Permatasari Devi Sarah Intan, Hermawan Dicky, Loebis Rozalina
Department of Ophthalmology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Pan Afr Med J. 2024 Oct 22;49:47. doi: 10.11604/pamj.2024.49.47.44754. eCollection 2024.
Anterior segment dysgenesis exerts its influence on a diverse array of ocular structures, encompassing the cornea, iris, ciliary body, anterior chamber and lens. We present a 20-month-old boy with bilateral corneal opacity. The visual acuity (VA) was 6/480 in both eyes. Upon examination, we found bilateral central corneal opacity with keratolenticular adhesions, anterior lens dislocation and opacification, aniridia. The clinical findings indicate diagnosis features of type II Peters anomaly (PA). Lens aspiration combined with adhesiolysis on the left eye (LE) was performed to address cataract-induced visual axis obstruction and prevent corneal decompensation from keratolenticular adhesions. We contemplated on prioritizing surgery for the LE initially due to the less severe corneal opacity compared to the right eye (RE). Further evaluations are required to determine the visual enhancement and the necessity of additional procedures. The management of type II PA proved to be a challenging experience. Cautious manipulation and extensive counseling can prevent further corneal decompensation.
前段发育异常会对多种眼部结构产生影响，包括角膜、虹膜、睫状体、前房和晶状体。我们报告一名20个月大的双侧角膜混浊男孩。双眼视力（VA）均为6/480。检查时，我们发现双侧中央角膜混浊伴角膜晶状体粘连、晶状体前脱位和混浊、无虹膜。临床发现提示为II型彼得斯异常（PA）的诊断特征。对左眼（LE）进行了晶状体抽吸联合粘连松解术，以解决白内障引起的视轴阻塞，并防止角膜晶状体粘连导致角膜失代偿。由于左眼角膜混浊比右眼（RE）轻，我们最初考虑优先对左眼进行手术。需要进一步评估以确定视力改善情况以及是否需要额外的手术。事实证明，II型PA的治疗是一次具有挑战性的经历。谨慎操作和充分的咨询可以防止角膜进一步失代偿。
