2006-2013年河北省眼科医院住院继发性青光眼患者的类型及治疗方法

The classification and treatment methods of secondary glaucoma in Eye Hospital of Hebei Province in 2006-2013

目的回顾2006-2013年河北省眼科医院住院继发性青光眼患病人群的类型及治疗方法。设计回顾性病例系列。研究对象2006年6月-2013年3月河北省眼科医院青光眼科住院的继发性青光眼1178例1361眼。方法回顾患者病历资料,分析患病年龄、病因、治疗方法等。病因构成比按例数计算。主要指标继发性青光眼的病因及构成比。结果 1178例继发性青光眼患者中新生血管性青光眼436例522眼(37.0%),外伤性青光眼166例166眼(12.2%),晶状体源性青光眼185例201眼(15.7%),葡萄膜炎继发青光眼160例176眼(13.6%),角膜炎所致青光眼63例71眼(5.4%),其他病因者168例225眼(14.3%)。新生血管性青光眼中以糖尿病视网膜病变(46.2%)和视网膜静脉阻塞(32.8%)为多。外伤性青光眼以眼球钝挫伤晶状体脱位(27.7%)、前房玻璃体出血(25.9%)比例较大。晶状体源性青光眼以晶状体膨胀因素(36.8%)居多。手术治疗1204眼(88.5%),其中小梁切除术351眼(29.2%),Ahmed阀植入术257眼(21.3%),睫状体冷冻术131眼(10.9%),白内障摘除联合滤过性手术127例(10.5%),睫状体光凝术122眼(10.1%),晶状体摘除术84眼(7.0%),其他手术132眼(11.0%)。结论 2006-2013年河北省眼科医院住院继发性青光眼以新生血管性青光眼为首位病因。其次为外伤性青光眼、晶状体源性青光眼和葡萄膜炎继发青光眼。依据继发性青光眼的病因不同,采用多种不同的治疗方式。

Objective To investigate the classification and treatment methods of secondary glaucoma in Eye Hospital of Hebei Province in 2006-2013. Design Retrospective case series. Participants 1178 cases （1361 eyes） were hospitalized with secondary glaucoma were analyzed in Eye Hospital of Hebei Province from June 2006 to March 2013. Method The diagnosis, age and treatment scenario of patients with secondary glaucoma was retrospectively analyzed. Main Outcome Measures Etiology of secondary glaucoma and constituent ratio. Results There were 1178 cases of secondary glaucoma, which were divide into neovascular glaucoma, traumatic glaucoma, phacogenic glaucoma, glaucoma secondary to uveitis, glaucoma secondary to keratitis and others. Constituent ratio was 37.0% （436 cases 522 eyes）, 12.2% （166 cases 166 eyes）, 15.7% （185 cases 201 eyes）, 13.6% （160 cases176 eyes）, 5.4% （63 cases 71 eyes）, 14.3%（168 cases 225 eyes）, respectively. In neovascular glaucoma, the diabetic retinopathy and retinal vein occlusion were major etiology. Dislocation of lens caused by blunt trauma （27.7%） and hyphema or vitreous hemorrhage （25.9%） made the larger percentage in traumatic glaucoma. The lens inflation （36.8%） accunted for the larger percentage in phacogenic glaucoma. Surgical therapy was performed in 1204 eyes （88.5%）, in which trabeeulectomy was performed in 351 eyes （29.2%）, Ahmed valve implantation in 257 eyes （21.3%）, ciliary body condensation in 131 eyes （10.9%）, cataract extraction and filtering surgery was 127 eyes （10.5%）, ciliary body photocoagulation was in 122 eyes （10.1%）, only removal of the lens was in 84 eyes （7.0%）, other surgery in 132 eyes （11.0%）. Conclusions In the classification of secondary glaucoma in Eye Hospital of Hebei Province in 2006-2013, the majority is neovascular glaucoma, traumatic glaucoma, phacogenic glaucoma, glaucoma secondary to uveitis. The treatment methods for secondary glaucoma are various based on different etiology.