McWhae John A, Crichton Andrew C S, Rinke Monique
University of Calgary, #201, 506-71st Avenue SW, Calgary, Alberta T2V 4V4, Canada.
Ophthalmology. 2003 Jul;110(7):1340-3. doi: 10.1016/S0161-6420(03)00464-0.
To evaluate the role of ultrasound biomicroscopy (UBM) as a method for assessing the zonules after trauma to the anterior segment. These patients might develop traumatic cataract or glaucoma requiring surgery. If occult zonular defects can be identified preoperatively, this might lead to a modified surgical technique and improved outcomes.
Retrospective observational case series.
Fifty-nine patients who were referred for UBM after anterior segment trauma.
UBM examinations were performed using the Humphrey Instruments Ultrasound Biomicroscope equipped with a 50-mHz transducer. A plastic eyecup filled with 2% methylcellulose solution was used in each case. The chart and UBM images of all anterior segment trauma patients examined between 1995 and 2000 were reviewed. The age, gender, and mechanism of injury were recorded for each patient. Follow-up data were obtained from the referring physician in patients who subsequently underwent ocular surgery.
The number of studies judged to be of adequate quality to evaluate zonules was noted, and the number of cases in which zonular defects were found was recorded. The number of cases in which surgery was subsequently performed was noted, and postoperative results were obtained.
Fifty-nine charts and 60 UBM studies were reviewed. Forty-nine studies were judged to be adequate for imaging zonules. Most poor-quality studies were in the early years of the study. Further analysis was carried out on the reliable studies. Occult zonular defects were identified in 21 of 49 patients (42.9%). Thirty-one patients went on to have cataract, filtering, and/or vitreoretinal surgery. One surgeon (ACS) performed 25 of the surgical cases, for which a summary is provided. Referring surgeons found the information helpful in surgical planning and anticipating complications in reliable study cases.
UBM is an effective method for identifying occult zonular damage in patients with anterior segment trauma. There is a significant learning curve in the examination technique. The ability to diagnose zonular rupture preoperatively is of significant benefit to the surgeon and might reduce the chance of intraoperative complications.
评估超声生物显微镜（UBM）作为一种评估眼前节外伤后悬韧带的方法的作用。这些患者可能会发展为需要手术治疗的外伤性白内障或青光眼。如果术前能够识别隐匿性悬韧带缺损，这可能会导致手术技术的改进并改善手术效果。
回顾性观察病例系列。
59例眼前节外伤后接受UBM检查的患者。
使用配备50兆赫换能器的汉弗莱仪器超声生物显微镜进行UBM检查。每例均使用装有2%甲基纤维素溶液的塑料眼罩。回顾了1995年至2000年间所有接受检查的眼前节外伤患者的病历和UBM图像。记录每位患者的年龄、性别和损伤机制。对随后接受眼科手术的患者，从转诊医生处获取随访数据。
记录判定为质量足以评估悬韧带的研究数量，以及发现悬韧带缺损的病例数量。记录随后进行手术的病例数量，并获取术后结果。
回顾了59份病历和60项UBM研究。49项研究被判定为足以对悬韧带进行成像。大多数质量较差的研究来自研究早期。对可靠的研究进行了进一步分析。49例患者中有21例（42.9%）发现隐匿性悬韧带缺损。31例患者随后接受了白内障、滤过和/或玻璃体视网膜手术。一位外科医生（ACS）进行了25例手术病例，并提供了总结。转诊医生发现这些信息有助于可靠研究病例的手术规划和并发症预测。
UBM是识别眼前节外伤患者隐匿性悬韧带损伤的有效方法。检查技术存在显著的学习曲线。术前诊断悬韧带破裂的能力对外科医生有很大益处，并可能减少术中并发症的发生几率。
