Authors: Wu Bin, Wu Di, Zhou Zhen, He Guanghui, Wang Jian, Xu Zhigang, Chen Song, Li Yan
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The situation of zonule is very important for determining the cataract surgery.Ultrasound biomicroscopy (UBM) is an important method to observe the situation of zonule before cataract surgery.
This study was to evaluate the accuracy and clinical significance of observing the zonule of cataract patients by UBM.
A series cases-observational study was performed.One hundred and thirty eyes of 130 cataract patients who were to receive extracapsular cataract enucleation were enrolled in Tianjin Eye Hospital from January to June 2015, including 59 eyes with cataract associated with primary angle-closure glaucoma (PACG) and 71 eyes with traumatic cataract.UBM examination was carried out before surgery, and the abnormalities of zonule were recorded and compared between UBM and surgery findings.This study was approved by the Ethic Committee of Tianjin Eye Hospital and informed consent was obtained from all subjects.
A large space between lens and cilliary was exhibited and the echo of zonule was clear on the UBM image in the eyes with traumatic cataract.The typical anatomic findings of the anterior eye segment were displayed, and lens equator came into contact with cilliary on the UBM image, and the echo of zonule was blurry in the eyes with cataract associated with PACG.The eye number of abnormal zonule was consistent between UBM and surgery findings (Kappa=0.952), and no significant difference in the eye number of abnormal zonule between UBM and surgery findings (P=0.250). In 75 zonule abnormal eyes diagnosed by both UBM and surgery findings, zonule abnormal range could not be compared in 1 eye (1/130, 0.77%), and exactly consistent in 8 eyes (8/130, 6.15%) between the two methods.The difference of zonule abnormal range between the two methods was 1 clock in 35 eyes (35/130, 26.92%), and 2 clock in 27 eyes (27/130, 20.77%), 3 clock in 4 eyes (4/130, 3.08%). In 74 zonule abnormal eyes, the mean difference of zonule abnormal meridian between the two methods was (1.36±1.29) clock, an those in 28 traumatic cataract eyes and 36 cataract with PACG eyes were (1.14±1.10) clock and (1.64±1.48) clock, respectively.
UBM is able to observe zonule accurately, the observation effectiveness of UBM for traumatic cataract is better than that of cataract combined with PACG.These results are of clinical valueable for surgical strategy of cataract and prediction of surgical complications.