Surgical exploration minimised by ultrasound biomicroscopy localisation of intraocular foreign body

Observing implantable collamer lens dislocation by panoramic ultrasound biomicroscopy

PURPOSE

Observe the image characteristics and dislocation of implantable collamer lenses (ICL) following their use to correct high myopia.

METHODS

A total of 127 patients (242 eyes); 64 females (50.3%) and 63 males (49.7%) were included in this retrospective study with ICL V4 implantation and mean spherical equivalent -9.08±2.04 diopters (D). Panoramic ultrasound biomicroscopy (UBM) was utilized to observe anterior segment morphology and ICL location at various follow-up periods (1 week preoperative, followed by 1, 3, 6, and yearly postoperative).

RESULTS

Twenty-eight ICL eyes (11.2%) were noted to have abnormal postoperative positioning. The central vault of 12 eyes was too high with ICL decentration, mean central vault 1.14±0.39 mm; 10 eyes were too low but without ICL decentration, mean central vault 0.13±0.11 mm. The remaining subjects were only ICL decentration without abnormal central vault, mean central vault was 0.54±0.28 mm.

CONCLUSIONS

This study shows the abnormal characteristics regarding ICL locations. The ICL dislocation closely correlates with the central vault. The ICL dislocation is the primary cause of several postoperative complications. Panoramic UBM is one of the most effective imaging means to observe the ICL positioning and its stability after implantable surgery.

Role of Ultrasound Biomicroscopy (UBM) in the Detection and Localisation of Anterior Segment Foreign Bodies

Introduction: The aim of this study was to investigate the role of ultrasound biomicroscopy (UBM) in imaging anterior segment foreign bodies and compare it with conventional B-scan ultrasound and computed tomography (CT). Materials and Methods: The charts of 18 eyes with anterior segment foreign bodies were reviewed. The rates of detection of foreign bodies using ultrasound, CT scan and UBM were compared. Results: The foreign body detection rates were 36.5% by ultrasound, 88.9% by CT scan, and 94.4% by UBM. The diagnosis of presence of a foreign body using UBM was made based on high reflective echoes causing shadowing or reverberations. In 7 eyes, UBM detected injury to the zonules, guiding the operative procedure. In the 8 eyes for which all tests were performed, rates of detection of foreign bodies were 25% (2/8) with ultrasound, 87.5% (7/8) with CT, and 100% (8/8) with UBM. Conclusion: UBM is a valuable adjunct for the accurate localisation of small foreign bodies, including cilia. It offers a higher detection rate than that provided by ultrasound and CT scan. Key words: B-scan ultrasonography, Computed tomography, Ocular trauma, Retained foreign bodies

Retained intraocular foreign body

The presence of an intraocular foreign body following eye trauma may not be readily apparent. Serous complications may include, inter alia, endophthalmitis, cataract, retinal detachment and siderosis bulbi. We report an iron intraocular injury due to hammering 'metal on metal', which was diagnosed using ultrasonic biomicroscopy and successfully removed. Two months post-operatively, unaided vision was 6/6.