BACKGROUND To report three cases of congenital corneal opacity where intraocular pressure (IOP) readings were high despite the use of multiple anti-glaucoma eye drops and normalized after corneal transplantation. CASE PRESENTATION Three Korean infants presented with bilateral dense stromal opacification which had been present since birth. IOPs measured by rebound tonometer were high despite administration of multiple anti-glaucoma medications. One eye of each patient underwent penetrating keratoplasty (PK) because corneal opacity impaired visual development. Immediately after PK, IOPs were normalized and maintained normal without medication, whereas they remained high in the contralateral unoperated eye. On histology, stromal fibrosis was observed in the removed corneal button, and molecular assays revealed increased levels of type 1 and 5 collagens. CONCLUSION The IOP measurement using the conventional applanation-based tonometry can be inaccurate in congenital corneal opacity which is marked by corneal fibrosis. Therefore, IOP values should be interpreted with caution in these patients, and the possibility of false-positive diagnosis of glaucoma considered.

中文翻译：

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先天性角膜混浊的眼内压测量不准确：三例报告。

背景技术要报告三例先天性角膜混浊，尽管使用了多种抗青光眼滴眼液，但眼内压（IOP）读数仍很高，并且在角膜移植后恢复正常。病例介绍自出生以来，三名韩国婴儿表现出双侧浓密基质混浊。尽管使用了多种抗青光眼药物，但通过回弹眼压计测量的IOP仍然很高。每个患者的一只眼睛都进行了穿透性角膜移植术（PK），因为角膜混浊会损害视力发育。PK后立即使眼压恢复正常，无需药物即可维持正常，而对侧未手术眼的眼压仍然很高。在组织学上，在去除的角膜纽扣中观察到间质纤维化，分子检测显示1型和5型胶原蛋白水平增加。结论使用传统的基于压平法的眼压测量法在以角膜纤维化为特征的先天性角膜混浊中可能不准确。因此，在这些患者中应谨慎解释IOP值，并考虑对青光眼进行假阳性诊断的可能性。