Abstract：
OBJECTIVE: To describe the clinical spectrum and management of glaucoma in congenital aphakia.
METHODS: The demographics and clinical spectrum of eyes with congenital aphakia with and without glaucoma were compared, and management outcomes of congenital aphakia cases with glaucoma were studied retrospectively between April 2000 and June 2020.
RESULTS: There were a total of 168 eyes (84 subjects) with a diagnosis of congenital aphakia, of which 29 eyes of 18 subjects were diagnosed with glaucoma. Corneal opacity was the presenting complaint in 26/29 eyes with glaucoma and 139/139 eyes without glaucoma. The (interquartile range (IQR)) horizontal corneal diameterwas 10.5mm (IQR, 9.0-12.5) and 8mm (IQR, 5-10) in eyes with and without glaucoma (P = 0.01), respectively. The median (IQR) axial length was 17.5mm (IQR, 13.5-19.5) and 15mm (IQR, 14-16) mm in eyes with and without glaucoma (P = 0.03), respectively. Nineteen eyes with glaucoma had adequate intraocular pressure (IOP) control with one medication. Three eyes underwent transscleral diode cyclophotocoagulation and maintained IOP without medications. Three eyes underwent trabeculectomy and trabeculotomy, trabeculectomy followed by penetrating keratoplasty, and trabeculectomy, respectively, of which two eyes became phthisical. At the last follow-up, the median (IQR) IOP was 14 mm Hg (IQR, 14-17) Hg. The median(IQR) follow-up duration was 4.53 months (IQR, 2.03- 48.06).
CONCLUSIONS: One-fifth of the eyes with congenital aphakia had secondary developmental glaucoma. The corneal diameter and axial lengths were higher in the eyes with glaucoma compared to eyes without glaucoma. Medical management is the preferred short-term mode of IOP control. Transscleral cyclophotocoagulation may be preferred over surgical intervention.
METHODS: The demographics and clinical spectrum of eyes with congenital aphakia with and without glaucoma were compared, and management outcomes of congenital aphakia cases with glaucoma were studied retrospectively between April 2000 and June 2020.
RESULTS: There were a total of 168 eyes (84 subjects) with a diagnosis of congenital aphakia, of which 29 eyes of 18 subjects were diagnosed with glaucoma. Corneal opacity was the presenting complaint in 26/29 eyes with glaucoma and 139/139 eyes without glaucoma. The (interquartile range (IQR)) horizontal corneal diameterwas 10.5mm (IQR, 9.0-12.5) and 8mm (IQR, 5-10) in eyes with and without glaucoma (P = 0.01), respectively. The median (IQR) axial length was 17.5mm (IQR, 13.5-19.5) and 15mm (IQR, 14-16) mm in eyes with and without glaucoma (P = 0.03), respectively. Nineteen eyes with glaucoma had adequate intraocular pressure (IOP) control with one medication. Three eyes underwent transscleral diode cyclophotocoagulation and maintained IOP without medications. Three eyes underwent trabeculectomy and trabeculotomy, trabeculectomy followed by penetrating keratoplasty, and trabeculectomy, respectively, of which two eyes became phthisical. At the last follow-up, the median (IQR) IOP was 14 mm Hg (IQR, 14-17) Hg. The median(IQR) follow-up duration was 4.53 months (IQR, 2.03- 48.06).
CONCLUSIONS: One-fifth of the eyes with congenital aphakia had secondary developmental glaucoma. The corneal diameter and axial lengths were higher in the eyes with glaucoma compared to eyes without glaucoma. Medical management is the preferred short-term mode of IOP control. Transscleral cyclophotocoagulation may be preferred over surgical intervention.
摘要：
目的：描述先天性无晶状体眼青光眼的临床谱和治疗。
方法：比较先天性无晶状体眼合并和不合并青光眼的人口统计学和临床谱，我们对2000年4月至2020年6月间先天性无晶状体眼合并青光眼病例的治疗结果进行了回顾性研究.
结果：共有168只眼（84名受试者）诊断为先天性无晶状体眼，其中18例受试者的29只眼被诊断为青光眼。角膜混浊是26/29眼青光眼和139/139眼无青光眼的主诉。（四分位距（IQR））水平角膜直径为10.5mm（IQR，9.0-12.5）和8mm（IQR，5-10）在有和没有青光眼的眼中（P=0.01），分别。中位数（IQR）轴向长度为17.5mm（IQR，13.5-19.5）和15mm（IQR，14-16）mm，有和没有青光眼的眼睛（P=0.03），分别。19只眼青光眼用一种药物控制了足够的眼内压（IOP）。三只眼睛接受了经巩膜二极管睫状体光凝术，并在不使用药物的情况下维持了IOP。三只眼接受了小梁切除术和小梁切开术，小梁切除术后穿透性角膜移植术，小梁切除术,分别,其中两只眼睛变成了phthisical。在最后一次随访中，眼压中位数（IQR）为14mmHg（IQR，14-17）汞。中位随访时间(IQR)为4.53个月(IQR,2.03-48.06）。
结论：1/5的先天性无晶状体眼患有继发性青光眼。与无青光眼的眼睛相比，有青光眼的眼睛的角膜直径和眼轴长度更高。医疗管理是IOP控制的首选短期模式。经巩膜睫状体光凝术可能比手术干预更可取。
方法：比较先天性无晶状体眼合并和不合并青光眼的人口统计学和临床谱，我们对2000年4月至2020年6月间先天性无晶状体眼合并青光眼病例的治疗结果进行了回顾性研究.
结果：共有168只眼（84名受试者）诊断为先天性无晶状体眼，其中18例受试者的29只眼被诊断为青光眼。角膜混浊是26/29眼青光眼和139/139眼无青光眼的主诉。（四分位距（IQR））水平角膜直径为10.5mm（IQR，9.0-12.5）和8mm（IQR，5-10）在有和没有青光眼的眼中（P=0.01），分别。中位数（IQR）轴向长度为17.5mm（IQR，13.5-19.5）和15mm（IQR，14-16）mm，有和没有青光眼的眼睛（P=0.03），分别。19只眼青光眼用一种药物控制了足够的眼内压（IOP）。三只眼睛接受了经巩膜二极管睫状体光凝术，并在不使用药物的情况下维持了IOP。三只眼接受了小梁切除术和小梁切开术，小梁切除术后穿透性角膜移植术，小梁切除术,分别,其中两只眼睛变成了phthisical。在最后一次随访中，眼压中位数（IQR）为14mmHg（IQR，14-17）汞。中位随访时间(IQR)为4.53个月(IQR,2.03-48.06）。
结论：1/5的先天性无晶状体眼患有继发性青光眼。与无青光眼的眼睛相比，有青光眼的眼睛的角膜直径和眼轴长度更高。医疗管理是IOP控制的首选短期模式。经巩膜睫状体光凝术可能比手术干预更可取。
