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一例白内障手术后植入囊袋张力环并发双侧恶性青光眼的罕见病例:病例报告

A rare case of bilateral malignant glaucoma after cataract surgery with capsular tension ring implantation: a case report.

作者信息

Jin Ganying, Hu Dongrui, Li Qi, Yang Shouyun, Zhuo Youer, Zeng Qingsen

机构信息

Aier Guangming Eye Hospital, Ningbo, 315000, Zhejiang, China.

出版信息

BMC Ophthalmol. 2024 Oct 1;24(1):427. doi: 10.1186/s12886-024-03692-3.

Abstract

BACKGROUND

Bilateral malignant glaucoma induced by a capsular tension ring associated with ring-shaped cysts of the ciliary body post-cataract surgery is rare. Herein, we present a case to highlight the possibility of capsular tension ring-induced malignant glaucoma.

CASE PRESENTATION

A 59-year-old woman underwent phacoemulsification combined with capsular tension ring implantation for cataracts and zonular fibre laxity in both eyes. Upon admission, annular ciliary masses were detected in both eyes using ultrasound biomicroscopy. Two months post-surgery, the patient experienced vision deterioration, high intraocular pressure, and an axial shallowing anterior chamber in the right eye, and responded poorly to traditional anti-glaucoma medication. Ten days later, similar symptoms appeared in the left eye. Ultrasound biomicroscopy detected contact between the ciliary body and the capsular tension ring. Subsequently, malignant glaucoma was diagnosed. Anterior and posterior capsulotomies performed peripheral to intraocular lens optics using neodymium: YAG laser restored communication and alleviated the symptoms. A one-year follow-up revealed stable intraocular pressure and anterior chamber in both eyes.

CONCLUSIONS

This is the first case report of bilateral malignant glaucoma after cataract surgery induced by capsular tension ring, which is associated with bilateral ring-shaped cysts of the ciliary body. Blockage between the ciliary body and capsular tension ring was confirmed using ultrasound biomicroscopy.

摘要

背景

白内障手术后,由囊袋张力环诱发并伴有睫状体环形囊肿的双侧恶性青光眼较为罕见。在此,我们报告一例以强调囊袋张力环诱发恶性青光眼的可能性。

病例报告

一名59岁女性因双眼白内障及悬韧带松弛接受了超声乳化白内障吸除联合囊袋张力环植入术。入院时,双眼超声生物显微镜检查发现环形睫状体肿物。术后两个月,患者右眼出现视力下降、高眼压及前房轴深变浅,对传统抗青光眼药物反应不佳。十天后,左眼出现类似症状。超声生物显微镜检查发现睫状体与囊袋张力环接触。随后,诊断为恶性青光眼。使用钕:钇铝石榴石激光在人工晶状体光学部周边进行前后囊切开术,恢复了房水流通并缓解了症状。一年随访显示双眼眼压及前房稳定。

结论

这是首例白内障手术后由囊袋张力环诱发的双侧恶性青光眼病例报告,该病例与双侧睫状体环形囊肿相关。超声生物显微镜检查证实了睫状体与囊袋张力环之间的阻塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6276/11443734/106ab1c311e6/12886_2024_3692_Fig1_HTML.jpg

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