Abstract:
Glaucoma is one of the world\'s leading causes of irreversible vision loss. It is often asymptomatic until it reaches an advanced stage, which can have a significant impact on patients\' daily lives. This paper describes the case of a 50-year-old female patient who presented with acute onset of ocular pain, photophobia, and loss of visual acuity in her right eye (RE). The patient\'s medical history includes congenital cataracts, surgical aphakia, nystagmus, strabismus, amblyopia, and secondary glaucoma. Ophthalmological examination showed BCVA RE-hand movement, left eye (LE)-0.08 with an intraocular pressure (IOP) of 30 mmHg in RE and 16 mmHg in LE. Biomicroscopic examination of RE showed corneal graft, epithelial and endothelial edema, endothelial precipitates, corneal neovascularization, aphakia, and Ahmed valve superotemporally. Despite maximal topical and systemic treatment, Ahmed valve, and trabeculectomy, secondary glaucoma in the right eye remained refractory. Reimplantation of an Ahmed valve was performed. This resulted in a favorable outcome with increased visual acuity and controlled intraocular pressure. The combination of aphakia, penetrating keratoplasty, and secondary glaucoma is a challenge for any surgeon. It is important that both the perioperative risks and the possible complications are carefully assessed in each patient, especially if associated pathology is present.
摘要:
青光眼是导致不可逆性视力丧失的主要原因之一。它通常是无症状的,直到它达到晚期,这会对患者的日常生活产生重大影响。本文描述了一名50岁女性患者的病例,该患者表现为急性眼痛,畏光,和视力丧失在她的右眼(RE)。患者的病史包括先天性白内障,外科无晶状体,眼球震颤,斜视,弱视,和继发性青光眼。眼科检查显示BCVARE-手部运动,左眼(LE)-0.08,RE的眼内压(IOP)为30mmHg,LE的眼内压为16mmHg。RE的生物显微镜检查显示角膜移植物,上皮和内皮水肿,内皮沉淀物,角膜新生血管形成,无晶状体,和艾哈迈德瓣膜超瞬时。尽管最大的局部和全身治疗,Ahmed阀门,小梁切除术,右眼继发性青光眼仍然难治。进行Ahmed瓣膜的再植入。这导致了良好的结果,具有增加的视敏度和控制的眼内压。无晶状体的组合,穿透性角膜移植术,继发性青光眼对任何外科医生来说都是一个挑战。重要的是要仔细评估每位患者的围手术期风险和可能的并发症。特别是如果存在相关病理。