The Anterior Chamber Angle Deformities in Traumatic Hyphema

ABSTRACT

The contusive anterior chamber angle deformities after traumatic hyphema probably were related to the late onset of glaucoma but have been overlooked easily. Authors analysed clinically the angle deformities of 53 patients with traumatic hyphema at the Department of Ophthalmology, Pusan National University from May 1983 to April 1986 by gonioscopic findings. The results were as follows 1. Male to female ratio of 53 patients was 7.81, The average age was 23.7 years. 2. The traumatic hyphema was caused by missile injuries(58.5%) and blunt traumas(41.5%). 3. Of the 53 patients with traumatic hyphema, 42(79.2%) patients had angle recession and 9 patients had normal angle. 4. The degree of angle recession consisted of Grade I, 19.0%(8 cases), Grade II, 38.1%(16 cases), and Grade III, 42.9%(18 cases). The circumferential extent of angle recession increased proportionally with the degree of angle recession. 5. The circumferential extent of angle recession in the range of 271 degrees ~ 360 degrees was 57.1%, 181 degrees ~ 270 degrees was 23.8%, 91 degrees ~ 180 degrees was 11.9% and under 90 degrees was 7.1% of the patients. 6. There was no significant correlation between the amount of hyphema and the extent and degree of angle recession. 7. The distribution of angle recession was noted 42 cases in superonasal quadrant, 34 cases in superotemporal quadrant, 29 cases in inferotemporal quadrant and 23 cases in infercnasal quadrant and was not correlative to the amount of hyphema. 8. Of the 42 patients with angle recession, 35 patients developed peripheral anterior synechiae, its average extent was under 50 degrees, mostly being at the lower half of anterior chamber angle. 9. The relationship between the intraocular pressure and the degree of angle recession was not significant. 10. Associated ocular abnormalities other than angle abnormalities were iris damage(32.1%), chorioretinal damage(17.0%) and lens damage(7.5%). 11. The chorioretinal damage was the major cause of decreased visual acuity. 12. The chronic simple glaucoma was developed in 2(4.8%) of 42 patients with angle recession.