背景:患有先天性青光眼的儿童通常伴有下眼睑的获得性上眼睑,导致下眼睑内翻并损伤角膜。
目的:通过比较先天性青光眼患儿倒置和非倒置睫状眼眼轴和角膜直径的差异,推断下睑内翻的可能原因。
方法:纳入2016年7月至2019年1月在同仁医院诊断为先天性青光眼的患者15例(男11例,女4例)。5例患者有双侧青光眼,10人患有单侧青光眼。每位患者只有一只眼睛患有下眼睑内翻,这与先天性青光眼有关。所有患者的另一只眼睛都没有内翻。收集临床资料。主要结果指标为眼轴和角膜直径。
结果:15例患者的平均年龄为1.85±0.49岁。配对t检验显示,先天性青光眼伴下睑内翻眼的平均眼轴(24.86±3.44mm)明显长于先天性青光眼不伴下睑内翻眼的平均眼轴(20.79±1.34mm;P<0.001)。先天性青光眼伴下睑内翻的平均角膜直径(13.61±0.88mm)也明显大于先天性青光眼不伴下睑内翻的平均角膜直径(11.63±0.48;P<0.001)。
结论:眼轴和角膜直径的快速增长可能是先天性青光眼合并后下眼睑内翻的主要原因。因此,必须观察眼压控制不佳,眼轴和角膜直径过度生长的儿童是否存在获得性上睑。
BACKGROUND: Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid, which causes entropion of the lower eyelid and damages the cornea.
OBJECTIVE: To infer the possible causes of lower eyelid entropion by comparing the difference of ocular axis and corneal diameter between inverted and non-inverted ciliary eyes in children with congenital glaucoma.
METHODS: A total of 15 patients (11 males and 4 females) diagnosed with congenital glaucoma between July 2016 and January 2019 at Tongren Hospital were included. Five patients had bilateral glaucoma, and ten had unilateral glaucoma. Each patient had only one eye with lower eyelid entropion which is associated with congenital glaucoma. All the patients had no entropion in another eye. The clinical data were collected. Main outcome measures were the ocular axis and corneal diameter.
RESULTS: The average age of the 15 patients was 1.85 ± 0.49 years. Paired t-test showed that the average ocular axis of congenital glaucoma eyes with lower eyelid entropion (24.86 ± 3.44 mm) was significantly longer than that of congenital glaucoma eyes without lower eyelid entropion (20.79 ± 1.34 mm; P < 0.001). The average corneal diameter of congenital glaucoma eyes with lower eyelid entropion (13.61 ± 0.88 mm) was also significantly greater than that of congenital glaucoma eyes without lower eyelid entropion (11.63 ± 0.48; P < 0.001).
CONCLUSIONS: The rapid growth of the ocular axis and corneal diameter may be the main cause of congenital glaucoma with acquired lower eyelid entropion. Therefore, children with poor control of intraocular pressure and excessive growth of ocular axis and corneal diameter must be observed for the existence of acquired epiblepharon.