超声生物显微镜在儿童白内障25G扁平部前段玻璃体切割术后的应用  

Application of UBM after 25-gauge pars plana anterior vitrectomy in cataract children

作　　者：由彩云[1] 吴晓明[2] 应良[2] 谢立信[2] 

机构地区：[1]青岛大学,山东省青岛市266071 [2]山东省眼科研究所、山东省眼科学重点实验室-省部共建国家重点实验室培育基地,山东省青岛市266071

出　　处：《眼科新进展》2010年第5期454-457,共4页Recent Advances in Ophthalmology

摘　　要：目的应用超声生物显微镜(ultrasound biomicroscopy,UBM)观察儿童白内障25G扁平部前段玻璃体切割术后穿刺口的愈合过程及特点。方法行25G无缝线扁平部前段玻璃体切割术的儿童先天性白内障7例(11眼),观察切割时间、术中术后临床效果、术后穿刺口渗漏、眼压变化、并发症和穿刺口UBM影像学征象。结果所有患儿平均切割时间为(40.9±8.4)s。术中玻璃体波动小,术后炎症反应轻、恢复快,无严重并发症发生,术后巩膜穿刺口无明显渗漏。患儿眼压平稳,术前(13.41±3.44)mmHg(1kPa=7.5mmHg)与术后1d(13.77±4.47)mmHg、1周(13.11±3.20)mmHg、1个月(13.39±2.55)mmHg相比较,差异均无统计学意义(均为P>0.05)。UBM影像学检查显示术后3d巩膜穿刺口部位可见贯穿巩膜及睫状体扁平部的连续低回声缝隙;术后7d缝隙明显缩小;术后2周穿刺口内口已愈合;术后3周8眼(72.7%)已不能检测到扁平部穿刺口;术后4周所有穿刺口完全愈合。结论通过UBM观察到儿童25G无缝线扁平部前段玻璃体切割术后巩膜穿刺口的恢复迅速、愈合良好,未见切口渗漏及玻璃体嵌顿发生,临床表现和UBM影像学征象相符。Objective To observe the features of sclera puncture opening recovery after 25-gauge pars plana anterior vitrectomy in cataract children by UBM.Methods Seven children（11 eyes）with congenital cataract received 25-gauge pars plana anterior vitrectomy.The time of vitrectomy,clinical effect before and after surgery,leak from sclera puncture opening,intraocular pressure changes,complications and UBM imaging character of sclera puncture opening were observed.Results The mean time of vitrectomy was（40.9±8.4）seconds in all children.Few vitreous fluctuations were observed intraoperatively,postoperative inflammation was mild and recovered soon,no severe complications or leak occurred in any eye.The intraocular pressure was table,which was（13.41±3.44）mmHg（1 kPa=7.5 mmHg）before surgery,（13.77±4.47）mmHg,（13.11±3.20）mmHg,（13.39±2.55）mmHg at 1 day,1 week,1 month after surgery.Compared with that before surgery,there were statistical differences at 1 day,1 week,1 month after surgery（All P0.05）.UBM imaging showed that the sclera puncture opening was seen as a gap running through the sclera and pars plana corporis ciliaris with a low continuous echo at 3 days after surgery,which became thin at 7 days after surgery.The inner puncture position opening recovered at 2 weeks after surgery.Eight eyes（72.7%）couldn＇t detect the pars plana puncture opening on UBM imaging at 3 weeks after surgery.All the puncture opening recovered at 4 weeks after surgery.Conclusion UBM imaging shows that the sclera puncture opening after sutureless 25-gauge pars plana anterior vitrectomy in cataract children recovers soon,and no leak or vitreous incarceration is observed.UBM imaging is in accordance well with the clinical observations.

关 键 词：白内障 前段玻璃体切割 巩膜穿刺口 超声生物显微镜 

分 类 号：R779.66[医药卫生—眼科]