Reactivation of spontaneously resolved primary congenital glaucoma

Published:November 10, 2022DOI:
      A 15-year-old female was evaluated for elevated intraocular pressure (IOP). Ophthalmic examination showed bilateral enlarged corneal diameter, vertical Haab striae, concave iris, deep anterior chamber, and clear lens. IOPs in both eyes were 17 mm Hg with bilateral latanoprost, timolol/dorzolamide fixed-dose combination, and brimonidine eye drops. Immersion ultrasonography axial lengths were 26.1 and 25.6 mm in the right and left eyes, respectively. Ultrasound biomicroscopy of the right eye (Fig. 1A) showed posterior bowing of the iris (arrow) and iridozonular contact (asterisk). Gonioscopy revealed 4+ pigmentation in widely opened angles. Right eye gonioscopy-assisted transluminal trabeculotomy and iridectomy were performed without complications. Three weeks later, right eye ultrasound biomicroscopy (Fig. 1B) showed a flattened iris (arrow), resolved iridozonular chafing (asterisk), and a trabecular shelf (arrowhead). Eight months later, an uneventful left eye gonioscopy-assisted transluminal trabeculotomy/iridotomy was performed. At the last follow-up, best-corrected visual acuities were 20/25 and 20/30 and IOPs were 12 and 14 mm Hg in the right and left eyes, respectively. This appears to be a reactivated case of aborted primary congenital glaucoma (PCG) with a secondary pigmentary component.
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