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目的:分析晶状体脱位继发急性闭角型青光眼的临床特点及误诊原因。方法:对晶状体脱位继发急性闭角型青光眼患者36例(41只眼),采用房角镜和(或)超声生物显微镜(UBM)检查,根据其临床特点,选择适当的手术治疗。结果:41只眼中31只眼(75.61%)误诊为原发性急性闭角型青光眼。单眼晶状体脱位继发急性闭角型青光眼的前房深度较对侧眼明显变浅,差异有统计学意义(P<0.05)。术后1个月,患者视力不同程度提高;眼压正常。结论:晶状体脱位继发急性闭角型青光眼容易误诊为原发性急性闭角型青光眼,误诊原因主要为病史询问不清、眼部检查不仔细。治疗晶状体脱位继发急性闭角型青光眼,需要解除晶状体因素,才能提高手术成功率。
Objective: To analyze the clinical features and causes of misdiagnosis of secondary acute angle-closure glaucoma with lens dislocation. Methods: Thirty-six patients (41 eyes) with acute angle-closure glaucoma secondary to lens dislocation were examined by gonioscopy and / or ultrasound biomicroscopy (UBM). According to their clinical characteristics, appropriate surgical treatment was selected. Results: 31 eyes (75.61%) of 41 eyes were misdiagnosed as primary acute angle-closure glaucoma. The anterior chamber depth of secondary acute angle closure glaucoma in monocular lens dislocation was significantly lower than that in contralateral eye, the difference was statistically significant (P <0.05). 1 month after surgery, patients with varying degrees of improvement of visual acuity; normal intraocular pressure. Conclusion: Secondary acute angle-closure glaucoma may be misdiagnosed as primary acute angle-closure glaucoma. The main causes of misdiagnosis are unclear history, unclear eye examination. Treatment of lens dislocation secondary to acute angle-closure glaucoma, the need to lift the lens factors in order to improve the success rate of surgery.