Ciliary body tumor is a rare intraocular tumor. Due to its unique anatomical location, its correct diagnosis and reasonable treatment are very difficult problems. In terms of diagnosis and differential diagnosis, ophthalmologists need to fully utilize the role of slit lamp microscope and transillumination experiment to capture secondary changes in the anterior segment caused by hidden ciliary body tumors, such as monocular localized cataract, lens indentation, and pigment dissemination, etc. Ophthalmological imaging methods, especially ultrasound biomicroscopy, can achieve the purpose of early detection and early diagnosis. According to the size, location and morphological characteristics of the tumor, a reasonable treatment plan is formulated. Since ciliary body tumors are mostly benign, the recurrence rate of local resection is low, which can satisfy the pathological diagnosis and preserve part of the patient's vision. Therefore, eye-preserving treatment should be advocated. However, enucleation remains the treatment of choice for tumors that are too large to be treated with local excision or radiation, eyes with refractory glaucoma, and tumors that do not respond to radiation therapy.
Objective To explore the surgical techniques, efficacy and the management of complicated ocular trauma with anteriorposterior segment complications such as cyclodialysis.Methods Fifty-five patients (55 eyes) with complicated ocular trauma were enrolled in this study. Among them, there were 35 cases with eyeball contusion and 20 cases of eyeball rupture. Preoperative visual acuity was from no light perception to 0.15, intraocular pressure (IOP) ranged from one to 10 mm Hg(1 mm Hg=0.133 kPa）.Cyclodialysis, vitreous hemorrhage or retinal detachment were revealed by B-ultrasound and ultrasound biomicroscopy (UBM). Cyclodialysis clefts ranged from one to 12 clockhours. All patients underwent 3-port pars plana vitrectomy with gas/silicone oil tamponade and ciliary body reattachment by cryotherapy (cyclodialysis cleftsle;three clock-hours) or suture fixation (cyclodialysis clefts＞three clockhours). Healing after surgical trauma, visual acuity, intraocular pressure, intraocular hemorrhage, ciliary body and retinal reattachment were followed up.Results In one month after surgery, UBM showed 54 patients out of 55 patients had good ciliary body reattachment. Gonioscopy revealed cyclodialysis still existed in one patient, and this was cured by a second surgical suture fixation. In three months after surgery, ocular trauma healed in all 55 patients, the visual acuity ranged from no light perception to 0.15, with a best corrected visual acuity of 0.8. The ciliary body and retina had good reattachment. IOP of 52 patients was normal; IOP of three patients was still lower than 10 mm Hg. Three patients had secondary glaucoma which was treated by glaucoma surgery. Conclusions Complicated ocular trauma with cyclodialysis can be treated with vitrectomy and cryotherapy or transscleral sutures. The procedure is safe and effective.
Objective To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors. Methods UBM (Mode 840, Humphrey, 50 MHz 5 mm×5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B-scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation. Results Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations. Conclusion UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body. (Chin J Ocul Fundus Dis, 2002, 18: 128-130)