眼外伤所致继发性青光眼的临床分析

A clinical analysis of secondary glaucoma associated with ocular trauma

目的分析眼外伤所致继发性青光眼临床疗效。方法对62例（62眼）眼外伤所致继发性青光眼的临床表现、病因及治疗方法进行分类与分析。结果根据病因及临床表现将眼外伤所致继发性青光眼归纳为以下几类：前房积血型、房角损伤型、晶状体源型和粘连增生型。药物治疗或联合前房冲洗29例（46．77％），其他手术治疗（包括滤过手术、玻璃体切除和联合手术等）33例（53．22％）。治疗后眼压正常者眼压（6～21mmHg）53例（85．48％），眼压〉21mmHg者7例（11．29％），眼压〈6mmHg者1例（1．61％）。视力下降或丧失者4例。余58例视力均与人院视力相同或提高。术后低眼压1例，术后眼内出血1例。结论眼外伤所致继发性青光眼是由多种发病机制形成的，临床表现较为复杂。预后也较差，临床治疗要区别对待。

Objective To analyze the clinical effect of treatment on secondary glaucoma associated with ocular trauma. Methods 62 cases （62 eyes） of secondary glaucoma associated with ocular trauma were classified and analyzed by their clinical manifestation, causes and treatment. Results The patients were classified as hyphema type, anterior chamber angle injury type, lens-associated type and adhesion type accordding to their causes. 29 cases （46. 77% ） had undergone medicine treatment and anterior chamber irrigation. Filtration surgery, vitrectomy and combined surgery had been done in the other 33 cases （53.22%）. The intraocular pressure （lOP） was 6 - 21 mmHg in 53 cases （85.48%）, over 21 mmHg in 7 cases （11.29%）, below 6 mmHg in 1 case （ I. 61% ）. The visual acuity were decreased or lost in 4 cases. It was equal to or better than preoperative one in the other 58 eyes.Low IOP occurred in one case, and intraocular bleeding in one case. Conclusion The manifestation of secondary glaucoma after ocular trauma was copmlicated because of kinds of mechanism, the prognosis was poor, and the clinical treatment should be varied.