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Yujing Yang, Jianjiang Xu, Jun Xiang, Xinhan Cui, Jiaxu Hong; Evaluation of Anterior Synechiae after Penetrating Keratoplasty in Infants and Children with Peters’ Anomaly. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1573.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate anterior synechiae (AS) after penetrating keratoplasty (PK) in patients with Peters’ anomaly using anterior segment optical coherence tomography (OCT).
Retrospective, consecutive case series. This was a single-center analysis of 71 eyes of 58 patients with Peters’ anomaly, aged 5 to 23 months, who underwent PK. In addition to basic ophthalmic examinations, images of cornea and anterior segment structures were obtained by spectral-domain OCT scanning system at baseline and in the postoperative follow-up period. The profiles of postoperative AS and multiple potential risk factors were analyzed. Covariates included corneal diameter, anterior chamber depth, stromal vessels, disease severity, preoperative iridocorneal adhesion, graft size, internal graft-host junction alignment, and the width of residual recipient cornea ring.
Various extent of postoperative anterior synechiae were observed in 59 eyes (83.1%). Among them, 23 eyes had AS formation over two quadrants. OCT findings revealed graft-host junction synechiae, peripheral host cornea synechiae and a combination of both. Multivariate regression analysis identified preoperative iridocorneal adhesion (odds ratio [OR], 9.555; 95% confidence interval [CI], 2.363-38.642), anterior chamber depth (OR, 0.013; 95% CI, 0.000-0.354), and the width of residual recipient cornea ring (OR, 0.273; 95% CI, 0.095-0.784) as risk factors for the development of postoperative AS. Disease severity and malapposition of the internal graft-host junction were significantly associated with synechiae formation after PK.
This study results suggest that the incidence of postoperative AS is high in Peters’ anomaly patients that underwent PK. Eyes with larger amount of preoperative iridocorneal adhesion, shallow anterior chamber, or grafts closer to the recipient cornea limbus have greater tendency in postoperative AS formation. Anterior segment OCT allows early characterization of the type and the extent of postoperative AS, and may provide valuable information for clinical and surgical follow-up of these patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Types of synechiae on OCT: graft-host junction (GHJ) synechia with well-apposed junction (A), internal graft-host step (C), or protrusion (E); peripheral host cornea synechia (B, D); and combined peripheral and GHJ synechia (F).
Baseline characteristics of eyes with and without postoperative anterior synechiae.
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