For the majority of eyes with Peters’ anomaly, a congenital disorder leading to corneal opacity soon after birth, researchers recently found that penetrating keratoplasty (PKP) shows poor long-term success and multiple surgeries are required for secondary glaucoma.

This retrospective case series evaluated 58 eyes of 37 children with Peters’ anomaly, 19 of whom were male, who presented at 0.7±1.5 years of age and were followed for 10.2±10.8 years. The team analyzed visual acuity, intraocular pressure (IOP), corneal graft survival and glaucoma surgery success.

The investigators discovered that 23 eyes underwent PKP (average of 2.0±1.3 grafts per eye), with PKP survival rates ranging from 60% at one year to 34% at 10 years. These eyes did not show increased rates of glaucoma, higher IOP or greater necessity for IOP-lowering surgery.

The study authors also note that 34 eyes were diagnosed with glaucoma at 2.8±6.4 years of age, with 20 requiring glaucoma surgery (average of 2.9±2.0 IOP-lowering surgeries per eye). Fifteen of the eyes that underwent glaucoma surgery eventually obtained IOP control, and glaucoma drainage devices ± laser cycloablation accounted for 80% of the successes. They add that these drainage devices, cycloablation (average of 2.0±1.0 treatments per eye, nine eyes, transcleral or endoscopic), trabeculectomy with mitomycin-C (eight eyes) and trabeculotomy (eight eyes) had success rates of 53%, 67%, 25% and 0%, respectively.

Dolezal KA, Besirli CG, Mian SI, et al. Glaucoma and cornea surgery outcomes in Peters Anomaly. Am J Ophthalmol. August 28, 2019. [Epub ahead of print].