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Corneal fibrosis-related pseudoglaucoma: three case reports

Poster Details

First Author: B.Kang SOUTH KOREA

Co Author(s):    J. Jeoung   J. Oh                 

Abstract Details


Patients with anterior segment dysgenesis often present as congenital corneal opacity and glaucoma. In these patients, the diagnosis of glaucoma is challenging to make because the abnormal and opaque cornea makes the intraocular visualization and pressure measurement difficult. We here report three cases of congenital corneal opacity whose intraocular pressure (IOP) reading was initially high but markedly normalized after penetrating keratoplasty.


Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea


Three Korean patients were referred to our clinic within a few days of birth because of corneal opacity and glaucoma presented at birth. The anterior segment examination revealed intense corneal stromal opacity in both eyes where the iris, pupil and anterior chamber were invisible. The IOP measurements read high over 30 mmHg by pneumatic, rebound, or Tono-Pen tonometers and maintained high even after the use of multiple anti-glaucoma eye drops. The penetrating keratoplasty was performed in all three patients at the age of three months, and lens extraction was combined in two of three patients.


From the day after penetrating keratoplasty, the IOP decreased to normal values and stayed normal without the use of anti-glaucoma medication. The cornea extracted at the time of penetrating keratoplasty was examined for histology, and hematoxylin-eosin staining of the tissue revealed dense stromal fibrosis throughout the whole corneal thickness.


In cases of congenital corneal opacity where corneal hysteresis is altered due to corneal fibrosis, conventional methods for IOL measurements might be incorrect, leading to overestimation of IOP and misdiagnosis of glaucoma.

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