24 例眼外伤继发性青光眼的临床分析

目的:分析眼外伤继发青光眼的临床特点、病因及治疗方法,为临床治疗提供参考。方法:回顾性分析24例(24只眼)眼外伤继发青光眼患者的临床资料,分析诱发青光眼的原因、临床分型,根据具体情况选择治疗方法。结果:眼外伤诱发青光眼的原因为眼内积血11例,晶状体损伤7例,前房角挫伤4例,外伤性虹睫炎2例;单纯药物治疗4例,前房穿刺或冲洗4例,小梁切除联合丝裂霉素术10例,玻璃体切除术2例,滤过手术1例,激光周边虹膜切除术5例。治疗后随访6~12个月,眼压恢复正常率87.50%;视力下降或丧失8.33%;术中1例眼出血,1例术后晶体状浑浊加重,1例视网膜脱离。结论:眼外伤继发青光眼的临床表现复杂,治疗难度大,临床应根据患者的具体情况选择治疗措施。

Clinical Analysis on 24 Patients with Ocular Trauma Secondary Glaucoma

Objective:To analyze clinical features, etiology and treatment of patients with Ocular trauma secondary glaucoma, provide a reference for clinical treatment.Methods:We retrospectively analyzed the clinical data of 24 patients (24 eyes) with secondary glaucoma eye injury. We analyzed the reasons induced glaucoma, clinical classification, and chose treatment depending on the circumstances.Results:Eleven cases of ocular trauma-induced glaucoma were due to intraocular hemorrhage, seven cases due to lens injury, four cases due to contusion of anterior chamber angle, two cases due to traumatic iridocyclitis. Four cases had simple drug treatment. Four had paracentesis or wash. Ten had trabecula excision plus intraoperative mitomycin. Two vitrectomy, and one filtration surgery. Five cases had laser peripheral iridotomy. After treatment, during the follow-up of 6 to 12 months, 87.50% of them had IOP returned to normal, but 8.33%had vision decline or loss. One case occurred bleeding during operation, and one had increased turbidity crystals after operation, and another one occurred retinal detachment.Conclusion:Ocular trauma secondary glaucoma had complicated clinical manifestations. It was difficult to treat. Different treatments should be selected according to the specific circumstances of the patient.