CL0094：[分享]晶状体移位

zhongguolong518

患者：男56岁，外伤后右眼视力下降。

[本贴已被 翁志蓬 于 2004-10-12 12:23:00 修改过]

专党zey

真是个好冬冬，病人现在的视力是多少？

翁志蓬

确是难得一见的好病例。楼主能否进一步提供患者病历资料，比如外伤原因、体格检查等方面的资料？

chongsuzhi

好东西，谢谢。转了。

wwwhhhyyy

你的小屁股真可爱

rjbjl

dislocation of an iol【dislocations of the lens】我个人感觉晶状体脱位比较合适
晶状体脱位分先天和后天两种，后天原因主要是手术并发症和外伤
美国白内障手术并发此症的比率是0.2-1.8%
个人认为此病b超诊断要比ct强。
无独有偶搜到一片供大家一并欣赏：
traumatic crystalline lens dislocation
j. hopkins (1), s. mohammed (2)

radiology (1) and opthalmology (2), sandwell healthcare trust, lyndon, b71 4hj west bromwich
united kingdom

jon.hopkins@blueyonder.co.uk
  patient
age: 39 year(s)
sex: m  
   
clinical history and imaging  
the patient suffered a high-speed missile injury to his left eye whilst hammering an engine block in an attempt to dismantle it. no eye protection was worn. a ct scan was performed to exclude an intraocular foreign body (3mm contiguous incremental scans through the orbits). this showed a total postero-inferior dislocation of the crystalline lens in the left eye.

   
discussion  
the normal treatment for crystalline lens dislocation consists of conservative management to allow the inflammatory response in the eye to quieten down. the lens can then be removed and an intraocular lens can be sutured in its place, but visual recovery is likely to be prolonged and long-term follow-up is usually required. exclusion of an intra-ocular metallic foreign body is required as this requires immediate removal.

following traumatic intra-ocular dislocation there is increased risk of retinal detachment and glaucoma, both of which can lead to irreversible sight loss. in addition there may be accelerated cataract formation.

in this case, a few weeks following the event, the patient presented with severe eye pain. the lens had moved into the anterior chamber causing acute glaucoma necessitating emergency surgery with lens removal. the patient will need a further operation to implant an intraocular lens as a secondary procedure.

this case highlights the need for appropriate eye protection whilst hammering hard objects.

   
diagnosis
traumatic crystalline lens dislocation

axial 3mm ct scan showing normal position of the right crystalline lens.
note that the left lens is not seen.

axial 3mm ct scan in a more inferior position showing intact left globe
with complete postero-inferior dislocation of the left crystalline lens.
摘自：http://www.eurorad.org/case.cfm?uid=1649

[本贴已被 rjbjl 于 2004-10-12 20:37:04 修改过]

[本贴已被 rjbjl 于 2004-10-12 20:39:03 修改过]

Huxuelong

确实少见

sxdongfang

好片子，没见过！这个病人眼环完整，外伤后视力下降，是怎样的外力使晶状体脱落的。请赐教，谢谢！！

zhongguolong518

以下是引用翁志蓬在2004-10-12 12:51:31的发言：[br]确是难得一见的好病例。楼主能否进一步提供患者病历资料，比如外伤原因、体格检查等方面的资料？

病人素来体健因与他人发生矛盾被拳头击伤右眼、随行ct检查，住院治疗。患者其它检查均无阳性发现。

zhongguolong518

让您见笑了。

[本贴已被 zhongguolong518 于 2004-10-13 14:24:07 修改过]