超声生物显微镜在开放性Ⅱ区眼外伤中的应用

摘要

目的 探讨超声生物显微镜(UBM)在开放性Ⅱ区眼外伤中的临床应用.方法 38例(38眼)开放性Ⅱ区眼外伤均行一期修补手术,术后3～5d对外伤部位进行UBM检查,了解相应部位巩膜、睫状体及玻璃体的情况.所有病例均结合眼B型超声及检眼镜等检查后确认是否行玻璃体手术.检查前均经患者口头知情同意.结果 UBM检查可清晰地显示开放性眼外伤Ⅱ区巩膜、睫状体及相应周边部玻璃体等常规检查"盲区"结构,结合眼科B型超声检查可获得患眼较全面的信息.其中15眼行玻璃体手术,二期手术术中均证实创口部位存在UBM所示的病变;其余病例门诊随访,均未发生明显的玻璃体视网膜并发症.结论 UBM是活体检查开放性Ⅱ区眼外伤的无创性方法 ,可为外伤眼的整体评估提供重要信息.%Background Open-globe injury of zone Ⅱ is a severe eyeball wound in the sclera area near 5mm from the corneal limbus.To accurately evaluate the local tissue structure after the wounding is very important for lessening the complications of eye injury.Ultrasound biomicroscope (UBM) has been proven useful in examining eyeball wall and vitreous at the wound in order to offer the useful information about whether secondary operation is needed for the injured eyes and when is the optimal timing for surgery.Objective The present study is to explore the clinical application of UBM in open-globe injury of zone Ⅱ. Methods This is an observational study of clinical cases.UBM examination was performed on 38 eyes of 38 cases received emergency repair surgery of open-scleral injury.The restore status of sclera,ciliary body and vitreous of injuried zone (zone Ⅱ) were evaluated under the UBM in 3-5 days after the operation.The comprehensive results of UBM,B-scan and ophthalmoscope examinations were analyzed to determine the further treatment.The oral informed consent was obtained from each subject before this trial.Results Vitreous surgery were performed on 15 cases,and all wounds were found by UBM and were proven in the surgery.The other 23 cases were followed up in out-patient department and no obvious complications were found.Conclusion UBM is a valuable and atraumatic examination for open-globe injury of zone Ⅱ.It offers important and appraisal information about ocular injury.