摘要目的 分析眼前节光学相干断层扫描(AS-OCT)引导眼钝伤所致睫状体断离复位手术的准确性.方法 回顾性分析.2013年7月至2016年2月在山西省眼科医院就诊,经超声生物显微镜(UBM)检查确诊睫状体断离并行巩膜瓣下睫状体缝合复位术的56例(56眼)患者,其中男41例,女15例,年龄(43.14±13.85)岁,均于术前行AS-OCT检查,观察睫状体断离在AS-OCT中的表现,并在AS-OCT引导下精准确定手术缝合范围.比较患者术前及术后视力、眼压及前房深度的变化,并进行统计学分析.结果 56眼AS-OCT术前检查均可见全周睫状体脱离、睫状体断离及浅前房.睫状体脱离图像表现为全周睫状体与巩膜间有无回声区.睫状体断离则表现为睫状体脉络膜上腔与前房沟通,睫状体断离范围30°～ 240°,断离范围与UBM检查有0°～20°的差异.以AS-OCT直接定位作为睫状体缝合范围.术前最佳矫正视力0.21±0.17,术后第5天最佳矫正视力0.29 ±0.21,术后与术前相比差异有统计学意义(t=-4.98,P＜0.01).术前眼压(8.33±2.29) mmHg,术后第5天眼压(15.40±2.34) mmHg,术后与术前相比差异有统计学意义(t=-16.590,P＜0.01).前房深度术前(1.94±0.45)mm,术后第5天(2.69 ±0.44)mm,差异有统计学意义(t=-10.276,P＜0.01).56眼术后AS-OCT检查睫状体脱离及睫状体断离均良好复位.结论 AS-OCT对于睫状体断离的检查结果与UBM检查结果一致,并能精确定位睫状体复位手术的范围.

abstractsObjective To analyze the accuracy of cyclopexy on traumatic cyclodialysis cleft guided by anterior segment optic coherence tomography (AS-OCT).Methods 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.Results 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 (t =-4.98,P ＜ 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 (t=-16.590,P＜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 (t =-10.276,P ＜ 0.01).The postoperative reexamination found that ciliary body detachment or cyclodialysis clefts was not observed in the 56 eyes by AS-OCT.Conclusions 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.