Walton D S
Trans Am Ophthalmol Soc. 1986;84:59-70.
Repetitive gonioscopy of children with congenital aniridia confirms the presence of an angle abnormality which can be progressive and cause glaucoma. This abnormality features obstruction of the trabecular meshwork by variable mixtures of anterior migration of the peripheral iris and thickening of the uveal meshwork associated with a vascular net over exposed trabecular meshwork adjacent to the anterior edge of the iris. Preliminary results of prophylactic gonio-surgery in 28 eyes of 16 children with an average age of 4 years was reported. This surgery was performed without complication and produced a permanent exposure of the trabecular meshwork to the anterior chamber for an average of 8 circumferential hours, if two procedures were performed. Preliminary results suggest a stabilization of eye pressures at least through childhood and encourage the continuation of these prophylactic operations on selected eyes with congenital aniridia. Therapeutic goniotomy for established acquired glaucoma in congenital aniridia cannot be relied on, but may be a benefit for early detected cases or for glaucoma associated with aniridia in infancy.
对患有先天性无虹膜症的儿童进行反复前房角镜检查证实存在房角异常，这种异常可能会进展并导致青光眼。该异常的特征是周边虹膜向前移位和葡萄膜小梁增厚的不同组合阻塞小梁网，同时在虹膜前缘附近暴露的小梁网上伴有血管网。报告了对16名平均年龄为4岁儿童的28只眼睛进行预防性前房角手术的初步结果。该手术无并发症，若进行两次手术，小梁网平均向前房永久暴露8个圆周小时。初步结果表明至少在儿童期眼压可保持稳定，并鼓励对选定的先天性无虹膜症患眼继续进行这些预防性手术。对于先天性无虹膜症中已确诊的获得性青光眼，不能依赖治疗性前房角切开术，但对于早期发现的病例或婴儿期与无虹膜症相关的青光眼可能有益。
