Kanigowska Krystyna, Grałek Mirosława, Grajkowska Wiesława, Pronicki Maciej
Department of Ophthalmology of Children's Memorial Health Institute, Warsaw.
Klin Oczna. 2008;110(7-9):297-300.
The purpose of this paper is to present the case of a patient with PHPV, in whom the complication in a form of pupillary block glaucoma was observed as a result of idiopathic and complete lens dislocation into the anterior chamber.
Examination was performed on 3 months old boy with grey pupilla reflex, noted from the birth, in the right eye. Microphthalmia, subcapsular cataract and anterior-posterior form of PHPV was found in that eye. The patient was qualified to surgical treatment. Before the appointed time of operation the increased intraocular pressure and significant globe enlargement were noted. The reason of that was pupillary block caused by lens dislocation into the anterior chamber. One-step surgical procedure: trabeculectomy, lensectomy and cutting out the retrolenticular fibrous membrane, was performed in urgent course.
Performed complicated and difficult surgical treatment resulted in normalizing IOP and created good conditions for vision rehabilitation for the child. Postoperatively the detachment of the choroid was noted as a transient complication.
In this case luxated lens and pupillary block was caused by constriction of retrolenticular fibrous membrane. Early surgical intervention is necessary to prevent progressive pathologic changes in eyes with this developmental disorder and to obtain the best possible visual results.
本文旨在介绍一例患有永存原始玻璃体增生症(PHPV)的患者,该患者因特发性且完全性晶状体脱位至前房而出现瞳孔阻滞性青光眼并发症。
对一名3个月大的男童进行检查,其右眼自出生起就有灰色瞳孔反射。该眼存在小眼球、囊下白内障以及前后型PHPV。患者符合手术治疗条件。在预定手术时间前,发现眼压升高且眼球明显增大。原因是晶状体脱位至前房导致瞳孔阻滞。紧急进行了一步式手术:小梁切除术、晶状体切除术以及切除晶状体后纤维膜。
实施的复杂且困难的手术治疗使眼压恢复正常,并为患儿视力恢复创造了良好条件。术后发现脉络膜脱离是一种短暂并发症。
在该病例中,晶状体脱位和瞳孔阻滞是由晶状体后纤维膜收缩引起的。早期手术干预对于预防患有这种发育障碍的眼睛发生进行性病理变化并获得最佳视觉效果是必要的。