The role of ultrasound biomicroscopy in the assessment of posttraumatic changes in closed eye trauma (type A III) with IOL subluxation and dislocation

Khodjaev N.S.,Uzunyan D.G., Kislitsyna N.M., Sultanova D.M., Zinchenko V.I.

Rationale: Post-traumatic ocular changes make visualization of the anterior segment of the eye difficult. However, ultrasound biomicroscopy (UBM) is the only imaging technique that allows for high-resolution assessment of structural abnormalities of the anterior segment of the eyeball.

Objective: To analyze the results of UBM in the evaluation of posttraumatic changes in closed eye trauma (type A III) with subluxation or dislocation of IOLs.

Methods: The study included 40 patients (40 eyes) with closed eye trauma type AIII, who had dislocation of varying degrees of severity from 2 to complete dislocation of the IOL into the vitreal cavity as a result of trauma.

All patients underwent complex diagnostics, including UBM The anatomical objects of study during UBM scanning of the eyeball were cornea, sclera, iris, anterior chamber angle, IOL, capsular bag, posterior chamber, ciliary body and peripheral retina.

Results: During complex diagnostics all patients were divided into 4 groups depending on the degree of visual function impairment.

In the course of UBM in 40 patients (40 eyes – 100%) defects of lens ligament-capsular apparatus were detected, complete dislocation of IOL in 14 patients (14 eyes – 35%), defects of lens capsular bag in 14 patients (14 eyes – 35%), goniosynechia in 7 patients (7 eyes – 7.5%), ciliary body detachment with the height less than 0.5 mm in 2 patients (2 eyes – 5%), iridocular cysts – 6 patients (6 eyes – 15%), peripheral retinal changes – 20 patients (20 eyes – 50%), peripheral retinal detachment – 4 patients (4 eyes – 10%), retinoschisis – 8 patients (8 eyes – 20%), peripheral retinal tears – 4 patients (4 eyes – 10%), vitreous body herniation – 24 patients (24 eyes – 60%).

Depending on the results of diagnostic studies and the degree of IOL dislocation, all patients underwent IOL repositioning with suture fixation in one or two segments or IOL replacement with suturing into the ciliary sulcus.

Conclusion: The use of UBM method in the group of patients with posttraumatic IOL dislocation allows to determine all concomitant changes in the pre-equatorial zone of the eyeball and to develop the optimal tactics of surgical treatment, the possibility of IOL repositioning and the method of its fixation.

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