摘要
目的探讨眼外伤迟发性青光眼不同类型的治疗。方法根据临床表现将眼外伤迟发性青光眼分为五种类型:房角后退型;粘连增殖型;无晶状体型;新生血管型;虹膜缺损型。74例(74眼)眼外伤迟发性青光眼根据不同类型分别采用小梁切除联合MMC术、小梁切除联合玻璃体切除术、睫状体光凝进行手术治疗。结果74例中59例眼压被控制,成功率为79.73%,56例(75.68%)的视力与术前相同或提高,18例(24.32%)视力下降。术后5例出现白内障,3例合并视神经萎缩加重,1例视网膜脱离,1例脉络膜脱离。结论眼外伤迟发性青光眼应根据不同分型进行系统治疗,对于房角后退型和粘连增殖型及虹膜缺损型继发青光眼应选择小梁切除联合MMC术治疗;无晶状体型继发青光眼根据病情,选择小梁切除联合MMC或小梁切除联合玻璃体切除术;新生血管型继发青光眼可直接进行睫状体光凝治疗。
Objective： To investigate the treatment of lated secondary glaucoma associated with ocular trauma. Methods： Five different types of lated secondary glaucoma associated with ocular trauma were determined by clinical findings ：angle recession type, synechia and proliferation type, aphakia type, neovascularization type, and coloboma of the iris type. Trabeculectomy with intraoperative application of mitomycin C or combine vitrectomy, and laser cyclophotocoagulation were different performed in 74 eyes. Results： The intraocular pressure （ IOP ） was successfully controlled in 59 eyes （79.73%） .The postoperative visual acuity was decreased or lossed in 18 eyes（24.32%）, remained the same or increased in 56 eyes（75.68%）.The postoperative complications were cataract 5 eyes, hypotony 3 eyes, hypotonous maculopathy 1 eye, choroidal detachment 1 eye, retinal detach -ment 1 eye. Conclusion： Lated secondary glaucoma should be treatmented according different types. Trabeculectomy with intraoperative application of mitomycin C should be performed in angle recession type,synechia and proliferation type, coloboma of the iris type, Trabeculectomy with intraoperative application of mitomycin C or combine vitrectomy should be performed in aphakia type, Laser cyclophotocoagulation should be performed in neovascularization type.
出处
《当代医学》
2009年第4期6-8,共3页
Contemporary Medicine
