title: Should unilateral congenital corneal opacities in Peters' anomaly be grafted?
abstract: OBJECTIVE
  To evaluate the surgical outcomes and visual results after penetrating keratoplasty for congenital unilateral corneal opacities in Peters anomaly.
  
  
  METHODS
  This was a retrospective study of 14 children who underwent keratoplasty for a unilateral Peters anomaly between 1999 and 2009. All patients received a topical treatment of cyclosporine and corticosteroids. Suture ablation was performed between the first and second postoperative month and all patients had spectacle correction and amblyopia treatment. Age at time of surgery, posterior segment status evaluated by ultrasonography, axial length, preoperative intraocular pressure, fellow eye status, mean follow-up time, early and late complications, final graft outcome, refraction, and visual acuity upon the last visit were noted.
  
  
  RESULTS
  Mean age at the time of surgery was 9 months. Posterior segment was normal in all cases. Mean axial length was 18 mm and mean intraocular pressure was 11 mmHg. Mean follow-up was 30 months. Four children had graft rejection episodes, 2 of which responded to medication. Four underwent cataract surgery, one developed pupil deformation requiring a pupilloplasty, and 2 cases were complicated by surgical glaucoma. A total of 11 eyes (78.6%) had clear grafts at the end of the follow-up. Mean spherical equivalent was -1.5 D. Visual acuity was measurable in 3 cases and was 20/50 in one case, 20/63 in the second, and 20/2000 in the third. Concerning preverbal children, central, steady, and maintained fixation was found in 8 cases.
  
  
  CONCLUSIONS
  Operating on a unilateral congenital corneal opacity is a challenging decision and should be taken after explaining the need for long-term follow-up to the parents. Useful vision can be achieved and maintained after strict amblyopia therapy. A multidisciplinary ophthalmologic follow-up is necessary.
authors.affiliation: Pediatric Ophthalmology Department, Rothschild Foundation, Paris, France.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Basdekidou
authors.forename: Pascal
authors.initials: P
authors.lastname: Dureau
authors.forename: Catherine
authors.initials: C
authors.lastname: Edelson
authors.forename: Patrice
authors.initials: P
authors.lastname: De Laage De Meux
authors.forename: Georges
authors.initials: G
authors.lastname: Caputo
mesh_terms: D000869:Anterior Eye Segment / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D058452:Axial Length, Eye; D002675:Child, Preschool; D003318:Corneal Opacity / Q000503:physiopathology / Q000601:surgery*; D016572:Cyclosporine / Q000008:administration & dosage; D005124:Eye Abnormalities / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D015948:Keratoplasty, Penetrating; D008297:Male; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D016572:Cyclosporine