双眼先天性无虹膜一例

双眼先天性无虹膜一例 ? 400? 3WollensakG,SpeedE,SeilerT.Riboflavin/ultraviolet.a—inducedcollagen crosslinkingforthetreatmentofkeratoconus[J].AmJOphthalmol, 2003,135(5):620—627 4SpoerlE,MrochenM,SlineyD,eta1.SaltyofUVA—riboflavincross— linkingofthecornea[J].Cornea,2007,26(4):385—389 5WollensakG,IomdinaE.DittertDD,eta1.Woundhealingintherabbit corneaaftercornealcollagencross—linkingwithriboflavinandUVA[J]. Cornea,2007,26(5):600—605 6KohlhaasM,SpoerlE,SchildeT,eta1.Biomechanicalevidenceofthe distributionofcross.1inksincorneastreatedwithriboflavinandultraviolet Alight[J].JCataractRefractSurg,2006,32(2):279—283 7WollensakG,SpoedE,SeilerT.Stress—strainmeasurementsofhuman andporcinecorneasafterriboflavin??ultraviolet—A??inducedcross—linking [J].JCataractRefractSurg,2003,29(9):1780—1785 8WollensakG,WilschM,SpoeflE,eta1.Collagenfiberdiameterinthe rabbitcorneaaftercollagencrosslinkingbyriboflavin/UVA[J].Cornea, 2004,23(5):503—507 9WollensakG,AurichH,PhamDT,eta1.Hydrationbehaviorofporcine corneacrosslinkedwithriboflavinandultravioletA[J].JCataractRefract Surg,2007,33(3):516—521 10SpoerlE,WollensakG,SeilerT.Increasedresistanceofcrosslinked corneaagainstenzymaticdigestion[J].CurtEyeRes,2O04,29(1):35—4o 11WollensakG,SpoerlE,WilschM,eta1.Keratocyteapoptosisaftercorneal collagencross—linkingusingriboflavin/UVAtreatment[J].Cornea,2004, 23(1):43—49 12MazzottaC,BalestrazziA,TraversiC,eta1.Treatmentofprogressive keratoconusbyriboflavin?UVA—inducedcross—linkingofcornealcollagen; ultrastructuralanalysisbyHeidelbergretinaltomographIIinvivoconfocal microscopyinhumans[J].Cornea,2007,26(4):390—397 13SeilerT,HafeziF.CornealCroSS—linking?inducedstromaldemarcationline [J].Cornea,2006,25(9):1057—1059 l4MencucciR,MazzottaC,ROSSiF,eta1.RiboflavinandultravioletA collagencrosslinking:invivothermographicanalysisofthecorneal ChinOphthalRes,May2008,Vo1.26,No.5 surface[J].JCataractRefractSurg,2007,33(6):1005—1008 15WollensakG,SpoerlE,WilschM,eta1.Endothelialcelldamageafter riboflavin.ultraviolet.Atreatmentintherabbit[J].JCataractRefract Surg,2003,29(9):1786—1790 16WollensakG,SpOilE,ReberF,eta1.Cornealendothelialcytotoxicityof riboflavin/UVAtreatmentinvitro[J].OphthalmicRes,2003,35(6): 324—328 17WattersGA,OwensH.Evaluationofmild,moderate,andadvanced keratoconususingultrasoundpachometryandtheEyeSysvideokeratoscope [J].OptomVisSci,1998,75(9):640—646 18CaporossiA,BaiocchiS,MazzottaC,eta1.Parasurgicaltherapyfor keratoconusbyriboflavin?-ultraviolettypeAraysinducedCroSS?-linkingof cornealcollagen:preliminaryrefractiveresultsinanItalianstudy[J].J CataractRefractSurg,2006,32(5):837—845 19MazzottaC,TraversiC,BaiocchiS,eta1.Conservativetreatmentof keratoconusbyriboflavin.uva.inducedcross—linkingofcomealcollagen: qualitativeinvestigation[J].EurJOphthalmol,2006,16(4):530—535 20BinderPS,LindstromRL,StultingRD,eta1.Keratoconusandcorneal ectasiaafterLASIK[J].JRefractSurg,2005,21(6):749—752 21KIeinSR,EpsteinRJ,RandlemanJB,eta1.Comealectasiaafterlaserin situkeratomileusisinpatientswithoutapparentpreoperativeriskfactors [J].Cornea,2006,25(4):388—403 22MaenoA,NaorJ,LeeHM,eta1.Threedecadesofcomealtransplantation: indicationsandpatientcharacteristics[J].Cornea,2000,19(1):7—11 23WollensakG,IomdinaE.DittertDD,eta1.Cross.1inkingofscleral collagenintherabbitusingriboflavinandUVA[J].ActaOphthalmol Scand,2005,83(4):477—482 24WollensakG,SpoeflE.Collagencrosslinkingofhumanandporcinesclera [J].JCataractRefractSurg,2004,30(3):689—695 (收稿:2007—08—12修回:2008—04—02) (本文编辑:王璐璐) 图1右眼外观 双眼先天性无虹膜一例 刘利莉李学军崔晓冬 患儿,男,1O岁. 自幼双眼视力差,畏 光.于2008年3月 15日就诊.患儿为足 月顺产,父母非近亲 结婚,家族中无遗传 病史.全身检查:一 般情况好,智力及发 育无异常.眼部检 查:视力右眼0.3,矫正0.8(一3.75DS/+2.50DC×170.);左 眼0.2,矫正0.7(一4.25DS/+2.75DC×10.);双眼眼位正 常,各方向运动自如.右眼角膜透明,前房深度适中,全周虹膜 阙如,可见晶状体悬韧带.晶状体透明,余前节未见异常(图 1).左眼前节检查同右眼.眼底检查:双眼底未见明显异常. 诊断:双眼先天性无虹膜,屈光不正,弱视. 作者单位:075000河北省张家IZl市第四医院眼科 通讯作者:刘利莉(Email:ililuil@sohu.corn) ? 病例? 讨论:先天性无虹膜是一种少见的,与常染色体显性遗传 有关的先天性虹膜发育不良.群体患病率为1/55000.该病 发病原因不明,可能与胚胎发育时期神经外胚层或中胚层发育 异常有关,亦可与基因突变有关.先天性无虹膜多双侧发病, 患者多伴明显畏光,视力减退等症状.根据临床现的轻重, 该病可分为4种类型…:I型可同时伴白内障,青光眼,眼球震 颤,黄斑发育不良等眼部异常,且视功能较差;II型视功能较 好,可能与基因突变有关;?型可伴智力低下;IV型可伴肾胚胎 瘤等全身异常.本例患者由于无明显的家族遗传史且视功能 损害较轻,符合?型表现.该病一般无特殊治疗,可配戴变色 镜,墨镜或周边带色的虹膜型角膜接触镜以减轻患者的不适症 状.合并有白内障,青光眼等眼部异常者可考虑手术治疗. 参考文献 1刘英奇,赵亮,主编.现代眼科学[M].北京:北京科学技术出版社, l996:697 (收稿:2008—03-21) (本文编辑:王璐璐)