Causes and treatments of traumatic secondary glaucoma

To study the cause, treatment, and cure of traumatic secondary glaucoma in 103 cases (103 eyes).

The records of 103 patients (103 eyes) were reviewed. Causes of the high intraocular pressure (IOP) were analyzed according to the time after trauma. Most patients achieved a better visual acuity and ideal IOP after positive medical, neodymium:Yttrium aluminium garnet (Nd:YAG) laser, or surgical treatment. The operations included anterior chamber irrigation, filtering operation combined with mitomycin C, lensectomy, vitrectomy, and combination surgery.

Clinical findings of secondary glaucoma associated with ocular trauma are complex. Causes resulting in high IOP include intraocular bleeding, lens dislocation, phacoanaphylaxis, angle recession, and siderosis. After medical, laser, or surgical treatment, the IOP of most patients could be ideally controlled. After follow-up for half a year, the IOP of 3 cases (2.91%) was below 10 mmHg and 92 (89.32%) cases between 10 and 21 mmHg; only 8 cases (7.77%) still had IOP over 21 mmHg.

In traumatic secondary glaucoma, antiglaucoma medication should be used at the early stage, and surgery should be carried out when medical treatment does not reduce the elevated IOP, or in difficult cases to avoid severe complications. The postoperative IOP of most injured eyes was controlled within the safe range.