Document Detail

Peters' anomaly. A synopsis of surgical management and visual outcome.
MedLine Citation:
PMID:  11705147     Owner:  NLM     Status:  MEDLINE    
Peters' anomaly is not an isolated anterior segment abnormality, but occurs as a diverse, phenotypically heterogeneous condition associated with multiple underlying ocular and systemic defects. Surgical treatment of Peters' anomaly is a complex and challenging undertaking. The broad spectrum of disease severity, the lack of uniformity in clinical features, the differences and overlap of preoperative risk factors, and the variability in the numbers and types of intraocular procedures that are performed on individual eyes, as well as postoperative complications all contribute to the difficulties involved in surgical management. This article discloses useful information pertaining to keratoplasty for Peters' anomaly. The study by Yang et al showed that long-term graft clarity could be achieved in 36% of eyes. However, 93% of all clear grafts were first grafts, whereas only 7% were second grafts. All third or subsequent grafts failed. Other important findings were: (1) the significantly greater chance of maintaining a clear graft with initial grafts, compared with subsequent grafts; (2) the disclosure of periods of differential risk for graft failure; and (3) the identification of risk factors for graft failure. Surgical intervention involving one or more procedures is effective in controlling IOP in 32% of eyes with associated congenital glaucoma. Still, multiple procedures and adjunctive medical therapy are often required to achieve and maintain adequate IOP control. The visual outcome is guarded in children with Peters' anomaly. Achieving a satisfactory visual outcome and preventing further visual loss is impeded by the presence of congenital anterior and posterior segment anomalies, structural defects of the CNS, cognitive dysfunction and amblyopia, as well as postoperative complications such as graft failure, cataract, inoperable retinal detachment, and phthisis.
L L Yang; S R Lambert
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Ophthalmology clinics of North America     Volume:  14     ISSN:  0896-1549     ISO Abbreviation:  Ophthalmol Clin North Am     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-11-13     Completed Date:  2002-04-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8905383     Medline TA:  Ophthalmol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  467-77     Citation Subset:  IM    
Department of Ophthalmology, Emory University, Atlanta, Georgia, USA.
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MeSH Terms
Anterior Eye Segment / abnormalities*
Corneal Opacity / surgery*
Corneal Transplantation / methods
Eye Abnormalities / surgery*
Risk Factors
Visual Acuity
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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