术中超声生物显微镜检查诊断先天性白内障摘除术后瞳孔阻滞性青光眼：一例报告
Diagnosis of pupillary block glaucoma after removal of congenital cataracts with intraoperative ultrasound biomicroscopy: a case report.
作者信息
Zhu Xiang-Jia, Zhang Ke-Ke, He Wen-Wen, Sun Xing-Huai, Meng Fan-Rong, Lu Yi
机构信息
Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.
出版信息
BMC Ophthalmol. 2016 May 17;16(1):58. doi: 10.1186/s12886-016-0238-9.
BACKGROUND
Aphakic glaucoma is a common complication after congenital cataract extraction, especially in those who have surgery during infancy. This case report describes a case of bilateral pupillary block glaucoma diagnosed with intraoperative ultrasound biomicroscopy (UBM) after removal of congenital cataract.
CASE PRESENTATION
We present a case report of a 9-month-old infant with bilateral corneal enlargement and ocular hypertension after uneventful removal of congenital cataracts. Initial and follow-up examination findings were reviewed. The infant was suspected to have developmental glaucoma and schemed to have bilateral trabeculotomy until pupillary obstruction by vitreous herniation and angle closure with iris bombé were detected by intraoperative UBM. Anterior vitrectomy and goniosynechialysis were then performed as treatment.
CONCLUSION
Pupillary block glaucoma is a rare type of infantile aphakic glaucoma. Application of intraoperative UBM can assist in the differential diagnosis of aphakic glaucoma in infants.
背景
无晶状体性青光眼是先天性白内障摘除术后的常见并发症，尤其是在婴儿期接受手术的患者中。本病例报告描述了1例先天性白内障摘除术后经术中超声生物显微镜检查（UBM）诊断为双侧瞳孔阻滞性青光眼的病例。
病例介绍
我们报告1例9个月大婴儿，在顺利摘除先天性白内障后出现双侧角膜增大和高眼压。回顾了初始检查和随访检查结果。该婴儿被怀疑患有发育性青光眼，并计划进行双侧小梁切开术，直到术中UBM检测到玻璃体疝导致瞳孔阻滞和虹膜膨隆引起房角关闭。随后进行了前部玻璃体切除术和房角粘连分离术作为治疗。
结论
瞳孔阻滞性青光眼是婴儿无晶状体性青光眼的一种罕见类型。术中应用UBM有助于婴儿无晶状体性青光眼的鉴别诊断。
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