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Norma Allemann, Maira S. Morales, Maria H. Ramos, Virginia L. Torres; Evaluation of Anterior Segment Dysgenesis using High Frequency Ultrasound. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1746.
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Evaluation of anterior segment dysgenesis severity (Peters’ anomaly, association with congenital glaucoma) can be assessed by high frequency ultrasound.
High frequency ultrasound (50 MHz transducer, modified immersion technique with pediatric eyelid speculum, equipments: UBM 840, Paradigm and UBM-VUMAX, Sonomed) was performed in 25 patients (43 eyes) at early age (less than 30 days old: 6; 31 to 60 days old: 11; 61 to 6 months: 12; 7 to 12 months: 5; 13 to 24 months: 3; more than 24 months: 3, presenting corneal opacity at birth and suspicion of congenital anterior segment malformation.
UBM findings in eyes of children compromised by anterior segment dysgenesis: central corneal opacity (leukoma) and thickening (43 eyes); leukoma associated to "posterior keratoconus" demonstrating a defect of Descemet’s membrane (40 eyes); persistent mesenchymal tissue in the iridocorneal angle (28 eyes); congenital central anterior synechia (20 eyes); shallow AC or atalamia (17 eyes); adherence of anterior lens capsule to the cornea (24 eyes); iris malformation (7 eyes); lens malformation (8 eyes); buphthalmia (2 eyes); microcornea (3 eyes); corneal spontaneous perforation (1 eye). Description of findings permitted definition of surgical treatment: isolated anti-glaucomatous surgery or associated to anterior segment reconstruction, lensectomy and corneal transplant. High-frequency 50MHz ultrasound required immersion technique and small children do not collaborate for the diagnostic positions, determining technical difficulty.
Anterior segment malformations are accompanied with corneal opacities and cannot be evaluated by optical methods. Main complication is development of congenital glaucoma. The correct identification of the extent of anterior segment compromising using high frequency ultrasound (UBM) permitted planning the intervention at early age, required to avoid installation of irreversible glaucomatous lesion.
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