Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital Medical Center, Department of Ophthalmology, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Am J Ophthalmol. 2019 Dec;208:367-375. doi: 10.1016/j.ajo.2019.08.012. Epub 2019 Aug 28.
To conduct a qualitative description of corneal and glaucoma outcomes in Peters anomaly.
Retrospective case series.
Children with Peters anomaly who presented between 1982-2017 were included. Visual acuity, intraocular pressure (IOP), survival of corneal grafts, and success of glaucoma surgery (defined as IOP of 5-20 mm Hg and no additional IOP-lowering surgery or visually devastating complications) were analyzed.
Fifty-eight eyes of 37 patients (19 males) with Peters anomaly presented at 0.7 ± 1.5 years of age and had a follow-up of 10.2 ± 10.8 years. Twenty-three eyes underwent penetrating keratoplasty (PKP) with an average of 2.0 ± 1.3 grafts per eye. PKP survival at 1 year was 60% (95% confidence interval 41-75%) but decreased at 10 years to 34% (95% confidence interval 18-51%). Thirty-four eyes were diagnosed with glaucoma at 2.8 ± 6.4 years of age. Twenty eyes required glaucoma surgery, and the average number of IOP-lowering surgeries was 2.9 ± 2.0 per eye. Glaucoma drainage devices (15 eyes) had a 53% success rate. Laser cycloablation (9 eyes, transcleral or endoscopic) had a success rate of 67% with 2.0 ± 1.0 treatments per eye. Trabeculectomy with mitomycin C (8 eyes) and trabeculotomy (8 eyes) had 25% and 0% success rates, respectively. Fifteen eyes that underwent glaucoma surgery obtained IOP control, and GDD with or without cycloablation accounted for 80% of the successes. Eyes that underwent PKP did not show increased rates of glaucoma, higher IOP, or a greater necessity for IOP-lowering surgery.
In Peters anomaly, PKP shows poor long-term success. In addition, >50% of eyes with Peters anomaly have secondary glaucoma that often requires multiple surgeries.
对 Peters 异常的角膜和青光眼结果进行定性描述。
回顾性病例系列。
纳入了 1982 年至 2017 年间就诊的 Peters 异常患儿。分析视力、眼内压（IOP）、角膜移植物存活率和青光眼手术成功率（定义为 IOP 为 5-20mmHg，无需进一步降低眼压手术或视力严重并发症）。
37 例（19 名男性）患儿的 58 只眼在 0.7±1.5 岁就诊，随访时间为 10.2±10.8 年。23 只眼接受了穿透性角膜移植术（PKP），平均每只眼移植 2.0±1.3 个移植物。1 年时 PKP 存活率为 60%（95%置信区间为 41-75%），但 10 年后降至 34%（95%置信区间为 18-51%）。34 只眼在 2.8±6.4 岁时被诊断为青光眼。20 只眼需要接受青光眼手术，平均每只眼需要进行 2.9±2.0 次降眼压手术。青光眼引流装置（15 只眼）的成功率为 53%。激光环扎术（9 只眼，经巩膜或经内腔镜）的成功率为 67%，每只眼需要进行 2.0±1.0 次治疗。小梁切除术联合丝裂霉素 C（8 只眼）和小梁切开术（8 只眼）的成功率分别为 25%和 0%。15 只接受青光眼手术的眼获得了眼压控制，GDD 联合或不联合环扎术的成功率占 80%。接受 PKP 的眼并未表现出更高的青光眼发生率、更高的 IOP 或更需要降眼压手术。
在 Peters 异常中，PKP 显示出较差的长期成功率。此外，>50%的 Peters 异常眼患有继发性青光眼，通常需要多次手术。
