Department of Glaucoma, Hebei Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Xingtai, Hebei Province, China.
Medicine (Baltimore). 2023 Nov 3;102(44):e35784. doi: 10.1097/MD.0000000000035784.
Phacolytic glaucoma (PLG), a secondary open-angle glaucoma caused by high molecular weight proteins leaking through the capsule of a hypermature cataract. Leakage of liquefied lens cortex behind the posterior capsule is rare. In this paper, we review a case of phacolytic glaucoma in the lens cortex behind posterior capsule.
This case report describes a 79-year-old male patient with a 7-year history of progressive blurred vision and a 1-day history of distended in his left eye. He underwent phacoemulsification combined with intraocular lens implantation at our facility 7 years ago.
The patient had lower vision (light perception vision) and increased intraocular pressure (IOP) (60 mmHg) in the left eye. Auxiliary inspection found that the left eye had deep anterior chamber depth (around 1 corneal thickness of the peripheral AC angle) as well as vitreous and aqueous humor opacity in the left eye. Combining the clinical symptoms and examinations, we made the diagnosis of PLG in the left eye.
The patient underwent trabeculectomy and extracapsular cataract extraction of the left after a stable ocular condition, during the operation to see that white chyous cortex was visible under the posterior capsule and posterior capsule membrane of the lens was avulsed circularly.
The postoperative condition was stable. During the follow up of 3 months, the IOP of the left eye was stable without ocular discomfort.
This case reported a patient with phacolytic glaucoma in the lens cortex behind posterior capsule who underwent successful surgery, indicating spontaneous capsule rupture can occur in the posterior capsules in PLG and when this situation is detected during the operation, the posterior capsule tearing method can be applied to absorb the lens cortex sticking at the posterior surface of the posterior capsule.
由于高分子量蛋白质从过熟白内障囊袋中渗漏，导致的开角型青光眼称为 phacolytic 青光眼（PLG）。后囊下的液化晶状体皮质渗漏较为罕见。本文回顾了一例后囊下晶状体皮质的 phacolytic 青光眼病例。
一名 79 岁男性患者，7 年前出现进行性视力模糊，1 天前左眼肿胀。7 年前曾在我院行超声乳化白内障吸除联合人工晶状体植入术。
左眼视力更差（光感），眼压（IOP）升高（60mmHg）。辅助检查发现左眼前房深度较深（周边前房角约 1 个角膜厚度），左眼玻璃体及房水混浊。结合临床症状及检查，诊断为左眼 PLG。
待患者眼部情况稳定后，行左眼小梁切除术及白内障囊外摘除术。术中可见后囊下有白色晶状体皮质，晶状体后囊膜呈环形撕脱。
术后情况稳定。随访 3 个月，左眼 IOP 稳定，无眼部不适。
本文报道了一例后囊下晶状体皮质的 phacolytic 青光眼患者，手术成功，提示 PLG 后囊可发生自发性囊膜破裂，术中发现后囊破裂时，可采用后囊撕裂法吸收后囊表面附着的晶状体皮质。
