Wydanie 3/2014
str. 58

Ocena leczenia i stanu anatomicznego dzieci chorych na jaskrę wrodzoną pierwotną oraz analiza morfologiczna wycinków kąta rogówkowo-tęczówkowego pobranych do badania w trakcie zabiegu trabekulektomii

The Evaluation of Treatment and Anatomical Condition in Children with Primary Congential Glaucoma and Morphological Evaluation of Iridocorneal Angle Samples Obtained During Trabeculectomy

Erita Filipek1,2, Maria Formińska-Kapuścik1,2, Ewa Zielińska-Pająk3, Lidia Nawrocka1,2, Małgorzata Laskowicz2,4, Bogumiła Wójcik-Niklewska1,2, Dorota Barchanowska1,2

1 Klinika Okulistyki Dziecięcej Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Maria Formińska-Kapuścik
2 Uniwersyteckie Centrum Okulistyki i Onkologii Samodzielnego Publicznego Szpitala Klinicznego Uniwersytetu Medycznego w Katowicach
Dyrektor: Dariusz Jorg
3 Katedra i Zakład Patomorfologii Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: dr hab. n. med. Maciej Kajor
4 Klinika Okulistyki Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek


Summary: Purpose: The evaluation of intraocular pressure, anatomical condition and histological examinatiom of iridocorneal angle samples obtained during trabeculectomy in children with primary congenital glaucoma.
Material and Methods: Twenty nine eyes of 20 children (5 girls, 15 boys) with congenital glaucoma. The age of children at the moment of surgery ranged from 5 days to 30 weeks (mean 15.9), as the first procedure performed was trabeculectomy. In 11 children involved glaucoma in one eye, in 9 children in both eyes. Evaluated factors included: intraocular pressure, corneal diameter and transparency, axial length of the eyeball and optic disc. Small samples obtained during the surgery were examined histologically.
Results: In the eyes of the first surgery (group I) intraocular pressure (T0) prior to surgery averaged 31.9 mmHg (SD 6.7). In the first day after surgery (T1) 16.2 mmHg (SD 2.7), the repeat test after 30 days was (T2) 19.7 mmHg (SD 6.1) after 12 months (T3) 18.5 mmHg (SD 4.5). In the group as a second eye surgery (group II), the mean intraocular pressure before surgery were (T0) 28.8 mmHg (SD 6.0), T1 15.6 mmHg (SD 1.3), T2 17.6 mmHg (SD 1.1), T3 16.2 mmHg (SD 3.3), respectively. Mean corneal diameter in the group I was 12.5 mm (SD 0.8), in the II group mean was 12.3 mm (SD 1.2). Haab lines were found in 9 eyes. Mean axial length of the eyeballs was 20.65mm (SD 1.96). In 23 eyes at baseline optic disc was normal, 6 had glaucomatous optic neuropathy. The results of histopathologic specimens were as follows: only 4 weaving thickened trabecular meshwork, in 9 cases was weaving sclera, 10 pieces of connective tissue in 6 weaving the iris and ciliary body.
Conclusions: Trabeculectomy as the first surgical procedure is an effective method for intraocular pressure normalization in children with primary congenital glaucoma. These results confirm the presence of histopathological trabeculodysgenesis lock causing the outflow of aqueous humor from the anterior segment of the eye.

Słowa kluczowe: jaskra wrodzona pierwotna, trabekulektomia, histopatologia.

Keywords: primary congenital glaucoma, trabeculectomy, histopathology.


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