青少年眼钝伤性房角后退的观察  

Observation of angle recession after blunt trauma in teenagers eyes.

作　　者：郭华兰[1] 李立[1] 

机构地区：[1]重庆医科大学附二院眼科,400010

出　　处：《中国斜视与小儿眼科杂志》2002年第1期5-7,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的　本文观察 2 82例眼钝位对房角损伤所致房角后退的各种状态 ,并探讨房角后退与前房出血及青光眼的关系。方法　应用Goldmann前房角镜 ,检查 2 82例眼钝伤的双眼前房角 ,观察房角后退的各种形态 ,根据Howard等的分类法将房角后退分成浅 (Ⅰ度 ) ,中 (Ⅱ度 ) ,深 (Ⅲ度 )三度 ,并以圆周 0～ 3 60°范围作记录。结果　各种原因所致 2 82例钝伤眼中 ,2 67眼有房角后退占94 68% ,其中Ⅰ度房角后退 1 1 9眼 (4 4 5 7% ) ,Ⅱ度 95眼 (3 5 5 8% ) ,Ⅲ度 5 3眼 (1 9 85 % )。有前房出血记录者 1 98眼 (70 2 1 % ) ,全部有房角后退。在房角后退的 2 67眼中 ,41眼有眼压升高 ,其中1 7眼房角后退为唯一原因 ,眼压升高均发生在 1年内 ,大部分在 1周内。其中 1 6眼经药物治疗后 1年内眼压恢复正常 ,1眼手术治疗。结论　眼钝伤做房角镜检查 ,有利于发现房角损伤 ,并综合各种损伤分析病情 ,指导临床治疗。若发现房角后退 >1 80°时 ,有可能发生青光眼 。Objective To observation all kinds of states of 282 eyes, of which angle recession was lead by blunt trauma and to inqire the relations among angle recession, hyphema and glaucoma. Methods Using Goldmann gonisocope, we examined 282 eyes of blunt trauma. According to Howard, angle recession was classified as sallow (Ⅰ)?middle (Ⅱ)?deep (Ⅲ) three degree and recorded in 0～360° range. Results There were 267 eyes of angle recession (94 68%) in all 282 eyes examined, in which 119 eyes belonged to Ⅲ degree and 97 eyes (36 33%) whose range of angle recession <90°, 139 eyes ( 52 06% ) in 90°～180°, 24 eyes (8 99%) in 180°～270° and 7 eyes ≤360°. There were 198 eyes occurring hyphema (70 21%) and 41 eyes occuring ocular hypertension. Ocular hypertension of all cases occurred in one year (mostly in one week) after trauma. Intraocular pressure had come to normal after treated with medicine (16 eyes) and operation (1 eye). Conclusion By examining angle of anterior chamber with gonioscope after blunt trauma, we could find and analysis the condition of angle and instruct clinical treatment. Because there was glaucoma occurred when angle recession >180°, we should periodic follow-up.

关 键 词：青少年 眼钝伤 房角后退 

分 类 号：R779.1[医药卫生—眼科]