Zaidman Gerald W, Flanagan Jessica K, Furey Catherine C
Department of Ophthalmology, New York Medical College and Westchester Medical Center, Valhalla, New York 10595, USA.
Am J Ophthalmol. 2007 Jul;144(1):104-108. doi: 10.1016/j.ajo.2007.03.058.
To evaluate the long-term visual prognosis in children with corneal transplant surgery for Peters anomaly type I.
Retrospective review of interventional case series.
Twenty-four children treated in a university-based practice were divided into two groups for analysis: a younger preverbal group and an older group of children three years of age or older. Children underwent corneal transplantation surgery (penetrating keratoplasty [PKP]) for Peters anomaly type I as infants (age range, two to 18 months). Visual acuity using Snellen or Allen charts and glaucoma and other complications were tabulated.
Twenty-four patients had Peters anomaly; 16 had unilateral disease, eight had bilateral disease. Thirty eyes underwent PKP. Average age at PKP was five months. The mean follow-up from PKP to the most recent visit was 78.9 months. Fifteen eyes (50%) were treated for glaucoma. Five transplants (17%) had graft rejection episodes; two of these failed and were regrafted. Six eyes (20%) required cataract surgery. One eye had a retinal detachment. Currently, 27 eyes (90%) have clear grafts. In the younger group of children, five of six grafts are clear (83%). In the older group of 24 eyes of verbal children, seven eyes (29%) have visual acuity ranging from 20/20 to 20/50, six (25%) have visual acuity ranging from 20/60 to 20/100, nine (38%) have visual acuity ranging from 20/200 to counting fingers, and two eyes (8%) have visual acuity of hand movements. In this group, nine of 12 eyes without glaucoma had visual acuity better than 20/100; only four of 11 eyes with glaucoma were better than 20/100.
Many children with PKP for Peters anomaly type I can experience good or functional vision in their operated eye. Children with glaucoma have a poorer visual prognosis.
评估接受角膜移植手术治疗I型彼得斯异常的儿童的长期视觉预后。
干预性病例系列回顾性研究。
在一家大学附属医院接受治疗的24名儿童被分为两组进行分析：年龄较小的学前期儿童组和年龄在3岁及以上的较大儿童组。这些儿童在婴儿期（年龄范围为2至18个月）因I型彼得斯异常接受了角膜移植手术（穿透性角膜移植术[PKP]）。使用斯内伦视力表或艾伦视力表记录视力，并将青光眼及其他并发症制成表格。
24例患者患有彼得斯异常；16例为单眼患病，8例为双眼患病。30只眼睛接受了PKP手术。PKP手术时的平均年龄为5个月。从PKP手术到最近一次随访的平均时间为78.9个月。15只眼睛（50%）接受了青光眼治疗。5次移植（17%）发生了移植物排斥反应；其中2次失败并再次进行了移植。6只眼睛（20%）需要进行白内障手术。1只眼睛发生视网膜脱离。目前，27只眼睛（90%）的移植物清晰。在年龄较小的儿童组中，6次移植中有5次移植物清晰（83%）。在年龄较大的24只学语儿童眼睛组中，7只眼睛（29%）的视力在20/20至20/50之间，6只眼睛（25%）的视力在20/60至20/100之间，9只眼睛（38%）的视力在20/200至数指之间，2只眼睛（8%）的视力为手动。在该组中，12只没有青光眼的眼睛中有9只视力优于20/100；11只有青光眼的眼睛中只有4只视力优于20/100。
许多接受PKP手术治疗I型彼得斯异常的儿童手术眼可获得良好或功能性视力。患有青光眼的儿童视觉预后较差。
