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Lisch nodules after trabeculectomy.

Jennifer S Weizer1, Sharon F Freedman

  • 1Duke University Eye Center, Durham, North Carolina, USA.

Ophthalmic Surgery, Lasers & Imaging : the Official Journal of the International Society for Imaging in the Eye
|September 15, 2005
PubMed
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Lisch nodules, typically associated with neurofibromatosis type 1, can develop after glaucoma surgery. This case shows their appearance post-trabeculectomy with mitomycin C, even without systemic disease.

Area of Science:

  • Ophthalmology
  • Genetics
  • Dermatology

Background:

  • Glaucoma surgery, specifically trabeculectomy with mitomycin C, is a common procedure to lower intraocular pressure.
  • Lisch nodules are benign hamartomas of the iris, classically associated with neurofibromatosis type 1 (NF1).
  • The presence of Lisch nodules is a key diagnostic criterion for NF1.

Observation:

  • A 12-year-old boy developed Lisch nodules in his eye following trabeculectomy with mitomycin C.
  • Ophthalmologic examinations and genetic testing were conducted.
  • The patient did not exhibit other systemic manifestations of neurofibromatosis type 1.

Findings:

  • Lisch nodules can arise in the iris after ocular surgery, independent of systemic neurofibromatosis type 1.

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  • The development of these nodules may be a localized ocular response to surgical intervention or medication.

    • Implications:

    • This finding expands the differential diagnosis for iris nodules in patients who have undergone ocular surgery.
    • Further research may be needed to understand the specific mechanisms linking trabeculectomy with mitomycin C to Lisch nodule formation.
    • Clinicians should consider postsurgical ocular changes when evaluating patients for potential neurofibromatosis type 1.