Secondary glaucoma surgery for traumatic hyphema

The blunt eyeball produces a large elastic damage to the wall of the eyeball, especially the damage of the anterior pole, and the iris and anterior chamber angle rich in blood vessels and structures are damaged, and the anterior chamber blood and the angle of the anterior chamber are damaged. Hair glaucoma and so on. When the eyeball is bluntly injured, the anterior chamber of the eye is filled with trabecular meshwork, such as red blood cells, fibrin, macrophages that phagocytose blood, clots or blood, or blood clots or corneal damage. Increased intraocular pressure, inflammatory edema of trabecular meshwork after blunt trauma, decreased permeability, blocked drainage of aqueous humor, can also cause a transient increase in intraocular pressure. When there is a large amount of blood, it is necessary to choose an appropriate timing for anterior chamber puncture. If the bleeding time is long, especially recurrent bleeding can cause peripheral anterior iris adhesion or corneal clot formation can cause secondary open angle or angle closure glaucoma. When high intraocular pressure occurs, the intraocular pressure should be protected while protecting the corneal endothelium to prevent serious complications such as corneal blood staining. Curing disease: Indication The anterior chamber blood is up to grade III (Shingleton grade), secondary glaucoma occurs, followed by blood production, "black ball" sign, early corneal blood staining signs, and blood shadow cells secondary to glaucoma. Preoperative preparation Prepare according to the internal eye before surgery. Surgical procedure Surgical procedures include anterior chamber puncture, anterior chamber irrigation, and shaped clot removal. Simple anterior chamber puncture is difficult for anterior chamber coagulation (such as "black ball" sign), suitable for those who have non-coagulant components in the anterior chamber, and the eye pressure is extremely high, and if there is complicated operation, the blood will be released again. Possible eye injury. In general, anterior chamber irrigation should be used. The use of single-needle water injection is rarely used in contemporary surgery. The system with injection function is often used to complete the operation, because the injection function can maintain the intraocular pressure and the anterior chamber space stably during the operation, which not only prevents rebleeding but also facilitates the removal of loose blood clots. The removal of solid blood clots is not easy to use by the method of injecting. It is necessary to cooperate with the resection function. Usually, a perfusion needle is preset in the limbus to establish a perfusion. After the perfusion is selected, the vitreous cutting head enters the anterior chamber for suction. Edge cutting operation. It has been suggested to use tissue plasminogen activators to help clear blood clots.

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