超声生物显微镜在晶状体半脱位诊治中的应用  

Clinical applications of ultrasound biomicroscopy in diagnosis and treatment of lens subluxation

作　　者：刘奕志[1] 刘玉华[1] 吴明星[1] 罗莉霞[1] 张新愉[1] 蔡小于[1] 陈秀琦[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼科杂志》2004年第3期186-189,共4页Chinese Journal of Ophthalmology

摘　　要：目的　探讨超声生物显微镜 (UBM)检查在晶状体半脱位临床诊治中的应用价值。方法　收集 2 9例 (32只眼 )因不同原因致晶状体半脱位患者 ,分别于超声乳化晶状体吸除术前、后行UBM检查。术中根据术前UBM检查的晶状体半脱位范围和程度 ,选用不同类型囊袋张力环 (CTR) ,并采用不同手术方式完成手术。术后观察CTR和人工晶状体的位置 ,以及并发症的发生情况。结果术前UBM检查晶状体半脱位范围≤ 1/ 2象限的 19只眼 ,术中植入无钩CTR顺利完成手术 ;术前UBM检查晶状体半脱位范围 >1/ 2象限的 13只眼 ,术中植入固定型CTR顺利完成手术。术后UBM检查显示除 1只眼CTR贴附周边虹膜 ,其余术眼CTR均位于晶状体悬韧带水平 ;术后 2 9只眼人工晶状体正位 ,3只眼人工晶状体轻度倾斜。结论　术前对晶状体半脱位患者行UBM检查 ,判断晶状体脱位的程度和范围 ,有助于指导设计手术方案 ,提高手术疗效。术后行UBM检查 ,观察眼内植入物与眼内组织的位置关系 ,有助于准确判断手术疗效 ,正确、及时处理术后并发症。Objective To evaluate the clinical value in diagnosis and treatment of lens subluxation using ultrasound biomicroscopy (UBM). Method This study comprised 29 patients (32 eyes) that had cataract with subluxated lenses due to different causes admitted into our hospital between November 2000 and January 2002. All eyes received UBM examination preoperatively and postoperatively. Capsular tension ring (CTR) implantations were performed using different technique according to UBM examination. Then all patients received phacoemulsification and intraocular lens (IOL) implantation. The location of IOL and CTR and complications were evaluated postoperatively. Results Different kinds of subluxated lens shown different manifestations in UBM. The degree of zonular defect can be evaluated with UBM preoperatively. With UBM examination preoperatively, extent of lens subluxation less than 1/2 quadrant in 19 eyes while more than 1/2 quadrant in other 13 eyes were observed. Postoperative UBM examination in this series shown that CTRs were holding in place except one attached to the iris root. IOLs in 29 eyes were in proper position while IOLs in 3 patients were slightly tilted. Conclusions The degree and extent of lens subluxation can be evaluated using UBM examinations preoperatively, which is necessary in the selection of surgical protocol. With postoperative UBM examinations, a precise observation on the actual location of CTR and IOL can be achieved to produce an objective evaluation of the surgical outcomes.

关 键 词：超声生物显微镜 晶状体半脱位 诊断 治疗 超声乳化晶状体吸除术 

分 类 号：R770.4[医药卫生—眼科]