24例眼外伤继发性青光眼的临床分析

Clinical analysis of 24 cases with ocular trauma secondary glaucoma

目的：探讨眼外伤继发青光眼的发病原因、临床特征及防治措施，总结诊疗经验，提高该病的诊疗水平。方法对24例眼外伤继发青光眼（24眼）患者的临床资料进行回顾性分析，总结其治疗措施、临床表现及病因。结果根据致病成因以及临床表现，眼外伤所致继发性青光眼可以分为下述类型：房角挫伤6眼（24.0%）；眼内出血8眼（33.3%）；晶状体脱位或损伤7眼（28.0%）；眼球穿通伤术后4眼（16.0%）。治疗后，随访2~7个月，眼压跃21 mmHg 6例6眼（24.0%），6~21 mmHg（1 mmHg=0.133 kPa）18例18眼（76.0%）；患者视力状况：18例18眼视力上升（76.0%），5例5眼视力下降（20.8%）。术后1例1眼视网膜有脱落现象。本组患者治疗前平均眼压高达（40.7±3.4）mmHg，积极治疗后眼压恢复正常水平，平均眼压为（15.2±4.4）mmHg。结论在发生较为严重的眼外伤后，眼内组织常常损伤较为严重，由此导致的眼外伤继发性青光眼在治疗上更为困难。患者除眼压增高外，还有各种类型的并发症，对此我们应当积极采取措施，寻找对策。对于尚未发生或者情况不甚严重的患者，应当积极采取预防以及应对措施，防治病情的蔓延和恶化。

Objective To investigate the incidence of secondary glaucoma eye injury, clinical features and prevention measures,summarize clinic experience, and to improve diagnosis and treatment of the disease. Methods Clinical data of ocular trauma secondary glaucoma（n=24） patients were retrospectively analyzed and summarized, clinical manifes-tations and causes were summarized. Results According to pathogenic causes and clinical manifestations, eye injuries caused by secondary glaucoma were divided into the following typesangle contusion 6 （24.0%）;intraocular hemorrhage 8（33.3%）;lens dislocation or damage 7（28.0%）;after penetrating eye injuries after 4（16.0%）treatment,follow-up of 2 to Ju ly, IOP〉 21mmHg 6 Example 6 （24 . 0%）, 6-21 mmHg （1 mmHg=0 . 133kPa） 18 example 18 eyes（76.0%）;visual acuity following 18 cases of 18 patients with visual acuity increased by （76.0%）, five cases of five decreased vision （20.8%）. After the surgery, there was one case of a retina off phenomenon. The average intraocular pressure therapy for this group of patients as high as （40.7±3.4） mmHg, the intraocular pressure returned to normal levels after active treatment,the average IOP was （15.2±4.4）mmHg. Conclusion In the event of more serious eye in-jury after intraocular tissue damage is often more serious eye injuries resulting secondary glaucoma treatment more dif-ficult. In addition to increased intraocular pressure in patients, there are various types of complications, which we should take active measures to find countermeasures. For patients not yet occurred or less serious cases,should active-ly take preventive and response measures to prevent the spread and worsening of the disease.