虹膜环扎术联合前房角粘连分离术及泪小管支架植入术治疗新生血管性闭角型青光眼
Iris cerclage with goniosynechialysis and canalicular stent for neovascular angle closure glaucoma.
作者信息
Mahjabin Faria, Libre Peter E
机构信息
Frank H. Netter School of Medicine at Quinnipiac University, North Haven, Connecticut, USA.
Columbia University Medical Center, Norwalk, Connecticut, USA.
出版信息
Am J Ophthalmol Case Rep. 2025 Aug 5;39:102393. doi: 10.1016/j.ajoc.2025.102393. eCollection 2025 Sep.
PURPOSE
To report a surgical treatment for neovascular angle closure glaucoma.
OBSERVATIONS
A 69 year-old man with proliferative diabetic retinopathy developed neovascular angle closure with intraocular pressure (IOP) 60 mm Hg. Surgical goniosynechialysis and placement of a Hydrus canalicular stent were combined with pupilloplasty using an iris cerclage suture to maintain tension on the peripheral iris to limit reformation of goniosynechiae. Intravitreal injections to block vascular endothelial growth factor (VEGF) were given as needed and IOP ranged 10-20 mm Hg with 3 topical medications in the 21 months following his surgery.
CONCLUSIONS AND IMPORTANCE
Goniosynechialysis, Hydrus stent, and iris cerclage pupilloplasty with ongoing anti-VEGF injections may be an alternative to tube shunt implant or cyclophotocoagulation for patients with neovascular glaucoma.
目的
报告一种治疗新生血管性闭角型青光眼的手术方法。
观察结果
一名69岁患有增殖性糖尿病视网膜病变的男性发生新生血管性房角关闭，眼压（IOP）为60 mmHg。手术性房角分离术和植入Hydrus小管支架，并联合使用虹膜环扎缝线进行瞳孔成形术，以维持周边虹膜的张力，限制房角粘连的重新形成。根据需要进行玻璃体内注射以阻断血管内皮生长因子（VEGF），术后21个月内，使用3种局部用药时眼压范围为10 - 20 mmHg。
结论与意义
对于新生血管性青光眼患者，房角分离术、Hydrus支架、虹膜环扎瞳孔成形术以及持续的抗VEGF注射可能是引流管植入术或睫状体光凝术的替代方法。
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