临床病例讨论
患者因“左眼视物模糊2 0余年”就诊,2 0余年前曾行左眼小梁切除术,视力:右眼(oculus dexter,OD)无光感(no light perception,NLP),左眼(oculus sinister,OS)光感(light perception,LP)光定位准确,右眼巩膜葡萄肿(鼻上),前房浅约1/4 CT,瞳孔固定散大,晶状体脱位于玻璃体腔,左眼结膜上方滤过泡扁平,前房浅,约1/4 CT,虹膜层状分离漂浮于前房,上方虹膜切口引流通畅,C/D:0.4。眼压(intraocular pressure,IOP)示:右眼13.0 mmHg,左眼16.0 mmHg。超声生物显微(ultrasound biomicroscopy,UBM)示:右眼各象限前房角狭窄,晶体脱位;左眼前房浅,颞侧前房角狭窄,其余象限关闭,虹膜层状分离。B超示:右眼晶体脱离。诊断:左眼虹膜劈裂;右眼晶体脱位。
The patient was treated with ‘left eye blurred vision for more than 20 years’. The patient underwent left trabeculectomy more than 20 years ago. Visual acuity oculus dexter (OD): no light perception (NLP), oculus sinister (OS): light perception (LP), and light positioning was accurate, right eye scleral staphyloma (nose), the anterior chamber was approximately 1/4 CT, the pupil was fixed and scattered, the lens was displaced into the vitreous cavity, and the left eye conjunctiva was filtered. The blister was flat, the anterior chamber was shallow, about 1/4 CT, and the iris layer was separated and floated in the anterior chamber. The upper iris incision led to smooth flow, C/D: 0.4. Intraocular pressure (IOP): R 13.0 mmHg, L 16.0 mmHg. Ultrasound biomicroscopy (UBM): in the right eye, anterior chamber angle was narrow in each quadrant, dislocation of the lens; anterior chamber of the left eye was shallow, anterior chamber angle of the temporal stenosis was narrow, the remaining quadrants were closed, iris lamellar separated. B-ultrasound: the right eye lens was displaced into the vitreous cavity. Diagnosis: left eye Iridoshcisis; right eye lens dislocation.