Parmley V C, Stonecipher K G, Rowsey J J
Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City.
Ophthalmic Surg. 1993 Jan;24(1):31-5.
We reviewed the specimen records log of the McGee Eye Institute Histopathology Service from January 1979 to December 1990 for penetrating keratoplasty specimens submitted with a clinical diagnosis of Peters' anomaly. The records of the 19 cases thereby identified were reviewed for clinical outcome and visual rehabilitation, and the histopathology of all specimens was reviewed and correlated with the clinical diagnosis. Two specimens from the same patient were eliminated as histopathologically inconsistent with Peters' anomaly; one patient's data were not used because the patient was an adult when first grafted. Six eyes were grafted two or more times, for a total of 26 grafts on 16 eyes in 10 patients. Mean age at the time of first transplant was 18 weeks (range, 3 weeks to 40 months). Mean follow up was 30 months (range, 7 months to 6 1/2 years). Five eyes had preoperative glaucoma which persisted postoperatively. Ten eyes developed glaucoma postoperatively. Of the 15 eyes with glaucoma, 14 were uncontrolled medically and 12 underwent cyclodestructive or Molteno filtering procedures, or both, to control pressure. Graft rejection developed in 9 of the 10 eyes that required a cyclodestructive procedure, with partial or complete graft failure occurring shortly after the procedure. Glaucoma did not develop in one eye; in one other eye, it was medically controlled. These 2 eyes maintained clear grafts. Of the 6 eyes that were regrafted, only 1 obtained ambulatory vision. Of the 26 eyes receiving grafts, the grafts failed completely in 17 and partially in 5; 4 have remained clear. Five patients maintain ambulatory vision.
我们查阅了1979年1月至1990年12月间麦吉眼科研究所组织病理学服务的标本记录日志，以获取临床诊断为彼得斯异常的穿透性角膜移植标本。对由此确定的19例病例的记录进行了回顾，以了解临床结果和视力恢复情况，并对所有标本的组织病理学进行了回顾，并与临床诊断进行了关联。同一患者的两份标本因组织病理学与彼得斯异常不符而被排除；一名患者的数据未被使用，因为该患者首次移植时已成年。6只眼睛接受了两次或更多次移植，10名患者的16只眼睛共进行了26次移植。首次移植时的平均年龄为18周（范围为3周至40个月）。平均随访时间为30个月（范围为7个月至6年半）。5只眼睛术前患有青光眼，术后持续存在。10只眼睛术后发生青光眼。在15只患有青光眼的眼睛中，14只药物治疗无法控制，12只接受了睫状体破坏或莫尔顿引流手术，或两者兼施以控制眼压。在需要进行睫状体破坏手术的10只眼睛中，有9只发生了移植排斥反应，术后不久出现了部分或完全移植失败。一只眼睛未发生青光眼；另一只眼睛药物治疗得到控制。这2只眼睛的移植保持清晰。在6只再次移植的眼睛中，只有1只获得了可走动视力。在接受移植的26只眼睛中，17只完全失败，5只部分失败；4只保持清晰。5名患者保持可走动视力。
