Li Xintong, Mukkamala Lekha, Origlieri Catherine A, Holland Bart K, Fechtner Robert D, Khouri Albert S
Departments of *Ophthalmology, The Institute of Ophthalmology and Visual Sciences †Preventative Medicine and Community Health, Rutgers New Jersey Medical School, Newark, NJ.
J Glaucoma. 2016 Oct;25(10):e855-e860. doi: 10.1097/IJG.0000000000000471.
To perform a longitudinal analysis on the association of corneal haze with intraocular pressure (IOP) in eyes with primary congenital glaucoma (PCG) over 3 years.
Charts of all patients diagnosed with glaucoma of childhood from 2002 to 2012 at our institution were retrospectively reviewed. Inclusion criteria were age 18 years and below, plus elevated IOP or characteristic clinical signs. Exclusion criteria were eyes with secondary glaucoma or corneal haze not from PCG and patients with prior ocular surgery or incomplete follow-up.
Of 79 eyes with childhood glaucoma during this period, 36 eyes had PCG [25 patients; 15 male (60.0%), 14 bilateral (56.0%)]. Eighteen eyes (13 patients) presented with corneal haze, whereas 18 eyes (12 patients) did not. Eyes with haze were diagnosed at a younger age than eyes without haze (0.79 vs. 5.2 y, P<0.02). During year 1, eyes with haze underwent significantly more IOP-lowering procedures and used significantly fewer IOP-lowering medications. Multivariate analysis revealed that corneal haze increased IOP by 4.63 mm Hg when controlling for treatment over time (P<0.01). Eyes with haze had lower survival curves and a failure hazard of 1.3 times that of eyes without haze. These eyes had a lower proportion of qualified successes than eyes without haze at year 1 (P<0.05) but this was reversed at year 3 (P<0.02).
Eyes with PCG-related corneal haze generally presented more severely than did those without haze, but postmanagement outcomes may be similar to those in eyes without haze.
对原发性先天性青光眼（PCG）患者的角膜混浊与眼内压（IOP）之间的关联进行为期3年的纵向分析。
回顾性分析2002年至2012年在本机构诊断为儿童青光眼的所有患者的病历。纳入标准为年龄18岁及以下，眼压升高或有典型临床体征。排除标准为继发性青光眼或非PCG引起的角膜混浊的眼，以及既往有眼部手术或随访不完整的患者。
在此期间的79只儿童青光眼眼中，36只眼患有PCG[25例患者；15例男性（60.0%），14例双眼（56.0%）]。18只眼（13例患者）出现角膜混浊，而18只眼（12例患者）未出现。有混浊的眼比无混浊的眼诊断时年龄更小（0.79岁对5.2岁，P<0.02）。在第1年，有混浊的眼接受降眼压手术的次数明显更多，使用降眼压药物的次数明显更少。多变量分析显示，在控制随时间的治疗后，角膜混浊使眼压升高4.63 mmHg（P<0.01）。有混浊的眼生存曲线较低，失败风险是无混浊眼的1.3倍。这些眼在第1年获得合格成功的比例低于无混浊的眼（P<0.05），但在第3年情况相反（P<0.02）。
与PCG相关的角膜混浊的眼通常比无混浊的眼表现更严重，但治疗后的结果可能与无混浊的眼相似。
