超声生物显微镜在眼外伤患者眼前段异物中的应用  

Application of ultrasound biomicroscopy in the treatment of anterior segment intraocular foreign bodies in patients with ocular trauma

作　　者：王开芳 赵克娇 贾刚诒 杨骁 Wang Kaifang;Zhao Kejiao;Jia Gangyi;Yang Xiao(Jinan Mingshui Eye Hospital,Jinan 250200,China)

机构地区：[1]济南明水眼科医院,济南250200

出　　处：《中华眼外伤职业眼病杂志》2024年第6期452-456,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：山东省医药卫生科技项目重点项目(202307021727)。

摘　　要：目的探讨超声生物显微镜(UBM)在眼外伤患者眼前段异物诊断中的应用价值。方法回顾性病例系列研究。收集济南明水眼科医院在2021年12月至2023年6月接诊的隐藏性眼前段异物10例(10眼)的临床资料。其中男性8例(8眼),女性2例(2眼),患者在就诊时均诉有外伤史。所有患者术前进行眼前段照相、眼眶CT、彩色多普勒超声、眼前节OCT及UBM等检查,观察并分析各检查结果。结果本研究中,10例患者均为外院首诊,9例首诊未诊断出眼内异物。所有患者在本次接诊前均有至少2次外院就诊经历,裂隙灯显微镜下患者角膜巩膜伤口已闭合或被结膜所覆盖,眼眶CT均提示眼内异物,彩色多普勒超声提示眼内异物5例,眼前节OCT提示眼内异物3例,UBM检查均能够帮助确诊并定位异物位置,1例位于前房内虹膜与角膜粘连处,4例位于前房角处,3例位于后房睫状沟处,2例位于晶状体内。所有患者均接受手术治疗并成功摘出异物,7例为金属异物,3例为非金属异物。2例发生眼铁质沉着症,术中联合白内障摘出术。结论对于隐藏性眼前段异物的眼外伤患者,UBM可明确定位且辅助其他检查提高眼前段异物的诊断率。ObjectiveTo explore the application value of ultrasound biomicroscopy(UBM)in the diagnosis of anterior segment intraoclular foreign bodies in ocular trauma.MethodsThis was a retrospective case series study.The clinical data of 10 eyes of 10 patients with occult anterior segment intraocular foreign bodies were collected from Dec.2021 to Jun.2023 in Jinan Mingshui Eye Hospital,including 8 males(8 eyes)and 2 females(2 eyes),with chincal complaint of trauma history.All patients underment preoperative examinations including anterior segment photography,orbital CT,color Doppler ultrasound,anterior segment-OCT and UBM,and the results were observed and analysed.ResultsIn this study,all patients were initially diagnosed at other hospitals with 9 patients not diagnosed with intraocular foreign bodies.The corneal and scleral wounds were closed or covered by the conjunctiva under the slit lamp microscope,after no less than 2 visits for treatments to other hospitals made by all 10 patieats.Orbital CT showed intraocular foreign bodies in all patients.Color Doppler ultrasound showed intraocular foreign bodies in 5 patients,and anterior segment OCT showed intraocular foreign bodies in 3 patients.UBM examination was applied to diagnose and locate the foreign body with 1 case at the adhesion of iris and cornea in the anterior chamber,4 cases at the angle of the anterior chamber,3 cases at the ciliary sulcus in the posterior chamber,and 2 cases in the lens.All patients received surgical treatment and foreign bodies were successfully removed,including metal foreign bodies in 7 cases and non-metal foreign bodies in 3 cases.Two patients developed ocular siderosis who received surgery combined with cataract extraction.ConclusionFor ocular trauma patients who are highly suspected of intraocular foreign bodies,UBM has obvious advantages in locating hidden foreign bodies,and can assist other imaging examinations with enhanced diagnosis rate for foreign bodies in the anterior segment.

关 键 词：超声生物显微镜 异物 眼内 隐匿性 外伤 眼 

分 类 号：R445.1[医药卫生—影像医学与核医学] R779.1[医药卫生—诊断学]