Department of Ophthalmology, Beijing AnZhen Hospital, Capital Medical University, Beijing, 100029, China.
BMC Ophthalmol. 2024 Jun 14;24(1):258. doi: 10.1186/s12886-024-03507-5.
Congenital microcoria has been extensively reported and usually leads to visual dysfunction or blindness. However, micropupil development secondary to cataract surgery has never been reported. Here, we describe a rare case of micropupil development in infancy that occurred secondary to combined cataract extraction and intraocular lens implantation for treatment of congenital cataract. When the patient reached adulthood, the affected eye not only gained good vision but also showed better ocular development and refractive status than the fellow eye.
A 17-year-old boy presented to our outpatient clinic with decreased vision in his left eye related to congenital cataract surgery at 6 months of age. The affected eye had exhibited a pinhole pupil since the third month postoperatively. The condition had been managed with observation and regular monocular occlusion treatment. Upon presentation to our clinic, the best-corrected visual acuity (BCVA) in his fellow eye was 0.0 logMAR(20/20) with a refraction of - 5.75 diopters cylinder/-2.25 diopters sphere, and the BCVA in his affected eye was 0.5 logMAR(20/40) with a refraction of 0.00 diopters. Ophthalmic examination of the affected eye revealed a pinhole pupil (approximately 0.5 mm) with high light reflex sensitivity but no response to pupil-dilating drugs. The patient underwent pupilloplasty of the affected eye under corneal surface anesthesia. Postoperative examination revealed better ocular development in the affected eye than in the fellow eye (axial length: 24.21 vs. 27.02 mm, respectively) as well as better refractive status in the affected eye (BCVA of 0.0 logMAR(20/20) with a refraction of - 2.23 diopters cylinder/-3.00 diopters sphere vs. 0logMAR(20/20) with a refraction of -5.75 diopters cylinder/-2.25 diopters sphere).
We have reported a rare case of micropupil development secondary to congenital cataract surgery, which is an uncommon complication, especially in children. However, unlike congenital microcoria, the secondary pinhole pupil may have reduced imaging haze and halos, possibly favoring the development of the affected eye. This case provides further insight into the treatment of congenital cataract.
先天性小瞳孔已被广泛报道，通常会导致视觉功能障碍或失明。然而，白内障手术后小瞳孔的发生尚未被报道。在这里，我们描述了一例罕见的婴儿期小瞳孔发育病例，该病例继发于先天性白内障的白内障摘除联合人工晶状体植入术。当患者成年时，受影响的眼睛不仅获得了良好的视力，而且与对侧眼相比，眼部发育和屈光状态更好。
一名 17 岁男孩因 6 个月大时的先天性白内障手术导致左眼视力下降，来到我们的门诊就诊。术后第三个月，受影响的眼睛出现了小孔瞳孔。该情况通过观察和定期单眼遮盖治疗进行了管理。在就诊时，他对侧眼的最佳矫正视力（BCVA）为 0.0 logMAR（20/20），屈光度为-5.75 屈光度圆柱/-2.25 屈光度球，受影响眼的 BCVA 为 0.5 logMAR（20/40），屈光度为 0.00 屈光度。受影响眼的眼科检查显示小孔瞳孔（约 0.5 毫米），对高光反射敏感，但对瞳孔扩张药物无反应。患者在角膜表面麻醉下接受了受影响眼的瞳孔成形术。术后检查显示，受影响眼的眼部发育优于对侧眼（眼轴长度：分别为 24.21 毫米和 27.02 毫米），受影响眼的屈光状态更好（BCVA 为 0.0 logMAR（20/20），屈光度为-2.23 屈光度圆柱/-3.00 屈光度球，对侧眼为 0logMAR（20/20），屈光度为-5.75 屈光度圆柱/-2.25 屈光度球）。
我们报告了一例罕见的先天性白内障手术后小瞳孔发育病例，这是一种罕见的并发症，尤其是在儿童中。然而，与先天性小瞳孔不同的是，继发性小孔瞳孔的成像晕圈和光环可能减少，这可能有利于受影响眼的发育。该病例进一步深入了解了先天性白内障的治疗。
