Zusammenfassung
Problemstellung
Weisen die Irides beider Augen eine deutliche Farbdifferenz auf, so spricht man von Heterochromie. Sie ist manchmal auch nach einer Kataraktoperation bei den Kindern bemerkbar. Wir berichten über Heterochromieaufkommen nach der Operation einer einseitigen kongenitalen Katarakt mit Implantation einer Hinterkammerlinse.
Methoden und/oder Patienten
Bei einem 10 Wochen alten Jungen wurde wegen einer kongenitalen Katarakt des linken Auges eine Kataraktoperation durchgeführt. Es wurde eine vordere und hintere Kapsulorrhexis, dann eine vordere Vitrektomie durchgeführt und eine Hinterkammerlinse in den Kapselsack eingepflanzt.
Ergebnisse
17 Monate nach der Operation wurde erstens eine deutliche Heterochromie festgestellt. Die Iris des operierten Auges wurde dunkler. Diese Veränderung wurde nach 40 Monaten noch deutlicher. Gonioskopisch wurde auch eine stärkere Pigmentierung des Trabekelwerkes ohne Drucksteigerang gefunden.
Schlussfolgerungen
Betrachtet man die physiologische Pigmentierung des nichtoperierten Auges, so ist eine starke Zunahme der Pigmentierung, nicht nur der Iris, sondern auch des Trabekelwerkes 40 Monate nach der Kataraktoperation festzustellen. Das Aufkommen der kataraktinduzierten Heterochromie bei Kindern ist noch unklar.
Summary
Introduction
Heterochromia iridis is an asimetry of iris color. In some children, cataract surgery is associated with darkening of the iris color in the operated eye. We present a case of heterochromia iridis following unilateral pediatric cataract surgery with IOL implantation in 10-Week-old boy.
Methods and/or patients
10-week-old boy was reffered to our department for congenital cataract surgery in his left eye. Anterior and posterior capsulorhexis with anterior vitrectomy were performed. IOL was implanted into the capsular bag.
Results
17 months after surgery the heterochromia was observed with darkening of the iris color in the operated eye. 40 months after surgery the changes in iris color were more pronounced. On gonioscopy pathological trabecular hyperpigmentation was observed in the whole circumference with normal intraocular pressure.
Conclusion
40 months after cataract surgery severe pigmentation not only of the iris but also of the trabecular meshwork was observed. A further investigations are necessary to find out the mechanism of heterochromia incidence after pediatrie cataract surgery.
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Pahor, D., Gracner, B. Heterochromia iridis nach Kataraktoperation mit Linsenimplantation im Kindesalter — ein Fallbericht. Spektrum Augeheilkd 16, 214–216 (2002). https://doi.org/10.1007/BF03164337
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DOI: https://doi.org/10.1007/BF03164337