Kniestedt C, Hafezi F, Seiler T
Augenklinik, Universitätsspital Zürich.
Ophthalmologe. 2001 Jul;98(7):656-9. doi: 10.1007/s003470170103.
Chamber angle changes due to trauma represent a diagnostic challenge in modern ophthalmology and two examination techniques are compared: gonioscopy which has been used in ophthalmology for almost a century and is still undergoing continuous improvements and ultrasound biomicroscopy (UBM) which was introduced into clinical ophthalmology in 1991.
We report the case of a 14-year-old boy with ocular trauma caused by a soft gun projectile. Gonioscopy showed a large goniosynechia in the presence of ocular hypotension, therefore, cyclodialysis was suspected. However, a control investigation using UBM showed an intact and circularly attached but anteverted ciliary body behind the synechia, a circular choroidal effusion and an anterior displacement of the iris-lens diaphragm.
In ocular trauma, UBM may under certain conditions clearly be of a higher diagnostic value than gonioscopy. Therefore, UBM should not only be considered as an additional examination technique in the evaluation of traumatic ocular pathologies but rather as the technique of choice.
外伤导致的房角改变是现代眼科诊断中的一项挑战，本文对两种检查技术进行比较：已在眼科应用近一个世纪且仍在不断改进的前房角镜检查，以及1991年引入临床眼科的超声生物显微镜检查（UBM）。
我们报告一例14岁男孩因软质枪弹致眼外伤的病例。前房角镜检查显示在眼压降低的情况下存在广泛的虹膜前粘连，因此怀疑有睫状体脱离。然而，使用UBM进行的对照检查显示，在粘连后方有完整且呈环形附着但前倾的睫状体、环形脉络膜脱离以及虹膜 - 晶状体膈向前移位。
在眼外伤中，在某些情况下UBM的诊断价值明显高于前房角镜检查。因此，UBM不应仅被视为评估外伤性眼病的一项辅助检查技术，而应作为首选技术。
