Posters

Unusual anterior segment cases elucidated by ultrasound biomicroscopy

Poster Details

First Author: M.Zemba ROMANIA

Co Author(s):    A. Stamate                    

Abstract Details

Purpose:

To highlight the role that ultrasound biomicroscopy (UBM) had in managing three peculiar anterior segment cases: a retrocorneal membrane after penetrating keratoplasty, a self-sealing corneal wound with a fragment of glass lodged inferiorly in the anterior chamber and multiple glass fragments embedded in the cornea associated with blow-out orbital floor, medial wall and mandibular fracture after a car accident that was referred to our departament for surgery and a possible iris melanoma involving the anterior chamber angle in an elderly male glaucoma patient, that underwent trabeculectomy and phacoemulsification with intraocular lens implantation several years before, that presented for routine consultation.

Setting:

Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital and Arena Med Clinic, Bucharest, Romania

Methods:

Thorough anamnesis and careful clinical examination adjusted to each particular case, including visual acuity, biomicroscopy, fundus examination, ultrasound, UBM and anterior segment optical coherence tomography, were performed.

Results:

In the first case, UBM emphasized that the retrocorneal membrane actually arised at the graft-host junction; the diagnosis was retained host Descemet’s membrane and was surgically removed. In the second case, UBM proved that the remaining corneal fragment was superficial and also gave information about the position of the intraocular one; both were safely removed. In the third case, biomicroscopy revealed a well-defined placoid pigmented lesion of the iris. UBM surprisingly showed that the thickness of the iris was reduced at the level of the lesion; we concluded that the anterior surface of the iris was removed during phacoemulsification.

Conclusions:

In these particular cases, UBM proved its usefulness in several maners. In the first case, it helped in establishing an accurate diagnosis, in the second one in evaluating the severity of the case and elaboration of a proper plan for the surgical treatment of the case and in the last one, although initially used as a tool to estimate the dimension and degree of invasion of the lesion, it finally turned out to be useful in the differential diagnosis. Overall, UBM can provide insights in diagnosis and management of various pathologies.

Financial Disclosure:

None