Kolipaka Pratinya Gowri, Krishnamurthy Rashmi, Bagga Bhupesh
Academy of Eye Education, L V Prasad Eye Institute, Hyderabad, Telangana, India.
VST Centre for Glaucoma Care, L V Prasad Eye Institute, Hyderabad, Telangana, India.
BMJ Case Rep. 2021 Mar 23;14(3):e239585. doi: 10.1136/bcr-2020-239585.
We report a case of a 7-year-old boy, who presented with plate exposure after Ahmed glaucoma valve (AGV) implantation in the eye with secondary glaucoma following penetrating trauma. He underwent AGV explantation with scleral patch graft and conjunctival limbal autograft and started on topical and oral antiglaucoma medication (AGM) for intraocular pressure (IOP) control. Two months later, he presented to us with high intraocular pressure and uveal tissue prolapse at the site of previous tube entry displacing the scleral and conjunctival grafts posteriorly. The defect was closed with corneal patch graft. Patient underwent limited transscleral cyclophotocoagulation and was maintained on topical AGM for IOP control. Our case highlights that explantation is a definitive management in such cases of plate exposure. Tube entry site is a potential weak area and there is risk of uveal prolapse through this area with high IOP. Corneal patch graft helps in successfully managing such defects involving the sclero-limbal region.
我们报告一例7岁男孩,其在穿透性外伤后继发性青光眼的眼睛中植入艾哈迈德青光眼引流阀(AGV)后出现引流盘暴露。他接受了AGV取出术,并进行了巩膜补片移植和结膜角膜缘自体移植,同时开始使用局部和口服抗青光眼药物(AGM)来控制眼压(IOP)。两个月后,他因眼压升高和先前引流管入口处的葡萄膜组织脱垂前来就诊,脱垂的葡萄膜组织将巩膜和结膜移植物向后推移。该缺损用角膜补片移植进行了封闭。患者接受了有限的经巩膜睫状体光凝术,并继续使用局部AGM来控制眼压。我们的病例表明,在这种引流盘暴露的病例中,取出术是一种确定性的治疗方法。引流管入口部位是一个潜在的薄弱区域,眼压升高时存在葡萄膜通过该区域脱垂的风险。角膜补片移植有助于成功处理涉及巩膜角膜缘区域的此类缺损。