Abstract:
Gonioscopy-assisted transluminal trabeculotomy (GATT) has been used as a safe and effective procedure in the treatment of open angle glaucoma. In the present report, we demonstrated successful IOP control in two uveitic glaucoma cases secondary to juvenile idiopathic arthritis (JIA) following 360° GATT. Case 1 was a 7-year-old pseudophakic male with a preoperative IOP of 38 mmHg; his IOP stabilized at 17 mmHg with two topical antiglaucoma medications over 18 months. Case 2 was a 8-year-old aphakic male with a preoperative IOP of 42 mmHg; his IOP decreased to 12 mmHg over 15 months. We observed postoperative IOP spike in case 1 which was successfully controlled conservatively. Peripheral anterior synechia formation also occured in both cases during follow-up. One should be vigilant for possible complications after GATT in such cases. As glaucoma surgery success can have a tendency to decline with time in pediatric cases with uveitis-associated glaucoma, we believe that further evidence is still required to shed more light about the benefits of GATT technique in complex cases of pediatric secondary glaucoma subtypes like JIAU-induced glaucoma.
摘要:
房角镜辅助经腔小梁切开术(GATT)已被用作治疗开角型青光眼的安全有效方法。在本报告中,我们证实在2例360°GATT后继发于幼年特发性关节炎(JIA)的葡萄膜型青光眼患者中成功控制了IOP.病例1是一名7岁的假晶状体男性,术前IOP为38mmHg;他的IOP在18个月内通过两种局部抗青光眼药物稳定在17mmHg。病例2是一名8岁无晶状体男性,术前IOP为42mmHg;他的IOP在15个月内下降至12mmHg。我们观察到病例1术后IOP峰值,保守控制成功。在随访期间,两种情况下都发生了外周前粘连形成。在这种情况下,应警惕关贸总协定后可能出现的并发症。由于青光眼手术成功率在葡萄膜炎相关性青光眼的儿科病例中可能随着时间的推移而下降,我们认为,在JIAU诱导的青光眼等小儿继发性青光眼亚型的复杂病例中,GATT技术的益处仍需要进一步的证据.