眼外伤早期继发青光眼的临床分析  

Clinical analysis of early secondary glaucoma associated with ocular trauma

作　　者：王卫群[1] 孔令训[1] 张效房[1] 

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华眼科杂志》2005年第5期439-442,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨眼外伤患者早期继发青光眼的分类和治疗方法.方法收集139例(139只眼)眼外伤早期继发青光眼患者的临床资料,对患者的临床表现及治疗方法进行分型和分析.结果根据临床表现将眼外伤早期继发青光眼分为5种类型:眼内积血型、房角挫伤型、晶状体相关型、粘连增殖型和眼内炎型.单纯药物治疗37例(37只眼)(26.62%);药物治疗联合前房穿刺或冲洗32例(32只眼)(23.02%);其他手术治疗(包括玻璃体切除、滤过手术和联合手术)70例(70只眼)(50.36%).治疗后随访3～6个月,未用降眼压药物、眼压正常患者(6 mm Hg≤眼压≤21 mm Hg)121例(121只眼)(87.05%),眼压>21 mm Hg者13例(13只眼)(9.35%),眼压<6 mm Hg者5例(5只眼)(3.60%).视力下降或丧失7例(7只眼),余132例(132只眼)视力与术前相同或提高.术中和术后眼出血8例(8只眼),视网膜脱离2例(2只眼).结论眼外伤早期继发青光眼患者临床表现复杂,对每种病例应采取具体有针对性的治疗方法.Objective To determine the classification and management of early secondary glaucoma associated with ocular trauma. Methods The records of 139 patients (139 eyes) were reviewed and analyzed. Results Five different types of early secondary glaucoma associated with trauma were determined by clinical findings: hemorrhage type, chamber angle injury type,lens related type, synechia and proliferation type, and inflammation type. Each type of secondary glaucoma received different therapeutic methods. Thirty-seven cases (26.62%) received medical treatment; 32 cases (23.02%) received medical treatment and anterior chamber paracentesis or washing; 70 cases (50.36%) received other surgical procedures, including vitrectomy, filtration surgery and combine operation. After follow-up for 3-6 months, the intraocular pressure (IOP) was successfully controlled without anti-glaucoma medical treatment in 121 eyes (87.05%) (6 mm Hg≤IOP≤21 mm Hg); IOP>21 mm Hg was found in 13 eyes (9.35%) and IOP<6 mm Hg in 5 eyes (3.60%). The postoperative visual acuity was decreased or lost in 7 eyes, remained the same or improved in 132 eyes. Eight eyes had hemorrhage during or after the operation. Two eyes developed retinal detachment. Conclusions Clinical findings of early secondary glaucoma associated with trauma are complex. Each subtype of patients should take relevant different treatments.

关 键 词：继发青光眼 早期 临床分析 青光眼患者 治疗方法 临床表现 单纯药物治疗 眼外伤患者 玻璃体切除 治疗后随访 降眼压药物 视网膜脱离 临床资料 前房穿刺 手术治疗 联合手术 滤过手术 视力下降 挫伤型 相关型 晶状体 眼内炎 

分 类 号：R779.1[医药卫生—眼科] R775[医药卫生—临床医学]