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先天性葡萄膜外翻中的闭角型青光眼。

Angle closure glaucoma in congenital ectropion uvea.

作者信息

Wang Grace M, Thuente Daniel, Bohnsack Brenda L

机构信息

Department of Ophthalmology and Visual Sciences, University of Michigan, United States.

Grand Traverse Ophthalmology Clinic, United States.

出版信息

Am J Ophthalmol Case Rep. 2018 Mar 9;10:215-220. doi: 10.1016/j.ajoc.2018.03.009. eCollection 2018 Jun.

Abstract

PURPOSE

Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea.

OBSERVATIONS

Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months) and required additional surgery (cycloablation or trabeculectomy).

CONCLUSIONS AND IMPORTANCE

Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control.

摘要

目的

先天性葡萄膜外翻是一种罕见的异常情况,与开放但发育不良的虹膜角膜角相关,可导致儿童青光眼。在此,我们报告3例先天性葡萄膜外翻患儿发生闭角型青光眼的病例。

观察结果

3名儿童分别在7岁、8岁和13岁时最初被诊断为继发于先天性葡萄膜外翻的单侧青光眼。这3例病例均表现为患眼360°葡萄膜外翻和虹膜基质萎缩。在1例病例中,我们有照片记录显示病情进展至完全房角关闭,在小梁切开术和小梁切除术联合进行3年后需要植入青光眼引流装置。另外2例表现为完全房角关闭的病例也接受了青光眼引流装置植入术。所有3例病例均出现早期青光眼引流装置包封(4个月内),并需要再次手术(睫状体光凝或小梁切除术)。

结论及重要性

先天性葡萄膜外翻可与闭角型青光眼相关,在我们所有3例病例中,青光眼引流装置的植入均因引流板包封而早期失败。先天性葡萄膜外翻性青光眼需要关注房角结构,通常需要多次手术来控制眼压。

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