Rusmayani Emma, Hutauruk Johan A, Viona Viona
Jakarta Eye Center, Jakarta, Indonesia.
Int Med Case Rep J. 2023 Mar 18;16:179-185. doi: 10.2147/IMCRJ.S402944. eCollection 2023.
To illustrate the complexity in managing secondary glaucoma post-repeat penetrating keratoplasty in a developing country.
A patient with a history of five repeat penetrating keratoplasties (PKPs) showed good intraocular pressure (IOP) control with trabeculectomy; however, blebitis occurred as an undesirable complication. Trabeculectomy was done rather than tube implantation due to socioeconomic factors, although it's not an ideal treatment. After the infection subsided, we performed a bleb revision with a scleral patch graft. Intraocular pressure was high in the follow-up period after the scleral patch, therefore we decided to do tube implantation. Following glaucoma tube implant surgery, the patient had good IOP control and a clear graft after six months of follow-up.
Secondary glaucoma post repeat PKPs is challenging in both diagnosis and management. Immediate action is imperative to control IOP, prevent glaucoma progression, and minimize corneal graft damage. In addition to medical reasons, socioeconomic factors should be considered.
阐述在一个发展中国家处理重复穿透性角膜移植术后继发性青光眼的复杂性。
一名有五次重复穿透性角膜移植术（PKP）病史的患者，小梁切除术使其眼压（IOP）得到良好控制；然而，发生了令人不快的并发症——滤过泡炎。由于社会经济因素，尽管小梁切除术并非理想的治疗方法，但还是进行了该手术而非植入引流管。感染消退后，我们用巩膜补片移植进行了滤过泡修复。巩膜补片术后的随访期间眼压较高，因此我们决定植入引流管。青光眼引流管植入术后，经过六个月的随访，患者眼压得到良好控制，移植片保持透明。
重复PKP术后的继发性青光眼在诊断和处理上都具有挑战性。必须立即采取行动控制眼压，防止青光眼进展，并尽量减少角膜移植片的损害。除了医学原因外，还应考虑社会经济因素。
