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斯特奇-韦伯综合征患儿青光眼的管理:一项挑战。

Management of childhood glaucoma in Sturge Weber Syndrome: A challenge.

作者信息

Lavaju Poonam, Mahat Pawan

出版信息

Nepal J Ophthalmol. 2015 Jul;7(14):194-7. doi: 10.3126/nepjoph.v7i2.14979.

Abstract

BACKGROUND

Sturge-Weber syndrome (SWS) is a rare congenital neuro- oculo- cutaneous disorder. Glaucoma is one of the ocular abnormalities associated with it. Management of glaucoma in SWS is challenging.

OBJECTIVE

To report surgical and visual outcome of trabeculectomy in bilateral glaucoma in Sturge-Weber syndrome and the challenges encountered in its management.

CASE DESCRIPTION

A six-year-old girl presented with gradually progressive increase in size of both the eyes associated with watering, photophobia and diminution of vision since birth. On examination she was diagnosed to have bilateral SWS with glaucoma, refractive to antiglaucoma medications. She underwent trabeculectomy with intraoperative use of 5- FU. The post operative period was complicated with choroidal effusion in both the eyes with shallow anterior chamber. In the second post operative day, the right eye anterior chamber re- formation was done with ringer lactate solution. There was spontaneous resolution of choroidal effusion with normalization of intraocular pressure with no adverse effect on visual acuity within one week.

CONCLUSION

Treatment of glaucoma associated with Sturge-Weber syndrome is challenging. When planning surgical intervention an increased risk of choroidal effusion associated with it, should be kept in mind.

摘要

背景

斯特奇-韦伯综合征(SWS)是一种罕见的先天性神经-眼-皮肤疾病。青光眼是与之相关的眼部异常之一。SWS 中青光眼的治疗具有挑战性。

目的

报告斯特奇-韦伯综合征双侧青光眼小梁切除术的手术及视觉效果,以及治疗中遇到的挑战。

病例描述

一名 6 岁女孩自出生以来双眼逐渐增大,伴有流泪、畏光和视力下降。检查发现她被诊断为双侧 SWS 合并青光眼,对抗青光眼药物治疗无效。她接受了小梁切除术,术中使用了 5-氟尿嘧啶。术后双眼出现脉络膜渗漏并伴有前房变浅。术后第二天,右眼用乳酸林格液进行前房重建。脉络膜渗漏在一周内自行消退,眼压恢复正常,视力未受不良影响。

结论

斯特奇-韦伯综合征相关青光眼的治疗具有挑战性。在计划手术干预时,应考虑到与之相关的脉络膜渗漏风险增加。

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