Surgical treatment of advanced chronic angle closure glaucoma in Weill-Marchesani syndrome.
OBJECTIVE
To describe the surgical treatment of advanced chronic angle closure glaucoma in Weill-Marchesani syndrome.


METHODS
Two children with Weill-Marchesani syndrome (4 eyes) undergoing lensectomy, anterior vitrectomy, and sutured intraocular lens (IOL) and Molteno tube shunt surgery at Wills Eye Hospital were prospectively studied. Visual acuity and intraocular pressure (IOP) were recorded.


RESULTS
Both patients presented with increasing myopia and advanced glaucomatous damage. Laser iridotomy was ineffective in deepening the anterior chamber. The first patient developed a flat anterior chamber after trabeculectomy. At the 12-month follow-up visit, all 4 eyes had an important decrease in IOP and cupping after combined lensectomy, anterior vitrectomy, and sutured IOL and Molteno tube shunt placement. One eye had a transitory postoperative choroidal effusion and retinal detachment that resolved spontaneously.


CONCLUSIONS
Advanced chronic angle closure glaucoma in Weill-Marchesani syndrome may be treated with a combination of lensectomy, anterior vitrectomy, and sutured IOL and Molteno tube shunt surgery. In early cases, prophylactic peripheral iridotomies should be stressed.
The Ana and William Goldberg Department of Glaucoma, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Paul
P
Harasymowycz
Richard
R
Wilson
D000015:Abnormalities, Multiple / Q000601:surgery*; D002648:Child; D002908:Chronic Disease; D005124:Eye Abnormalities / Q000601:surgery*; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000002:abnormalities / Q000601:surgery; D008297:Male; D018465:Molteno Implants; D009216:Myopia / Q000235:genetics; D011446:Prospective Studies; D019919:Prosthesis Implantation; D013577:Syndrome; D014792:Visual Acuity; D014821:Vitrectomy