Miyako Fumiya, Kiuchi Yoshiaki, Onoe Hiromitsu, Okada Naoki, Okumichi Hideaki, Hirooka Kazuyuki
Ophthalmology, Hiroshima University, Hiroshima, JPN.
Cureus. 2022 Jun 30;14(6):e26445. doi: 10.7759/cureus.26445. eCollection 2022 Jun.
In recent years, glaucoma tube surgery has been recommended for refractory cases that have failed to respond to angle surgery. In this study, we described the case of the fibrous proliferative membrane caused in the anterior chamber after Ahmed glaucoma valve implantation in a pediatric glaucoma patient. He was born full term, weighing 3228 g. Corneal opacity in both eyes was seen at birth and he was referred to the Department of Ophthalmology, Hiroshima University Hospital on the 13th day of his life. At the initial examination, the intraocular pressure was 37mmHg right 25mmHg left. Corneal diameter expansion and diffuse corneal opacity were seen in both eyes. Nine days after the initial examination, trabeculotomy was performed in both eyes but they were ineffective, and Ahmed glaucoma tubes were inserted in both eyes two months later. Four months later the intraocular pressure remained 30mmHg range in both eyes and micropulse cyclophotocoagulation was performed. One year after the Ahmed glaucoma valve implantation, the tube of right eye was exposed, and we planned to perform a repair procedure. At this time, ultrasound biomicroscopy (UBM) showed proliferative tissue around both tubes. They were removed next month. Although silicone is a highly biocompatible material, it can cause foreign body reactions such as encapsulation around the silicone plate and proliferative membranes around silicone oil. We speculated that a similar reaction occurred to the silicone tube in this case. We reported a case of fibrous proliferative membrane in the anterior chamber. This might be caused by the silicon tube of the Ahmed glaucoma valve.
近年来,对于对房角手术无反应的难治性病例,已推荐进行青光眼引流管手术。在本研究中,我们描述了一名小儿青光眼患者植入艾哈迈德青光眼引流阀后前房内出现纤维增殖膜的病例。他足月出生,体重3228克。出生时即发现双眼角膜混浊,出生后第13天被转诊至广岛大学医院眼科。初诊时,右眼眼压为37mmHg,左眼眼压为25mmHg。双眼均可见角膜直径扩大和弥漫性角膜混浊。初诊9天后,双眼均进行了小梁切开术,但效果不佳,两个月后双眼均植入了艾哈迈德青光眼引流管。四个月后,双眼眼压仍维持在30mmHg左右,并进行了微脉冲睫状体光凝术。艾哈迈德青光眼引流阀植入一年后,右眼引流管外露,我们计划进行修复手术。此时,超声生物显微镜(UBM)显示两根引流管周围均有增殖组织。下个月将其切除。尽管硅酮是一种具有高度生物相容性的材料,但它可能会引起异物反应,如硅酮板周围的包裹和硅油周围的增殖膜。我们推测本病例中硅酮引流管也发生了类似反应。我们报告了一例前房内纤维增殖膜病例。这可能是由艾哈迈德青光眼引流阀的硅酮引流管引起的。