PDF(Pubmed)
Abstract：
Childhood glaucoma is a rare disorder that occurs from birth until teenage years caused by an abnormality of aqueous humor pathways. About 50-70% of Peters\' anomaly is accompanied by secondary childhood glaucoma. The presence of glaucoma will affect the prognosis. We reported the evaluation and treatment of secondary childhood glaucoma due to Peters\' anomaly. A 5 months-old boy was presented with the complaint of a enlarged left eye since 3 months old. The complaint was accompanied by a watering eye and frequently closed upon light exposure. The left eye looked opaquer than contralateral. Examination under anesthesia showed that the intraocular pressure (IOP) was 35 mmHg in the left eye and the corneal diameter was 14 mm. Other findings were keratopathy, diffuse corneal edema, buphthalmos, shallow anterior chamber, anterior synechiae, and linear slit shaped pupils in the nasal region. Patient was treated with ophthalmic timolol maleate which was later followed by trabeculectomy. After 1 week post-surgery, IOP assessment by palpation suggested the right eye within normal range while the IOP of left eye was higger than normal. Blepharospasm, epiphora, photophobia, bleb on superior, subconjunctiva bleeding, buphthalmos, keratopathy, minimal corneal edema, anterior chamber with shallow image, and posterior synechia were found in left eye anterior segment. In conclusion, trabeculotomy and trabeculectomy are recommended if there is no reduction of IOP observed after receiving timolol maleate therapy. The choice of surgical management is dependent on the feasibility of the protocol.
摘要：
儿童青光眼是一种罕见的疾病，从出生到青少年时期都是由房水通路异常引起的。大约50-70％的Peters异常伴有继发性儿童期青光眼。青光眼的存在会影响预后。我们报告了因Peters异常引起的继发性儿童青光眼的评估和治疗。一个5个月大的男孩从3个月大开始就出现左眼增大的抱怨。投诉伴随着令人垂涎的眼睛，并且经常在暴露于光线时关闭。左眼看起来比对侧更不透明。麻醉下检查显示，左眼眼压（IOP）为35mmHg，角膜直径为14mm。其他发现是角膜病变，弥漫性角膜水肿,buthalmos,浅前房,前粘连，和鼻区的线性狭缝状瞳孔。患者接受眼用马来酸噻吗洛尔治疗，随后进行小梁切除术。手术后1周，通过触诊评估的IOP表明右眼在正常范围内，而左眼的IOP比正常更高。眼睑痉挛,顿唇,畏光,bleb在上级，结膜下出血,buthalmos,角膜病变,角膜轻度水肿,前房图像浅，左眼眼前段可见后粘连。总之,如果在接受马来酸噻吗洛尔治疗后未观察到眼压降低,则建议进行小梁切开术和小梁切除术.手术管理的选择取决于方案的可行性。
