Yuki Kenya, Matsuura Yumi, Yaginuma Mizuki, Negishi Takashi, Shinjoh Masayoshi
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, JPN.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, JPN.
Cureus. 2025 Sep 15;17(9):e92358. doi: 10.7759/cureus.92358. eCollection 2025 Sep.
We report a rare case of unilateral secondary angle-closure glaucoma associated with congenital acorea in a 10-month-old male infant. Acorea is a rare congenital eye abnormality characterized by the complete absence of the pupil. The left cornea of this patient measured 13.0 mm vertically and horizontally, with opacities observed. The anterior chamber was absent, and the pupil was completely occluded. Intraocular pressure (IOP) was 26 mmHg, and axial length was 25.3 mm. The fundus was not visible due to acorea. The patient was diagnosed with secondary angle-closure glaucoma due to acorea. To relieve angle closure, a pupil was created under general anesthesia. After blunt dissection with viscoelastic, a vitreous cutter was inserted through a corneal incision, and central iridectomy was performed. Anterior chamber depth was normalized immediately. Despite initial surgical pupil formation and two trabeculotomies, IOP remained uncontrolled, requiring sequential implantation of an Ahmed glaucoma valve and a Baerveldt glaucoma implant. Although the postoperative IOP stabilized, the patient developed endophthalmitis six months later due to . Despite intensive treatment, the infection developed into phthisis bulbi after tube exposure. This case highlights the potential for secondary angle-closure glaucoma in patients with acorea and emphasizes the risk of severe postoperative complications, including endophthalmitis, following glaucoma drainage device implantation in infants.
我们报告了一例罕见的单侧继发性闭角型青光眼病例，该病例发生在一名10个月大的男婴身上，与先天性无瞳孔症相关。无瞳孔症是一种罕见的先天性眼部异常，其特征是完全没有瞳孔。该患者的左眼垂直和水平测量均为13.0毫米，可见混浊。前房消失，瞳孔完全闭塞。眼压（IOP）为26 mmHg，眼轴长度为25.3毫米。由于无瞳孔症，眼底不可见。该患者被诊断为因无瞳孔症导致的继发性闭角型青光眼。为缓解房角关闭，在全身麻醉下造了一个瞳孔。在用粘弹性物质钝性分离后，通过角膜切口插入玻璃体切割器，并进行了中央虹膜切除术。前房深度立即恢复正常。尽管最初进行了手术造瞳和两次小梁切开术，但眼压仍未得到控制，需要先后植入艾哈迈德青光眼阀和贝尔维尔德青光眼植入物。尽管术后眼压稳定，但患者在六个月后因……发生了眼内炎。尽管进行了强化治疗，但在引流管暴露后，感染发展为眼球痨。本病例突出了无瞳孔症患者发生继发性闭角型青光眼的可能性，并强调了婴儿青光眼引流装置植入术后发生包括眼内炎在内的严重术后并发症的风险。
