先天性无虹膜患者的临床分析

目的探讨先天性无虹膜患者的l临床表现及其治疗。方法为回顾性系列病例研究。选择1984年1月至2007年1月于我科就诊的8例（16只眼）先天性无虹膜患者,均为双眼患病,矫正视力均低于1．0。8例患者均伴不同程度白内障;其中5只眼伴青光眼,均为难治性青光眼;4只眼伴弱视;8只眼伴眼球水平震颤。根据病情不同分别行囊外白内障摘除术和人工晶状体植人术、小梁切除术、睫状突激光光凝术、戴镜行弱视训练、配戴角膜接触镜等治疗。结果6只晶状体明显混浊眼行白内障手术后视力有不同程度提高,无手术并发症。5只青光眼中,1只眼行小梁切除术,但术后眼压仍然不能控制于正常范围内,又行睫状突光凝术;3只眼仅行睫状突光凝术;1只眼局部使用降眼压药物治疗。此5只青光眼中,3只眼眼压得到控制,另2只眼仍不能控制于正常范围内。4只弱视眼经配镜、弱视训练后视力均有一定提高,2只眼配戴角膜接触镜后畏光症状得到缓解。结论先天性无虹膜患者眼部表现多种多样,虽治疗棘手,但经适当的治疗后可改善视力和临床症状。（中华眼科杂志．2008,44：46-49）

Clinical features of aniridia

OBJECTIVE: To explore the various clinical features of aniridia and its treatment. METHODS: It was a retrospective case series. All the 8 cases of 16 aniridia patients in our department from January, 1984 to January, 2007 were assayed. All the patients were bilateral aniridia suffering from abnormal vision and manifested with various degree of cataract, 5 eyes manifested with refractory glaucoma, 8 eyes with horizontal nystigmus. These patients underwent cataract extraction and intraocular lens implantation, trabeculectomy, ciliary process laser photocoagulation, in some of patients glass and cover strabismus exercise, color contact lens therapy were applied. RESULTS: Vision acuity in all of patients with severe cataract were improved after cataract surgery. One glaucoma eye underwent trabeculectomy, but failed to control the IOP and then received ciliary process laser photocoagulation. Three glaucoma eyes only underwent ciliary process laser photocoagulation, 1 eye received topical anti-glaucoma eye drops. The IOP of 3 eyes was controlled. However, the IOP of 2 eyes was not to be controlled. Vision acuity was improved in 4 strabismus eyes after wearing glass and strabismus exercise, the symptom of photophobia was disappeared in 2 eyes after wearing a pair of color contact lens. CONCLUSION: Although it is hard selection to select the proper treatment for aniridia, most of the cases can obtain a better vision, and relief of the symptom after proper treatment.