Ahalia Foundation Eye Hospital, Palakkad, Kerala, India.
Jasti V Ramanamma Children's Eye Care Center, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2022 Mar;70(3):834-836. doi: 10.4103/ijo.IJO_1782_21.
To describe the clinical spectrum and management of glaucoma in congenital aphakia.
The demographics and clinical spectrum of eyes with congenital aphakia with and without glaucoma were compared, and management outcomes of congenital aphakia cases with glaucoma were studied retrospectively between April 2000 and June 2020.
There were a total of 168 eyes (84 subjects) with a diagnosis of congenital aphakia, of which 29 eyes of 18 subjects were diagnosed with glaucoma. Corneal opacity was the presenting complaint in 26/29 eyes with glaucoma and 139/139 eyes without glaucoma. The (interquartile range (IQR)) horizontal corneal diameterwas 10.5mm (IQR, 9.0-12.5) and 8mm (IQR, 5-10) in eyes with and without glaucoma (P = 0.01), respectively. The median (IQR) axial length was 17.5mm (IQR, 13.5-19.5) and 15mm (IQR, 14-16) mm in eyes with and without glaucoma (P = 0.03), respectively. Nineteen eyes with glaucoma had adequate intraocular pressure (IOP) control with one medication. Three eyes underwent transscleral diode cyclophotocoagulation and maintained IOP without medications. Three eyes underwent trabeculectomy and trabeculotomy, trabeculectomy followed by penetrating keratoplasty, and trabeculectomy, respectively, of which two eyes became phthisical. At the last follow-up, the median (IQR) IOP was 14 mm Hg (IQR, 14-17) Hg. The median(IQR) follow-up duration was 4.53 months (IQR, 2.03- 48.06).
One-fifth of the eyes with congenital aphakia had secondary developmental glaucoma. The corneal diameter and axial lengths were higher in the eyes with glaucoma compared to eyes without glaucoma. Medical management is the preferred short-term mode of IOP control. Transscleral cyclophotocoagulation may be preferred over surgical intervention.
描述先天性无晶状体眼中青光眼的临床特征和治疗方法。
比较了伴有和不伴青光眼的先天性无晶状体眼的人口统计学和临床特征，并回顾性研究了 2000 年 4 月至 2020 年 6 月期间患有青光眼的先天性无晶状体病例的治疗结果。
共有 168 只眼（84 例）被诊断为先天性无晶状体，其中 29 只眼（18 例）被诊断为青光眼。26/29 只青光眼眼中的主要症状是角膜混浊，而 139/139 只无青光眼眼中的主要症状是角膜混浊。伴有青光眼的眼的水平角膜直径为 10.5mm（IQR，9.0-12.5），不伴青光眼的眼的水平角膜直径为 8mm（IQR，5-10）（P = 0.01）。伴有青光眼的眼的平均（中位数（IQR））轴长为 17.5mm（IQR，13.5-19.5），不伴青光眼的眼的平均（中位数（IQR））轴长为 15mm（IQR，14-16）（P = 0.03）。19 只青光眼眼通过一种药物治疗实现了足够的眼压控制。3 只眼接受了经巩膜二极管光凝术治疗，无需药物即可维持眼压。3 只眼分别接受了小梁切除术和小梁切开术、小梁切除术后继穿透性角膜移植术和小梁切除术，其中 2 只眼发生眼球萎缩。最后一次随访时，平均（中位数（IQR））眼压为 14mmHg（IQR，14-17）mmHg。平均（中位数（IQR））随访时间为 4.53 个月（IQR，2.03-48.06）。
五分之一的先天性无晶状体眼患有继发性发育性青光眼。与无青光眼的眼相比，青光眼眼中的角膜直径和眼轴较长。药物治疗是控制眼压的首选短期方式。经巩膜光凝术可能优于手术干预。
