Wang Grace M, Thuente Daniel, Bohnsack Brenda L
Department of Ophthalmology and Visual Sciences, University of Michigan, United States.
Grand Traverse Ophthalmology Clinic, United States.
Am J Ophthalmol Case Rep. 2018 Mar 9;10:215-220. doi: 10.1016/j.ajoc.2018.03.009. eCollection 2018 Jun.
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.
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).
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.
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。
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)。
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。