Zheng D P, Dai D N, Mi L, Tian J N
Department of Fundus Diseases, Shanxi Eye Hospital, Taiyuan 030001, China.
Zhonghua Yi Xue Za Zhi. 2018 Dec 25;98(48):3921-3924. doi: 10.3760/cma.j.issn.0376-2491.2018.48.003.
To analyze the accuracy of cyclopexy on traumatic cyclodialysis cleft guided by anterior segment optic coherence tomography (AS-OCT). Fifty-six eyes of 56 consecutive patients[41 males, 15 females, with a mean age of (43.14±13.85) years]who diagnosed with traumatic cyclodialysis cleft confirmed by ultrasound biomicroscopy (UBM) and underwent cyclopexy surgery at Shanxi Eye Hosiptal from July 2013 to February 2016 were included in the study. Patients were measured with the AS-OCT system before cyclopexy. AS-OCT findings of the cyclodialysis clefts were recorded. Localizing and suturing the clefts was guided by AS-OCT imaging. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP) and anterior chamber depth (ACD) were recorded and analyzed. Imaging of preoperative AS-OCT of the 56 eyes showed an annular ciliary body detachment, a cyclodialysis cleft and shallow anterior chamber. The ciliary body detachment detected by AS-OCT showed an echo free zone between the annular ciliary body and the sclera. The cyclodialysis cleft showed a new pathway between the anterior chamber and the suprachoroidal space. AS-OCT imaging showed that the extent of cyclodialysis clefts ranged from 30 degrees to 240 degrees, which had a 0 degree to 20 degrees difference compared with UBM imaging. Localizing and suturing of the cyclodialysis clefts was guided by AS-OCT imaging. The best corrected visual acuity (BCVA) was 0.21±0.17 at baseline and 0.29±0.21 at five days postoperatively. The initial and final BCVA showed a remarkable difference after treatment (=-4.98, <0.01). The mean intra-ocular pressure (IOP) was (8.33±2.29) mmHg before surgery and (15.40±2.34) mmHg at five days postoperatively. There was a significant difference of IOP between preoperative and postoperative period (=-16.590, <0.01). The mean ACD was (1.94±0.45) mm preoperatively and (2.69±0.44) mm at five days postoperatively. There was also a significant difference of ACD between preoperative and postoperative period (=-10.276, <0.01). The postoperative reexamination found that ciliary body detachment or cyclodialysis clefts was not observed in the 56 eyes by AS-OCT. As a non-invasive method, AS-OCT is accurate, correlating well with UBM in the examination of cyclodialysis cleft, and can localize the extent of clefts before cyclopexy.
分析眼前节光学相干断层扫描（AS-OCT）引导下睫状体缝合术治疗外伤性睫状体分离的准确性。纳入2013年7月至2016年2月在山西眼科医院确诊为外伤性睫状体分离并接受睫状体缝合术的56例患者的56只眼[男41例，女15例，平均年龄（43.14±13.85）岁]。术前用AS-OCT系统对患者进行测量，记录睫状体分离的AS-OCT表现，在AS-OCT成像引导下对睫状体分离部位进行定位和缝合。记录并分析术前、术后视力（VA）、眼压（IOP）和前房深度（ACD）。56只眼术前AS-OCT成像显示环状睫状体脱离、睫状体分离和前房变浅。AS-OCT检测到的睫状体脱离表现为环状睫状体与巩膜之间的无回声区。睫状体分离表现为前房与脉络膜上腔之间的新通道。AS-OCT成像显示睫状体分离范围为30度至240度，与超声生物显微镜（UBM）成像相比相差0度至20度。在AS-OCT成像引导下对睫状体分离部位进行定位和缝合。最佳矫正视力（BCVA）术前为0.21±0.17，术后5天为0.29±0.21。治疗后初始和最终BCVA有显著差异（=-4.98，<0.01）。术前平均眼压（IOP）为（8.33±2.29）mmHg，术后5天为（15.40±2.34）mmHg。术前和术后眼压有显著差异（=-16.590，<0.01）。术前平均ACD为（1.94±0.45）mm，术后5天为（2.69±0.44）mm。术前和术后ACD也有显著差异（=-10.276，<0.01）。术后复查发现AS-OCT检查56只眼中未观察到睫状体脱离或睫状体分离。作为一种非侵入性方法，AS-OCT在睫状体分离检查中准确，与UBM相关性良好，且能在睫状体缝合术前定位分离范围。
