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术中超声生物显微镜引导下直接睫状体缝合术治疗外伤性睫状体分离:四例病例系列

Intraoperative UBM-guided direct cyclopexy for traumatic cyclodialysis cleft: a four-case series.

作者信息

Wang Fei, Jin Xin, Chen Xiang, Chen Bing, Kong Qing-Li, Hou Bao-Ke

机构信息

Senior Department of the Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing, 100039, China.

Senior Department of the Ophthalmology, the First Medical Center of PLA General Hospital, Beijing, 100039, China.

出版信息

BMC Ophthalmol. 2025 Aug 21;25(1):479. doi: 10.1186/s12886-025-04250-1.

Abstract

PURPOSE

To evaluate the feasibility and effectiveness of intraoperative ultrasonic biomicroscopy (UBM)-guided direct cyclopexy for treating traumatic cyclodialysis clefts.

METHODS

Intraoperative UBM-guided direct cyclopexy was performed on a total of four eyes. Prior to the conjunctival incision, UBM evaluation was facilitated with a self-designed eye cup. Scleral flaps were generated according to their respective locations. Before the scleral flaps and conjunctiva were closed, UBM was used to promptly assess the repositioning status.

RESULTS

1.UBM-guided direct cyclopexies were performed on four male patients (mean age: 39.7 years). In all instances, the cyclodialysis cleft resulted from blunt ocular trauma, with an average time interval between injury and surgical treatment of 29.5 days. 2. A simple cyclodialysis cleft was observed in two patients. One patient had retinal detachment and subluxation of the lens, and one presented with a shallow anterior chamber, iridodialysis, cataract, vitreous hemorrhage, papilledema, and hypotony maculopathy. 3. Prior to surgery, the mean IOP in all four patients was 7 mmHg (range: 6-9 mmHg), which increased to an average of 16.5 mmHg on postsurgical day three (range: 11-22 mmHg). 4. UBM examination confirmed successful closure of the cleft in all patients.

CONCLUSION

During the procedure, UBM-guided direct cyclopexies can accurately assess cyclodialysis cleft repair without being affected by the optical clarity of the refractive media. Preliminary findings demonstrate the feasibility of this approach.

摘要

目的

评估术中超声生物显微镜(UBM)引导下直接睫状体缝合术治疗外伤性睫状体分离裂隙的可行性和有效性。

方法

对4只眼进行术中UBM引导下直接睫状体缝合术。在结膜切开前,使用自行设计的眼罩便于进行UBM评估。根据各自位置制作巩膜瓣。在巩膜瓣和结膜关闭前,使用UBM及时评估复位情况。

结果

  1. 对4例男性患者(平均年龄:39.7岁)实施了UBM引导下直接睫状体缝合术。所有病例中,睫状体分离裂隙均由钝性眼外伤引起,受伤至手术治疗的平均时间间隔为29.5天。2. 2例患者观察到单纯性睫状体分离裂隙。1例患者合并视网膜脱离和晶状体半脱位,1例表现为前房浅、虹膜根部离断、白内障、玻璃体积血、视乳头水肿和黄斑部低眼压病变。3. 术前,所有4例患者的平均眼压为7 mmHg(范围:6 - 9 mmHg),术后第3天平均升至16.5 mmHg(范围:11 - 22 mmHg)。4. UBM检查证实所有患者的裂隙均成功闭合。

结论

在手术过程中,UBM引导下直接睫状体缝合术可准确评估睫状体分离裂隙修复情况,不受屈光介质光学清晰度的影响。初步研究结果表明了该方法的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2e0/12369265/53b0addd09a7/12886_2025_4250_Fig1_HTML.jpg

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