不同手术方式治疗眼外伤继发青光眼的临床对比分析  

Clinical analysis of different surgeries on glaucoma secondary to ocular trauma

作　　者：郑涂芳[1] 金纬[2] 

机构地区：[1]仙桃市第一人民医院眼科,湖北省仙桃市433000 [2]武汉大学人民医院眼科中心,湖北省武汉市430060

出　　处：《眼科新进展》2014年第4期380-381,384,共3页Recent Advances in Ophthalmology

摘　　要：目的对比分析不同手术方式治疗眼外伤继发青光眼的临床效果。方法随机对照研究。选取2010年1月至2012年6月我院收治的经药物控制不佳的眼外伤继发青光眼患者80例(80眼),按照随机数字表法分为A组和B组各40例,分别采用小梁切除术和周围虹膜切除术。分别于术前、术后随访期末记录两组患者的眼压、裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)等变化。结果术后两组眼压、UCVA比较,差异均有统计学意义(均为P<0.05),小梁切除术对眼外伤继发青光眼术后眼压、UCVA的改善情况优于周边虹膜切除术。A组术后BCVA提高30眼,不变6眼,降低4眼;B组术后BCVA提高18眼,不变12眼,降低10眼;两组术后BCVA改善情况比较,差异有统计学意义(P<0.05),小梁切除术对眼外伤继发青光眼术后BCVA的改善情况优于周边虹膜切除术。结论在药物不能控制眼压后,根据具体的发病原因、病理类型合理考虑小梁切除术治疗能有效改善患者的眼压和视力。Objective To summarize and analyze the clinical effects of different surgeries on glaucoma secondary to ocular trauma. Methods Random control study. Eighty patients （80 eyes）with glaucoma secondary to ocular trauma in our hospital from January 2010 to June 2012 were enrolled, the intraocular pressure in all patients could not be controlled by drug. The patients were random divided into two groups： group A and group B, 40 cases in each group, the trabeculectomy and peripheral iridec- tomy were performed in two groups, respectively. The intraocular pressure, uncorrect- ed visual acuity （ UCVA）, best corrected visual acuity （BCVA） at pre-operation and the final follow-up were recorded. Results There were statistical differences in postoper- ative intraocular pressure and UCVA between two groups （ all P 〈 0.05 ）, the trabecu- lectomy was better in controlling the intraocular pressure and improving UCVA than the peripheral iridectomy. In group A, BCVA increased in 30 eyes, unchanged in 6 eyes, decreased in 4 eyes; In group B, BCVA increased in 18 eyes, unchanged in 12 eyes, de- creased in 10 eyes; There was statistical difference between two groups （P 〈 0.05 ）, the trabeculectomy was better in improving BCVA than the peripheral iridectomy. Conclu- sion When the intraocular pressure can not be controlled by drugs, according to the etiology and pathological type, the trabeculectomy can improve the visual acuity and decrease the intraocular pressure for patients with glaucoma secondary to ocular trau- ma.

关 键 词：眼外伤 继发性青光眼 小梁切除术 周边虹膜切除术 眼压 视力 

分 类 号：R775.3[医药卫生—眼科]