Long-term visual outcome of penetrating keratoplasty in infants and children with Peters anomaly.
OBJECTIVE
To determine the long-term visual outcome of penetrating keratoplasty for Peters anomaly and to identify prognostic factors affecting final vision.


METHODS
The records of children 12 years of age or younger who underwent penetrating keratoplasty for Peters anomaly between January 1, 1971 and December 31, 1992 at Emory University were reviewed. Characteristics of the recipient, eye, donor, and surgical procedure were examined with the use of multivariate analyses.


RESULTS
One hundred forty-four keratoplasties in 72 eyes of 47 children who were followed for a minimum of 3 years from the date of first keratoplasty (median, 11.1 years) were reviewed. Visual acuities ranged from 20/25 to no light perception. Twenty-nine percent of eyes achieved 20/400 or better visual acuities, whereas 38% had light perception or no light perception. Stromal vessels (p < 0.001) and larger donor corneas (p < 0.001) were independent predictors of poor outcome. Postoperative complications included graft failure (n = 44), cataract (n = 15), glaucoma (n = 14), retinal detachment (n = 16), and phthisis (n = 22). More than half of the eyes (n = 18) without graft failure, retinal detachment and/or phthisis saw 20/400 or better.


CONCLUSIONS
Less than one-third of eyes with Peters anomaly undergoing keratoplasty achieved a visual acuity of 20/400 or better. Stromal vessels and large corneal grafts (>or=8 mm) were the only independent predictors of a poor visual outcome.
Yang
Lucy L H
LL
Emory Eye Center, Atlanta, Georgia, USA.
Lambert
Scott R
SR
Drews-Botsch
Carolyn
C
Stulting
R Doyle
RD
D000293:Adolescent; D000867:Anterior Chamber / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D005124:Eye Abnormalities / Q000453:epidemiology* / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult