RESUMO
PURPOSE: To report a case of successful intraocular pressure (IOP) reduction after a 360-degree gonioscopy-assisted transluminal trabeculotomy (GATT) using the iTrack catheter in a patient with steroid-induced glaucoma as a result of treatment of vernal keratoconjunctivitis (VKC). MATERIALS AND METHODS: Case report. RESULTS: An 8-year-old male individual with a long-standing history of VKC, treated with topical steroids, developed elevated IOP and glaucoma in the right eye despite maximum topical glaucoma therapy. Reducing the steroid was not a viable option given the severity of VKC. A 360-degree GATT was successfully performed and IOP has been maintained off all glaucoma drops. CONCLUSIONS: GATT is a viable option for steroid-induced glaucoma in the pediatric population. This obviates the need for riskier, more invasive conjunctival-based procedures.
Assuntos
Glaucoma de Ângulo Aberto/induzido quimicamente , Glaucoma de Ângulo Aberto/cirurgia , Glucocorticoides/efeitos adversos , Gonioscopia/métodos , Etabonato de Loteprednol/efeitos adversos , Cirurgia Assistida por Computador , Trabeculectomia/métodos , Antialérgicos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Criança , Conjuntivite Alérgica/tratamento farmacológico , Quimioterapia Combinada , Seguimentos , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Imunossupressores/uso terapêutico , Pressão Intraocular/fisiologia , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: To report a case of successful intraocular pressure (IOP) reduction following Cypass supraciliary stent implantation in a postvitrectomized eye filled with silicone oil and chronic angle-closure glaucoma. MATERIALS AND METHODS: This is a case report. RESULTS: A 19-year-old female with chronic angle-closure glaucoma underwent combined cataract extraction, goniosynechiolysis and Cypass supraciliary shunt implantation. Patient had a history of proliferative diabetic retinopathy and a tractional retinal detachment, which required pars plana vitretomy and silicone oil implantation, and was subsequently complicated by neovascular glaucoma requiring implantation of an inferior glaucoma drainage device. Approximately 6 months later, the patient's IOP increased to 36 mm Hg on maximum tolerable medical therapy. The patient underwent combined cataract extraction and Cypass implantation and is now controlled with an IOP of 16 mm Hg on 3 classes of medications 6 months postoperatively. CONCLUSIONS: Implantation of a Cypass supraciliary shunt can be an effective means for controlling IOP in patients with chronic angle-closure glaucoma in a postvitrectomized eye with silicone oil implantation and failed glaucoma drainage device.
