Long-term visual prognosis in children after corneal transplant surgery for Peters anomaly type I.
OBJECTIVE
To evaluate the long-term visual prognosis in children with corneal transplant surgery for Peters anomaly type I.


METHODS
Retrospective review of interventional case series.


METHODS
Twenty-four children treated in a university-based practice were divided into two groups for analysis: a younger preverbal group and an older group of children three years of age or older. Children underwent corneal transplantation surgery (penetrating keratoplasty [PKP]) for Peters anomaly type I as infants (age range, two to 18 months). Visual acuity using Snellen or Allen charts and glaucoma and other complications were tabulated.


RESULTS
Twenty-four patients had Peters anomaly; 16 had unilateral disease, eight had bilateral disease. Thirty eyes underwent PKP. Average age at PKP was five months. The mean follow-up from PKP to the most recent visit was 78.9 months. Fifteen eyes (50%) were treated for glaucoma. Five transplants (17%) had graft rejection episodes; two of these failed and were regrafted. Six eyes (20%) required cataract surgery. One eye had a retinal detachment. Currently, 27 eyes (90%) have clear grafts. In the younger group of children, five of six grafts are clear (83%). In the older group of 24 eyes of verbal children, seven eyes (29%) have visual acuity ranging from 20/20 to 20/50, six (25%) have visual acuity ranging from 20/60 to 20/100, nine (38%) have visual acuity ranging from 20/200 to counting fingers, and two eyes (8%) have visual acuity of hand movements. In this group, nine of 12 eyes without glaucoma had visual acuity better than 20/100; only four of 11 eyes with glaucoma were better than 20/100.


CONCLUSIONS
Many children with PKP for Peters anomaly type I can experience good or functional vision in their operated eye. Children with glaucoma have a poorer visual prognosis.
Zaidman
Gerald W
GW
Department of Ophthalmology, New York Medical College and Westchester Medical Center, Valhalla, New York 10595, USA. pedkera@aol.com
Flanagan
Jessica K
JK
Furey
Catherine C
CC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000002:abnormalities* / Q000503:physiopathology; D003318:Corneal Opacity / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology; D012189:Retrospective Studies; D014019:Tissue Donors; D014792:Visual Acuity / Q000502:physiology*