Tourame B, Ben Younes N, Guigou S, Denis D
Service d'Ophtalmologie, CHU Nord, Marseille.
J Fr Ophtalmol. 2009 May;32(5):335-40. doi: 10.1016/j.jfo.2009.03.023. Epub 2009 May 17.
To study the future of vision and IOP in congenital glaucoma.
We studied 33 eyes from 20 separate patients divided into two groups: group one consisted of 19 eyes with isolated trabeculodysgenesis and group two 14 eyes associated with Sturge-Weber-Krabbe syndrome, angiomatosis, or Peters syndrome. All patients underwent filtering surgery between 1995 and 2006. We studied a number of different forms of surgery; visual acuity after amblyopia treatment (> or =5/10, good; 4/10-2/10, average; < or =1/10, poor), objective refraction, and intraocular pressure (<16 mmHg, good; > or =16 mmHg, poor).
We found that 54.8% of the patients had visual acuity 5/10 or greater and 44.2% between 4 and the ability to perceive light. Objective refraction was emmetropic in 19.4% (group 1, 60%; group 2, 40%), myopic in 53.8% (group 1, 28.5%; group 2, 71%), and hyperopic in 26.9% of cases (100%, group 1). All patients underwent surgery (45.5% deep sclerectomy and 54.5% trabeculectomy); 39.4% of the patients underwent more than one type of surgery (the number of operations is a prognosis factor for visual acuity). IOP was less than 19 mmHg in 87.9% of eyes.
Visual acuity, refractive errors, and IOP depend on the type of congenital glaucoma. Isolated trabeculodysgenesis seems to give a better prognosis.
If early diagnosis and treatment occur, visual acuity that is 5/10 or less can be expected for more than 50% of patients; therefore their visual future seems to be better.
研究先天性青光眼患者视力和眼压的预后情况。
我们对来自20例不同患者的33只眼睛进行了研究,将其分为两组:第一组包括19只单纯小梁发育异常的眼睛,第二组包括14只合并斯-韦-克综合征、血管瘤病或彼得斯综合征的眼睛。所有患者均在1995年至2006年间接受了滤过手术。我们研究了多种不同的手术方式;弱视治疗后的视力(≥5/10,良好;4/10 - 2/10,一般;≤1/10,差)、客观验光以及眼压(<16 mmHg,良好;≥16 mmHg,差)。
我们发现54.8%的患者视力≥5/10,44.2%的患者视力在4/10至能感知光线之间。客观验光结果显示,19.4%的患者为正视眼(第一组,60%;第二组,40%),53.8%的患者为近视眼(第一组,28.5%;第二组,71%),26.9%的患者为远视眼(第一组为100%)。所有患者均接受了手术(45.5%为深层巩膜切除术,54.5%为小梁切除术);39.4%的患者接受了不止一种手术方式(手术次数是视力预后的一个因素)。87.9%的眼睛眼压低于19 mmHg。
视力、屈光不正和眼压取决于先天性青光眼的类型。单纯小梁发育异常似乎预后较好。
如果能早期诊断和治疗,超过50%的患者有望获得≥5/10的视力;因此他们的视力预后似乎较好。