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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(6mmHg≤眼压≤21mmHg)121例(121只眼) (87 .05% ),眼压>21mmHg者13例(13只眼) (9 .35% ),眼压<6mmHg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 investigate the classification and treatment of early secondary glaucoma in ocular trauma patients. Methods The clinical data of 139 patients (139 eyes) with early secondary glaucoma after eye injury were collected. The clinical manifestation and treatment of the patients were classified and analyzed. Results According to the clinical manifestations of early traumatic ocular trauma secondary glaucoma divided into five types: intraocular hemorrhage, atrial contusion, lens-related, proliferative and intra-endophthalmitis type. Treatment of 37 cases (37 eyes) with simple drug therapy (26.62%); drug treatment combined with anterior chamber puncture or flushing in 32 cases (32 eyes) (23. 02%); other surgical treatment (including vitrectomy, filtration surgery And combined surgery) in 70 patients (70 eyes) (50.36%). After treatment, the patients were followed up for 3 to 6 months. There were 13 patients (121 eyes) (87.05%) with intraocular pressure (IOP), patients with normal intraocular pressure (6mmHg≤ IOP≤21mmHg) and intraocular pressure> 21mmHg 13 eyes) (9.35%), intraocular pressure <6mmHg in 5 cases (5 eyes) (3.60%). Visual acuity decreased or lost in 7 cases (7 eyes), 132 cases (132 eyes) visual acuity and preoperative same or increased. Intraoperative and postoperative ocular hemorrhage in 8 cases (8 eyes), retinal detachment in 2 cases (2 eyes). Conclusions The clinical manifestations of patients with early secondary glaucoma after ocular trauma are complicated. Specific targeted therapy should be taken for each case.