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1、眼外伤继发青光眼的临床分析作者:罗谦,黎静,程依琏单位:610041)中国四川省成都市,四川省医学科学院四川省人民医院眼科【摘要】目的:探讨眼外伤继发青光眼的原因和治疗。方法:对100例100眼眼外伤继发青光眼患者的临床表现和治疗方法进行分析。结果:眼外伤继发青光眼可山多种原因引起,根据木组资料可将其发病原因主要归为4种:眼内积血、前房角挫伤、晶状体源性、炎性粘连或增殖。单纯药物治疗25眼,药物联合各类手术治疗75眼(前房冲洗、H内障摘除、玻璃体切割、小梁切除、联合手术)。治疗后随防2〜12mo,眼压正常者(6〜21mmHg)(lmmHg=0.133kPa)82眼(82%);眼压&
2、gt;2ImmHg者14眼(14%);眼压<6mmHg者4眼(4%)o结论:眼外伤继发青光眼的发病原因复杂,应针对病因及时治疗。【关键词】眼外伤;青光眼;原因;治疗ClinicalanalysisofsecondaryglaucomawithoculartraumaQianLuo,JingLi,YiLianChengDepartmentofOphthalmology,SichuanProvincialPeoplesHospital,Chengdu610041,SichuanProvince,ChinaAbstractAIM:Tostudythereasonandtreatme
3、ntofsecondaryglaucomawithoculartrauma.METHODS:Onehundredpatients(onehundredeyes)withsecondaryglaucomacausedbyoculartraumawerestudiedandtheclinicalsituationandthetreatmentwereanalyzed・RESULTS:Secondaryglaucomawithoculartraumacouldbecausedbyavaiietyofreasonswhichmightbeclassifiedasfourmainreason
4、saccordingtothedata,suchasintraocularhemorrhage,angleofanteriorchambercontusion,lensderivedandinflammationconglutinationandproliferation・Twentyfiveeyesweretreatedbydrugssimply,andseventyfiveeyesweretreatedbydrugsandoperations(anteriorchamberirrigation,cataractextraction,Strectomy,trabeculectom
5、yandcombinedsurgery).Aftertreatment,allthepatientswerefollowedupfor212months.Theintraocularpressure(IOP)of82eyes(82%)werenormal(62ImmHg)(ImmHg二0.133kPa).TheIOPof14eyes(14%)weremorethan2ImmHg.TheIOPof4eyes(4%)werelessthan6mmHg.CONCLUSION:Thecausesofsecondaryglaucomawithoculartraumawerecomplex.T
6、hepathogenyshouldbetreatedintime.KEYWORDS:oculartrauma;glaucoma;cause;treatment0引言全壯界每年有近240万眼受各种眼外你眼外伤是眼科住院患者的第三大病因。眼外伤可以引起多种眼部并发症,继发性青光眼是眼外伤后严重而顽固的并发症之一,最终对视力的损害很大,致盲率很高,药物及手术的治疗效果通常不理想[1]。眼外伤继发青光眼的治疗是一个复杂的临床问题,医师必须在明确了解患者的发病原因及对患者眼损伤的病情预测基础上來选择治疗方案。I对彖和方法1」对象选择200001/200701我院收治的眼外伤继发青光眼100例
7、100眼患者,年龄4〜65(平均34.5)岁;男78例(78眼,78%),女22例(22眼,22%)。眼外伤类型:钝挫伤63例(63眼,63%),穿通伤37例(37眼,37%)。就诊时眼压均>28mmHgo一般表现为外伤眼眼球胀痛、视力急剧下降,球结膜水肿,前房积血、晶状体脱位、虹膜断裂、玻璃体积血等不同的眼内表现,根据本组病例,将眼外伤继发青光眼的发病原因主耍总结为以下4种:(1)眼内积血:36例(36%),其中单纯前房积血28例,玻璃体积血3例,同时有前房积