Ultrasound Biomicroscopy for Zonular Evaluation in Eyes with Ocular Trauma

To evaluate the role of ultrasound biomicroscopy (UBM) in detecting zonular abnormalities in eyes with ocular trauma.

Prospective study of 143 eyes of 143 patients with ocular trauma and having opaque media was evaluated using a UBM. The presence or absence of zonular damage (zonular tears and/or zonular stretching) was examined and the clock-hour involvement was noted.

One-hundred and one eyes had blunt trauma (70.63%; group 1), while 42 eyes had penetrating trauma (29.37%; group 2) The mean age of the patient population was 48.01±17.93 years with a male:female ratio of 2.11:1. Group 1 had significantly greater visual acuity than group 2 (p = 0.03). Zonular damage was present in 79 (55.2%) eyes, including zonular tears (48 eyes; 33.6%) and zonular stretching (31 eyes; 21.7%). Zonular damage was seen significantly more in eyes with blunt trauma (64.28%) as compared to penetrating trauma (25.74%) (p = 0.015). On quantitative analysis, zonular damage between 3 and 6 clock hours was most frequent, both in eyes having zonular tears (70.83%) and zonular stretching (96.77%). Additionally, 3-6 clock hours of zonular stretching was seen significantly more in blunt trauma as compared to penetrating trauma (p = 0.015).

UBM is an effective imaging modality to diagnose zonular abnormalities in patients with ocular trauma having opaque media. The ability to detect the presence of zonular weakness and their quantification by performing a UBM is critical to formulate the optimal surgical approach and avoid any untoward surgical complications.