。方法:应用UBM观察30例30眼因眼球挫伤导致睫状体脱离的特点,其中5例5眼行房角漏对应位置和范围的睫状体缝合复位手术,观察视力、眼压及复查UBM及B超(其余患者为门诊患者,具体治疗及预后情况不详)。结果:UBM检查示不同程度的睫状体脱离,27眼为全周睫状体脱离,26眼存在房角漏口,平均中央前房深度(1.830±0.575)mm。5眼行房角漏对应位置和范围的睫状体缝合复位手术后,所有患者房角漏口全部封闭,全周睫状体脉络膜脱离痊愈,前房加深,视力提高,眼压上升至正常。5眼中,4眼行1次手术后睫状体脉络膜脱离痊愈,1眼行4次手术后痊愈。结论:UBM是诊断眼挫伤后睫状体脱离的较好的工具,UBM指导下睫状体缝合手术治疗房角漏的临床效果好,UBM对于眼挫伤致睫状体脱离的临床诊断、治疗和随访具有指导意义。