Anton Nicoleta, Dohotariu Francesca Cristiana, Pîrvulescu Ruxandra Angela, Barac Ileana Ramona, Bogdănici Camelia Margareta
Department of Ophtalmology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
St. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania.
Biomedicines. 2024 Sep 24;12(10):2164. doi: 10.3390/biomedicines12102164.
We report a surgically challenging case, in the context of a diagnosis of juvenile glaucoma refractory to drug therapy, multi-operated, known patient with congenital ichthyosis, part of Dorfman-Chanarin Syndrome (DCS), with a single functional eye. She is a young patient (54) and housewife in an urban environment known to have DCS and BE (both eyes), strong myopia, and congenital nystagmus. She initially underwent cataract surgery in 2015 and again in 2017. As of 2015, she was known to have juvenile glaucoma under maximal therapy. The important increases in pressure started in 2020 when the dermatological condition worsened (exacerbation of skin changes in the context of ichthyosis), the patient is in menopause, and presbyopia has set in. The glaucoma could no longer be controlled with medication and required serial surgery in both eyes (initially in the right eye in 2020 and in the left eye in 2023). The right eye showed a favorable evolution until 2024, when a second trabeculectomy became necessary, with a favorable evolution. : To our knowledge, such a case has not been documented in the medical literature. Frequent monitoring of intraocular pressures and prompt treatment are required. It is a rare association, a very complicated case of managing a patient with refractory glaucoma and multiple associated ophthalmic and systemic pathologies. We are also dealing with a single functional eye, difficult to manage due to a thin sclera that has caused intraoperative difficulties, and the association of congenital nystagmus and strabismus.
我们报告了一例手术难度较大的病例,该患者被诊断为药物治疗无效的青少年青光眼,曾多次接受手术,患有先天性鱼鳞病,是 Dorfman-Chanarin 综合征(DCS)的一部分,仅存一只功能眼。她是一名年轻患者(54 岁),居住在城市,是家庭主妇,患有 DCS 和双眼睑裂斑炎、高度近视以及先天性眼球震颤。她最初于 2015 年接受了白内障手术,并于 2017 年再次接受该手术。截至 2015 年,已知她在最大剂量治疗下患有青少年青光眼。眼压在 2020 年开始显著升高,当时皮肤病况恶化(鱼鳞病皮肤变化加剧),患者处于更年期,且出现了老花眼。青光眼无法再通过药物控制,需要对双眼进行系列手术(最初于 2020 年对右眼进行手术,2023 年对左眼进行手术)。右眼在 2024 年之前情况良好,之后需要进行第二次小梁切除术,术后情况良好。据我们所知,此类病例在医学文献中尚无记载。需要频繁监测眼压并及时治疗。这是一种罕见的关联情况,是管理一名患有难治性青光眼以及多种相关眼科和全身疾病患者的非常复杂的病例。我们还面临着一只功能眼的情况,由于巩膜薄导致术中困难,以及先天性眼球震颤和斜视的关联,使得管理变得困难。