上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (11): 1496-.doi: 10.3969/j.issn.1674-8115.2017.11.008

• 论著（临床研究） • 上一篇    下一篇

改良超声生物显微镜检查法在眼表热化学烧伤后中度及重度 睑球粘连诊疗中的应用

陈良波，何芳邻，严晨曦，陆琳娜，范先群 ，傅瑶   

  1. 上海交通大学  医学院附属第九人民医院眼科，上海  200011
  • 出版日期:2017-11-28 发布日期:2018-01-10
  • 通讯作者: 傅瑶，电子信箱：fuyaofy@sina.com。范先群，电子信箱：drfanxianqun@126.com。# 共同通信作者
  • 作者简介:陈良波（1993—），男，住院医师，硕士生；电子信箱：13761753010@163.com
  • 基金资助:
    国家自然科学基金（81570812，81370992）；上海市教育委员会高峰高原学科建设计划（20161421）

Application of improved ultrasound biomicroscopy in the clinical diagnosis of moderate and severe symblepharon in patients with thermal and chemical ocular surface burns#br#

CHEN Liang-bo, HE Fang-lin, YAN Chen-xi, LU Lin-na, FAN Xian-qun, FU Yao   

  1. Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2017-11-28 Published:2018-01-10
  • Supported by:
    (National Natural Science Foundation of China, 81570812, 81370992; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20161421)

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摘要： 目的 · 评价改良超声生物显微镜（UBM）检查法在眼表热化学烧伤后中度及重度睑球粘连的患者临床诊疗中的应用价值。
 方法 · 回顾性收集眼表热化学烧伤导致的中度及重度睑球粘连患者的临床资料，共 33 例（33 眼）。通过改进 UBM 检查方法，将其应 用于患者眼前段检查，分析患者眼角膜、前房、虹膜、房角、睫状体以及晶状体的损伤情况，对比中度与重度睑球粘连合并眼前段损 伤的严重程度。结果 · 33 只眼均完成 UBM 检查。其中角膜基质混浊深度 >1/2 的有 29 眼，角膜后弹力层脱离有 1 眼，角膜层间积液 有 4 眼，角膜基质床变薄有 2 眼，虹膜前粘连有 6 眼，虹膜后粘连有 2 眼，前房变浅有 2 眼，前房高反射渗出有 1 眼，房角狭窄有 6 眼，晶状体回声增高有 6 眼；重度睑球粘连合并的眼前段损伤明显比中度睑球粘连合并的眼前段损伤更严重。结论 · UBM 作为一种 无创性诊断技术，在改进检查方法后可对中度及重度睑球粘连的眼前段组织进行细致观察，显示出常规检查方法不能揭示的病变，为 疾病的严重程度、手术方案及预后的判断提供指导。

关键词: 眼表热化学烧伤, 睑球粘连, 超声生物显微镜, 眼前段损伤

Abstract:

 Objective · To investigate the value of technique of improved ultrasound biomicroscopy (UBM) in the clinical diagnosis of moderate and severe symblepharon after thermal and chemical ocular surface burns.  Methods · The clinical data of 33 patients (33 eyes) who had suffered moderate and severe symblepharon after thermal and chemical ocular surface burns were retrospectively analyzed. Improved UBM was applied in the examination of the anterior segment injury, through which the cornea, anterior chamber, iris, anterior chamber angle, ciliary body and lens were analyzed carefully. Also the connection between severity of symblepharon and anterior segment injury was discussed.  Results · All the 33 eyes were examined by the UBM. Corneal opacity of more than 1/2 depth of the corneal was detected in 29 eyes, and detachment of the corneal elastic layer in 1 eye, corneal interstitial fluid in 4 eyes, corneal thinning in 2 eyes, anterior synechia of iris in 6 eyes, posterior synechia of iris in 2 eyes, shallower anterior chamber in 2 eyes, exudate in the anterior chamber in 1 eye, narrow anterior chamber angle in 6 eyes, high echo of lens in 6 eyes. The anterior segment injury in severe symblepharon eyes was worse than that in moderate symblepharon eyes.  Conclusion · UBM is a noninvasive diagnostic technique, which can be used in the meticulous detection of the anterior segment of moderate and severe symblepharon patients after a slight improvement of inspection methods. It can show the pathological changes that cannot be revealed by routine ophthalmologic examination, and provide guidance for estimating the severity of the disease, the choice of surgical plan and prognosis of patients.

Key words: thermal and chemical ocular surface burns, symblepharon, ultrasound biomicroscopy, anterior segment injury

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