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CJ Cape, G Zaidman, S Kodsi; Visual Acuity and Graft Clarity in Infants and Children after Corneal Transplant Surgery for Peters Anomaly Type I . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4179.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To demonstrate that infants and children with the milder, Type I Peters Anomaly (PA-I) may have clear grafts and develop useful visual acuity after corneal transplant surgery (CTS). Methods:Twenty-one eyes of 14 children were diagnosed with PA-I. Eighteen of the 21 eyes underwent CTS at ages ranging from 2 to 17 months. Those 18 eyes required 19 grafts. No patient needed cataract surgery. Each patient adhered to an intensive postoperative regime consisting of frequent follow-up appointments and multiple examinations under anesthesia. All sutures were removed by 10 weeks post-op. Depending on the age of the patient, best-corrected visual acuity was tested in one of three methods. Children were tested using a Snellen chart if they were 5 years or older, Allen pictures if they ranged from 3 to 5 years, and Teller Acuity Cards if they were less than 3 years. Results:With follow-up ranging from 4 to 107 months after CTS (mean of 29 months), 14 grafts were clear (74%), 2 grafts had trace edema (10%), and 3 grafts had failed (16%). Complications included 3 rejection episodes that cleared with medical therapy, 3 graft failures, and 1 early cataract. Glaucoma, present in 11 eyes, was controlled medically in 9 eyes and surgically in 2 eyes. Visual acuity with Snellen letters was 20/50 in 1 eye and 20/100 in 2 eyes. Using Allen pictures, vision was 20/25 in 1 eye and 20/40 in 2 eyes. Seven eyes were tested using Teller Acuity Cards at 55 cm. The normal monocular Teller visual acuity range in Snellen equivalents for infants from ages 4 to 12 months is 20/80 to 20/400 and for children from ages 1 to 3 years is 20/15 to 20/300. The 3 infants between 4 and 12 months of age had 3 eyes with vision ranging from 20/300 to 20/400. The 3 children between 1 and 3 years of age had 4 eyes with vision ranging from 20/400 to 20/1600. Five eyes were amblyopic, and vision could not be obtained by any of the 3 methods. Conclusion:This series demonstrates that CTS in patients with PA-I can be successful and result in useful visual acuity in the majority of patients.
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