ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1560475
Surgical treatment of Autosomal Recessive Bestrophinopathy with Angle-Closure Glaucoma: Vitreous Liquefaction as the Key to Correcting Postoperative Malignant Glaucoma: Three Case Reports
Provisionally accepted
- The Second People’s Hospital of Jinan, Jinan, China
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Purpose: To evaluate the surgical treatment of autosomal recessive bestrophinopathy (ARB) combined with angle-closure glaucoma (ACG) through a retrospective case series study. Methods: The treatment of three patients with ACG secondary to ARB was reviewed. The patients were admitted to the Department of Ophthalmology of Jinan Second People's Hospital from April 2023 to January 2024. Their conditions, treatments, and outcomes were extracted from the medical records and analyzed. Results: The patients' ages at the time of surgery were 48, 48, and 35 respectively. They all had bilateral ARB and received surgery for one eye (the one affected the most by ACG). Using eye drops failed to control the intraocular pressure (IOP), which was 27, 28 and 47 mmHg before the surgery. Their eyes exhibited a shorter axial length (AL) and shallower anterior chamber depth (ACD). The ALs of the surgical eyes measured 22.73 mm, 21.52 mm, and 20.96 mm, while the ACDs were 2.51 mm, 1.97 mm, and 2.19 mm, respectively. After receiving trabeculectomy, they all immediately developed malignant glaucoma, which could not be resolved by conservative treatment. Following a second surgery, which importantly included an anterior vitrectomy and posterior capsulotomy, the IOP was normal, the ACD was satisfactory, and visual function was preserved. Conclusions: For ACG/ARB patients, the risk of developing malignant glaucoma after glaucoma surgery is very high. Surgical intervention such as anterior vitrectomy is needed to increase vitreous fluidity, eliminate vitreous block, assist the formation of the anterior chamber and stabilize the IOP to save the patient's vision. Long-term, close follow-up is essential, as there is a risk of recurrence in the operated eyes and occurrence in the non-operated eyes.
Keywords: Autosomal recessive bestrophinopathy, Angle-closure glaucoma, Malignant glaucoma, Vitreous humor, Compound trabeculectomy
Received: 14 Jan 2025; Accepted: 17 Oct 2025.
Copyright: © 2025 Sun, Liu, Liu, Zhang, Ren, Gao and Ji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhen Ji, 574754860@qq.com
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