The Consistency Of The Application Of Slit LAMP Combined With Gonioscopy And UBM In Anterior Segment Blunt Trauma

Purpose:To study the application of slit lamp combined with anterior chamber angle microscope and UBM in anterior segment blunt trauma,and to investigate whether the diagnosis of slit lamp combined with anterior chamber gonioscopy and UBM in anterior segment bluntness disease is consistent.And treatment provides a theoretical basis.Method :Select 2016.9-2017.12 months in the Department of Ophthalmology,Affiliated Hospital of Yan'an University and suspected anterior segment of blunt trauma patients,the slit lamp combined with gonioscopy and UBM examination.Comparison of the slit lamp combined with gonioscopy and UBM in the anterior segment of blunt traumatic disease(hyphema,angle recession,iridodialysis,cyclodialysist,lens dislocation).Statistical analysis was performed using statistical software SPSS 21.0.Result :(1)The coincidence of slit lamp combined with gonioscopy and UBM for diagnosis of hyphema was identical(Kappa=1,P<0.001).The rate of positive diagnosis of slit lamp combined with gonioscopy was 79.3%,which was consistent with the positive rate of UBM diagnosis 79.3%.There was no statistically significant difference in the Fisher exact test(P=1).The data from this study showed no difference in the efficacy of the two methods for diagnosing hyphema.(2)Slit lamp combined with gonioscopy was highly consistent with the UBM in the diagnosis of,angle recession(Kappa=0.729,P<0.001).The rate of positive diagnosis of slit lamp combined with gonioscopy with 21.7% was lower than that with UBM,and the positive rate with UBM was 32.6%.There was no significant difference between the two methods with the Fisher exact test(P=0.349).The data from this study show that the two methods have little difference in the diagnosis of angle recession.(3)The agreement between the slit lamp combined with gonioscopy and UBM for the diagnosis of iridodialysis was excellent(Kappa=0.862,P<0.001).The diagnostic positive rate of slit lamp combined with gonioscopy was 17.4% lower than that of UBM,which was 21.7%,and the Fisher exact test(P=0.793)of the four grids was not statistically significant.The data from this study show that the two methods have little difference in diagnosing the effect of iridodialysis.(4)Slit lamp combined with gonioscopy was highly consistent with UBM in the diagnosis of cyclodialysis(Kappa=0.436,P<0.001).The diagnostic rate of the slit lamp combined with gonioscopy was 10.9%,which was lower than that of UBM,and the positive rate of UBM was 30.4%.The Fisher exact test(P=0.038)of the four-cell table was statistically significant.The data from this study show that the use of UBM to check the effect of cyclodialysist is better than slit lamp combined with gonioscopy.(5)The consistency of the lens dislocation between the slit lamp combined with gonioscopy and UBM was excellent(Kappa=0.888,P<0.001).The rate of positive diagnosis of slit lamp combined with gonioscopy was 23.9% lower than that of UBM,28.3%,and there was no significant difference in Fisher's exact test.The data from this study show that the two methods have little difference in the diagnosis of the lens dislocation.conclusion :(1)The results of this study show that slit lamp combined with gonioscopy and UBM examination have little effect on diagnosis methods of hyphema,angle recession,iridodialysis,and lens dislocation,but it should be wary when the refractive medium is turbid missing diagnosis of gonioscopy.UBM is superior to slit lamp combined with gonioscopy in diagnosing cyclodialysist.(2)The data of this study show that after anterior segment blunt trauma,anterior segmental lesion changes are the most common prior to hyphema,followed by angle recession,and most patients have 2 or more types of anterior segment structural changes;(3)slit lamp combined with gonioscopy can be supine or sitting position,can provide information such as color and glossiness in the field of vision inspection,and is basically not affected by the degree of patient coordination,but is affected by the refractive medium,and UBM is not affected by the refractive medium and can accurately reflect the trauma of the anterior eye tissue.Both of them have excellent application value in ocular trauma,so the two cannot replace each other and should complement each other.