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T. Sagara, M. Kozawa, K. Ota, Y. Fujitsu, K. Suzuki, T. Nishida; Pupillary Block in Peters’ Anomaly. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4350.
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In Peters’ anomaly, the anterior chamber angle is usually grossly normal even if the adhesion of the central corneal defect to the iris is severe. We now present a rare case of Peters’ anomaly with a flattened anterior chamber caused by pupillary block.Methods/
A 2-month-old infant presented with corneal leukoma in his right eye. Synechiae extending from the central iris to the periphery of the corneal opacity were apparent and the anterior chamber was flat. No abnormalities of the vitreous cavity or retina were detected by ultrasonography in the B-scan mode. The patient was thus diagnosed with unilateral Peters’ anomaly. Intraocular pressure (IOP) of his right eye was 31 mmHg under general anesthesia. We attempted to form the anterior chamber by injection of balanced salt solution and trabeculotomy. Minimal formation of the anterior chamber was achieved and the iris root unexpectedly prolapsed through the ruptured trabeculum. The prolapsed iris was excised. Five days after surgery, IOP was 10 mmHg and a shallow anterior chamber was detected in the inferior portion of the right eye. After 2 months, IOP was 11 mmHg and the anterior chamber was deepening in all quadrants.
Given that the anterior chamber formed after peripheral iridectomy, pupillary block was the likely cause of the flat chamber in the patient. As far as we are aware, this is the first report of Peters’ anomaly with pupillary block.
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