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目的 :观察复杂外伤性青光眼联合手术治疗的临床疗效 ,探讨手术方法及并发症。方法 :对 2 8例继发于钝挫伤、穿通伤的复杂外伤性青光眼行联合手术治疗 ,其中行晶状体摘除、前部玻璃体切除联合青光眼阀前房植入术 10例 ,保留晶状体、前部玻璃体切除联合青光眼阀前房植入术 3例 ,无晶状体眼行前部玻璃体切除、人造瞳孔术联合青光眼阀前房植入术 4例及睫状体扁平部植入术 5例 ,人工晶状体眼行可调整缝线小梁切除联合前部玻璃体切除术 4例 ,恶性青光眼行前房成形术 ,前部玻璃体切除联合青光阀扁平部植入术 2例 ,以上眼其中 7例同时行人工晶状体缝线固定术。结果 :术后随诊 9～ 4 0个月 ,平均 18 6个月 ,手术成功 (眼压 :6～ 2 1mmHg) 2 1只眼 (75 % )视力提高 15只眼 (5 3 5 % )。并发症 :早期低眼压 18例 ,脉络膜脱离 12例 ,眼压失控 7例 ,玻璃体出血 4例 ,引流管内口阻塞 5例 ,驱逐性出血 1例 ,视网膜脱离 1例。结论 :联合手术是治疗复杂外伤性青光眼的一种有效方法
Objective: To observe the clinical efficacy of combined surgical treatment of complicated traumatic glaucoma and to explore the surgical methods and complications. Methods: Twenty-eight cases of complicated traumatic glaucoma secondary to blunt contusion and penetrating trauma were treated with combined surgery. Among them, 10 cases were treated with lens extraction, anterior vitrectomy combined with glaucoma valve anterior chamber implantation, and retained the lens, anterior vitreous 3 cases underwent anterior chamber implantation combined with glaucoma valve, anterior vitrectomy with aphakia, 4 cases with artificial pupil surgery combined with glaucoma valve anterior chamber implantation and 5 cases with ciliary body flattened implant, Adjustable suture trabeculectomy combined with anterior vitrectomy in 4 cases, malignant glaucoma underwent anterior chamber angioplasty, anterior vitrectomy combined with flat valve glaucoma implantation in 2 cases, of which 7 cases of the upper eye simultaneously with intraocular lens Line fixation. Results: All patients were followed up for 9 to 40 months (average 186 months). Visual acuity was improved in 15 eyes (53.5%) in 21 eyes (75%) with successful operation (intraocular pressure: 6-221 mmHg). Complications: early low intraocular pressure in 18 cases, choroidal detachment in 12 cases, intraocular pressure in 7 cases, vitreous hemorrhage in 4 cases, 5 cases of drainage tube obstruction, 1 case of bleeding bleed, retinal detachment in 1 case. Conclusions: Combined surgery is an effective method for the treatment of complicated traumatic glaucoma