再報告四例外傷性前房出血性青光眼（手術治療）

Second Report of Secondary Glaucoma Due to Traumatic Hyphema (Surgical Treatment)

那玉(Y. Na)

《中華民國眼科醫學會會刊》 11卷 (1972/05) Pp. 93-102

https://doi.org/10.30048/ACTASOS.197205.0013

並列摘要

When glaucoma occurs due to traumatic hyphema and fails to respond to medical treatment, certain surgical treatment is worthy of trying; otherwise the prognosis is poor.
Although there were several methods of surgical treatment for this condition reported in the literatures but the post operative course were not uneventful and no one was considered satisfactory.
The author reported two cases in 1962 and here reports again on four cases of secondary glaucoma due to traumatic hyphema the author experienced in the recent years. The details of these cases were reported. On all the six cases, the traditional Elliot's trephination was done and the results were satisfactory. Vision improved from light sense or hardly to recongnize the light sense at the time of operation to useful good vision (0.8, corrected to 1.2; 0.7, with hope of improving, vitreous opicaty; 1.0; 0.4, with hope of improving, vitreous opacity; 0.9; count finger, membranous cataract).
Experience of these six cases revealed that no further bleeding occurred after the trephination; even large anount of clotted blood still remained in the anterior chamber after the operation, it will dissolve and comes out from the trephine hole or absorbs spontaneouly in about one week; the post operative courses were all uneventful and all cases were able to be dischargeds in about two weeks; in more severe cases, corneal cloudiness, mainly endothelium in nature, and vitreous opacity developed which needs months or even years to get a complete cure, so the vision at the time of discharge are poor but vision may be improved later.
In the explanation of the mechanism of the healing process, the author believes that the trephination nomalizes the tension of the eye ball and so also the circulation of the eye ball which promotes the wound healing and then there will be no source of bleeding. Damage of the cornea and vitreous will recover too under the normalized circulation. The author believes trephination is the logical, simple and safe surgical procedure in handling this troublesome condition.
Different surgical procedures for this con dition were also discussed.