外伤性晶状体脱位合并青光眼手术的疗效分析

目的：回顾性评价晶状体摘除联合玻璃体切割术用于外伤性晶状体脱位合并继发性青光眼的手术疗效。
　　方法：对31例31眼因钝挫伤导致晶状体脱位,合并继发性青光眼患者分别行晶状体摘除联合前部玻璃体切割术,小梁切除术及人工晶状体植入术。随访术后1wk；1,3mo术眼眼压、视力。
　　结果：患者31眼全部成功摘除晶状体联合前部玻璃体切割术,其中联合小梁切除术6眼,植入前房型人工晶状体9眼,后房缝线固定晶状体15眼。一期植入16眼,二期植入8眼。术后31眼眼压全部控制正常。有23眼术后矫正视力0.3以上。
　　结论：晶状体摘除联合玻璃体切割术是治疗晶状体脱位合并继发性青光眼的有效手段,但应根据患者情况选择人工晶状体植入类型及联合小梁切除术,以控制眼压,恢复视功能。

Surgical effect of traumatic lens dislocation with secondary glaucoma

AIM: To retrospectively evaluate the effect of lens extraction combined with vitrectomy to treat traumatic lens dislocation with secondary glaucoma.

METHODS:Thirty-one eyes(31 cases)of lens dislocation caused by blunt trauma with secondary glaucoma were treated respectively with cataract extraction combined with anterior vitrectomy, trabeculectomy and intraocular lens implantation. The visual acuity and pressure were observed 1wk, 1 and 3mo after operative.

RESULTS:Thirty-one eyes were all complete the operation successfully, and 6 eyes were given combined trabeculectomy, 9 eyes were implanted anterior chamber intraocular lens implantation(IOL)and 15 eyes were given posterior chamber suture fixation. Sixteen eyes were implanted in one-stage operation, while 8 eyes were implanted in two-stage operation. All intraocular pressure(IOP)were controlled to the normal level after operation and 23 eyes had visual acuity of more than 0.3.

CONCLUSION:Lens extraction combined with vitrectomy is an effective method for treatment of lens dislocation with secondary glaucoma. In order to control the IOP and get well visual function, we should choose IOL implantation or trabeculectomy according to the patient's condition.