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Am J Ophthalmol. 2019 Dec;208:367-375. doi: 10.1016/j.ajo.2019.08.012. Epub 2019 Aug 28.

Glaucoma and Cornea Surgery Outcomes in Peters Anomaly.

Author information

1
Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital Medical Center, Department of Ophthalmology, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.
2
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
3
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: brendabo@med.umich.edu.

Abstract

PURPOSE:

To conduct a qualitative description of corneal and glaucoma outcomes in Peters anomaly.

DESIGN:

Retrospective case series.

METHODS:

Children with Peters anomaly who presented between 1982-2017 were included. Visual acuity, intraocular pressure (IOP), survival of corneal grafts, and success of glaucoma surgery (defined as IOP of 5-20 mm Hg and no additional IOP-lowering surgery or visually devastating complications) were analyzed.

RESULTS:

Fifty-eight eyes of 37 patients (19 males) with Peters anomaly presented at 0.7 ± 1.5 years of age and had a follow-up of 10.2 ± 10.8 years. Twenty-three eyes underwent penetrating keratoplasty (PKP) with an average of 2.0 ± 1.3 grafts per eye. PKP survival at 1 year was 60% (95% confidence interval 41-75%) but decreased at 10 years to 34% (95% confidence interval 18-51%). Thirty-four eyes were diagnosed with glaucoma at 2.8 ± 6.4 years of age. Twenty eyes required glaucoma surgery, and the average number of IOP-lowering surgeries was 2.9 ± 2.0 per eye. Glaucoma drainage devices (15 eyes) had a 53% success rate. Laser cycloablation (9 eyes, transcleral or endoscopic) had a success rate of 67% with 2.0 ± 1.0 treatments per eye. Trabeculectomy with mitomycin C (8 eyes) and trabeculotomy (8 eyes) had 25% and 0% success rates, respectively. Fifteen eyes that underwent glaucoma surgery obtained IOP control, and GDD with or without cycloablation accounted for 80% of the successes. Eyes that underwent PKP did not show increased rates of glaucoma, higher IOP, or a greater necessity for IOP-lowering surgery.

CONCLUSIONS:

In Peters anomaly, PKP shows poor long-term success. In addition, >50% of eyes with Peters anomaly have secondary glaucoma that often requires multiple surgeries.

PMID:
31470000
DOI:
10.1016/j.ajo.2019.08.012

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