青光眼伴 Sturge-Weber 综合征的房角切开术失败。

Failure of Goniosurgery for Glaucoma Associated With Sturge-Weber Syndrome.

出版信息

J Pediatr Ophthalmol Strabismus. 2020 Nov 1;57(6):384-387. doi: 10.3928/01913913-20200825-01.

DOI:10.3928/01913913-20200825-01

PMID:33211896

Abstract

PURPOSE

To report the surgical results of goniosurgery for children with glaucoma associated with Sturge-Weber syndrome.

METHODS

Retrospective review of medical records of patients who had initial goniosurgery for glaucoma associated with Sturge-Weber syndrome.

RESULTS

A total of 46 eyes of 42 patients who had glaucoma associated with Sturge-Weber syndrome and were treated with initial goniosurgery were identified to determine the efficacy of therapeutic goniotomy and trabeculotomy (goniosurgery). The average age at the time of goniosurgery was 1.5 years (range: 1 month to 23 years). Office intraocular pressure (IOP) measurements before goniosurgery were recorded in 76% of patients (32 of 42 patients) with an average measurement of 35 mm Hg (range: 25 to 50 mm Hg). The average interval to failure was 4 months (range: 1 to 48 months). Forty-six eyes underwent goniosurgery with a rate of failure of 98% (45 of 46 eyes) and a qualified success rate of 2% (1 of 46 eyes). Fifty-one goniotomy and 11 trabeculotomy procedures were performed. On gonioscopy, the filtration angles were all abnormal with variable width and visibility of the ciliary body band and less visible scleral spur. The trabecular meshwork was seen preoperatively in 100% of eyes (41 of 41 eyes) examined, all of which underwent goniosurgery. Five eyes underwent goniosurgery without documented gonioscopy. The ciliary body band was seen in 39% of eyes (16 of 41 eyes) and the scleral spur was visible in 10% of eyes (4 of 41 eyes).

CONCLUSIONS

Goniosurgery is not an effective initial glaucoma surgery for glaucoma associated with Sturge-Weber syndrome. It can be used to temporize the IOP, but ultimately other forms of glaucoma surgery must be considered when indicated. [J Pediatr Ophthalmol Strabismus. 2020;57(6):384-387.].

摘要

目的

报告青光眼伴 Sturge-Weber 综合征患儿行房角切开术和小梁切开术的手术结果。

方法

对行初次房角切开术和小梁切开术治疗青光眼伴 Sturge-Weber 综合征的患者的病历进行回顾性分析。

结果

共确定了 42 例 46 只眼青光眼伴 Sturge-Weber 综合征患者，这些患者均接受了初次房角切开术和小梁切开术（房角手术）治疗，以确定治疗性房角切开术和小梁切开术的疗效。行房角手术时的平均年龄为 1.5 岁（1 个月至 23 岁）。记录了 76%（42 例患者中的 32 例）患者术前的门诊眼内压（IOP）测量值，平均测量值为 35mmHg（25mmHg 至 50mmHg）。平均失败间隔时间为 4 个月（1 个月至 48 个月）。46 只眼行房角手术，失败率为 98%（45 只眼），合格成功率为 2%（1 只眼）。共施行 51 次房角切开术和 11 次小梁切开术。房角镜检查发现滤过角均异常，睫状体带的宽度和可见度不同，巩膜突可见度较差。术前在 100%（41 只眼）检查的眼中可见小梁网，所有这些眼均行房角手术。5 只眼未行房角镜检查而行房角手术。睫状体带在 39%（16 只眼）的眼中可见，巩膜突在 10%（4 只眼）的眼中可见。