Case report: a two-step approach in the management of angle-closure glaucoma associated with Plateau iris configuration.

IF 1.2 4区 医学 Q3 OPHTHALMOLOGY
Arquivos brasileiros de oftalmologia Pub Date : 2025-08-29 eCollection Date: 2025-01-01 DOI:10.5935/0004-2749.2025-0020
Tiago Santos Prata, Isabella Cristina Tristão Pinto Resende, Daniela Mauricio Ribeiro, Fábio Nishimura Kanadani, Izabela Negrão Frota de Almeida
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引用次数: 0

Abstract

Angle-closure glaucoma is a major cause of visual impairment worldwide, with Plateau iris syndrome presenting management challenges. We present a case report of a 58-year-old woman with advanced, uncontrolled angle--closure glaucoma and Plateau iris. Her history included laser peripheral iridotomy and three glaucoma medications in both eyes. Different treatments were implemented. For the eye with lower intraocular pressure, fewer peripheral anterior synechiae, and milder disease: phacoemulsification with intraocular lens implantation. For the eye with more advanced disease, a two-step approach was used: slow-coagulation transscleral cyclophotocoagulation using the double-arc protocol, followed by phacoemulsification with intraocular lens implantation 2 months later. Both eyes achieved improved visual acuity and intraocular pressure control with fewer medications, without significant complications. This case highlights transscleral cyclophotocoagulation followed by phacoemulsification as an alternative to combined surgeries in uncontrolled angle-closure glaucoma with Plateau iris, offering a simpler technique, more predictable refractive and pressure-control outcomes, and more straightforward postoperative management.

病例报告:闭角型青光眼伴高原虹膜形态的两步法治疗。
闭角型青光眼是世界范围内视力损害的主要原因,高原虹膜综合征提出了管理挑战。我们报告一位58岁女性,患有晚期不可控闭角型青光眼和高原虹膜。她的病史包括激光周围虹膜切开术和双眼三种青光眼药物。采用了不同的处理方法。对于眼压较低,周围前粘连较少,疾病较轻的眼睛:超声乳化摘除合并人工晶状体植入术。对于病情较晚期的眼睛,采用两步方法:使用双弧方案进行慢凝经巩膜循环光凝,然后在2个月后进行超声乳化术并人工晶状体植入术。使用较少的药物,双眼视力和眼压均得到改善,无明显并发症。本病例强调经巩膜睫状体光凝后超声乳化术作为控制不可控闭角型青光眼伴高原虹膜联合手术的替代方案,提供了更简单的技术,更可预测的屈光和压力控制结果,以及更直接的术后管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
200
审稿时长
6-12 weeks
期刊介绍: The ABO-ARQUIVOS BRASILEIROS DE OFTALMOLOGIA (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - electronic version), the official bimonthly publication of the Brazilian Council of Ophthalmology (CBO), aims to disseminate scientific studies in Ophthalmology, Visual Science and Health public, by promoting research, improvement and updating of professionals related to the field.
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