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J. Flanagan, G.W. Zaidman, C. Cape; Long Term Visual Prognosis in Children With Clear Grafts After Corneal Transplant Surgery for Peters Anomaly Type I . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4971.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To address the long term visual prognosis in children with clear grafts after corneal transplant surgery for Peters Anomaly Type I. Methods: Peters Anomaly is a rare congenital malformation of the anterior segment of the eye. It is characterized by a central corneal opacity, defects in the posterior stroma, Descemet's membrane and endothelium in the area of opacification, and iris strands that arise from the collarette and extend to the corneal leukoma. Peters Anomaly Type I only involves the iris and cornea, without involvement of the lens. We performed a retrospective review of the medical records of all patients with Peters Anomaly I who had clear grafts and who had their corneal transplant done as infants (age 2–18 months). All children currently three years old or older were included. All operations were performed from 1988–2001. Vision was determined using Snellen Acuity or Allen charts. Vision was grouped in the following categories: 20/20–20/50; 20/60–20/100; 20/200–CF (counting fingers); HM (hand motions) or less. Glaucoma and other complications were tabulated. Results: Eighteen eyes of fourteen patients were included in the study. Average age at corneal transplant was five months old. The mean follow–up from corneal transplant to the most recent visit was seventy–two months. Average age at last follow–up visit was six years, eight months. Seven eyes (39%) were treated for glaucoma. One eye required glaucoma surgery. One eye had a graft rejection episode without a regraft. Two eyes needed a regraft. Five eyes had cataract surgery. At their final visit, four eyes (22%) were 20/20–20/50, five eyes (28%) were 20/60–20/100, eight eyes (44%) were 20/200–CF, one eye (6%) was HM. All seven eyes with congenital glaucoma had a final visual acuity of 20/100–HM. Conclusions: Many children with corneal transplants for Peters Anomaly I can develop good or functional vision in the operated eye. Children who have corneal transplants for Peters Anomaly I and also have glaucoma have a poorer visual prognosis.
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