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目的 :探讨睫状体肿瘤的临床特点、组织病理特征、超声生物显微镜 (UBM)诊断价值以及局部切除玻璃体视网膜联合手术的疗效、安全性及适应证范围。方法 :2 2例经UBM、B型超声等检查诊断为睫状体肿瘤的患者 ,肿瘤最大径 4～1 6mm ,晶状体限局性混浊或限局性赤道部凹痕 6例 ,完全混浊 3例 ,4例合并视网膜脱离。采用全身低血压麻醉 ,行局部板层巩膜睫状体或局部板层巩膜睫状体前脉络膜切除联合玻璃体视网膜手术和异体巩膜移植术 ,切除的肿瘤行病理检查。结果 :术后经 2个月～ 5年 3个月 (平均 2 8个月 )随访 ,未发现肿瘤复发 ,1例睫状体恶性黑色素瘤 (上皮细胞型 )直径超过 1 5mm ,术后 2年发生肝转移。末次随访时 ,视力 0 0 5～ 0 3者 7例 ,>0 3者 1 5例。病理诊断 :睫状体恶性黑色素瘤 9例 ,黑色素细胞瘤 4例 ,无色素上皮腺瘤 6例 ,神经纤维瘤 2例 ,神经鞘瘤 1例。结论 :睫状体肿瘤中良性肿瘤约占一半 (1 3/ 2 2 ) ,UBM对睫状体肿瘤的早期诊断有帮助 ,是确定病变大小、部位及与周围组织关系的重要工具。睫状体肿瘤局部切除不仅可以保留患眼 ,挽救视力 ,而且对切除组织病理检查可明确诊断。联合玻璃体视网膜手术可减少并发症 ,提高成功率 ,是治疗某些睫状体良、恶性肿瘤的安全有效的方法
Objective: To investigate the clinical features, histopathological features, the diagnostic value of ultrasound biomicroscopy (UBM) and the efficacy, safety and range of indications of cystectomy with vitrectomy. Methods: Twenty-two patients diagnosed as ciliary body tumors by UBM and B-mode ultrasonography were selected. The maximum diameter of the tumor was 4 ~ 16 mm. The number of the lens was limited or 6, the complete turbidity was 3 and 4 Cases with retinal detachment. Using systemic hypotension anesthesia, the line of local lamellar scleral ciliary body or local lamellar scleral anterior choroidal excision combined with vitreoretinal surgery and scleral implantation, resection of the tumor line pathological examination. Results: No recurrence was found after 2 months to 5 years and 3 months (average 28 months). One case of ciliary body malignant melanoma (epithelial cell type) was over 1 5mm in diameter and 2 years after operation Liver metastases occur. At the last follow-up, visual acuity 0 0 5 ~ 0 3 7 cases,> 0 3 15 cases. Pathological diagnosis: ciliary body malignant melanoma in 9 cases, melanocytoma in 4 cases, no pigment epithelial adenoma in 6 cases, 2 cases of neurofibroma, schwannoma in 1 case. CONCLUSIONS: About half of the benign tumors in the ciliary body tumors (13/22), UBM is helpful for the early diagnosis of ciliary body tumors and is an important tool to determine the size, location and the relationship with the surrounding tissues. Partial excision of ciliary body tumor can not only preserve the eyes, save eyesight, but also clear the pathological examination of excised tissue can be diagnosed. Joint vitreoretinal surgery can reduce complications and improve the success rate, is a safe and effective treatment of some ciliary body benign and malignant tumors