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Jeon, Kim, and Na: A Case of Penetrating Keratoplasty and Cataract Surgery for Improving Visual Acuity in Peter's Anomaly
Case Report

Journal of the Korean Ophthalmological Society 2017; 58(7): 866-869.

Published online: 14 July 2017

DOI: https://doi.org/10.3341/jkos.2017.58.7.866

A Case of Penetrating Keratoplasty and Cataract Surgery for Improving Visual Acuity in Peter's Anomaly

Seung Hee Jeon, MD, Hyun Seung Kim, MD, PhD, Kyung-Sun Na, MD, PhD

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Kyung-Sun Na, MD, PhD. Department of Ophthalmology, The Catholic University of Korea Yeouido St. Mary's Hospital, #10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea. Tel: 82-2-3779-1520, Fax: 82-2-761-6869, drna@catholic.ac.kr

Received 6 April 2017       Revised 22 May 2017       Accepted 27 June 2017

©2017 The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of penetrating keratoplasty and cataract surgery for improving visual acuity in an adult with Peters' anomaly.

Case summary

A 70-year-old female patient presented with decreased visual acuity for a few years. The patient had a history of Peters' anomaly in both eyes and evisceration surgery of the right eye 4 years prior to presentation. The patient's visual acuity was measured as finger count 20 cm at the time of visitation due to Peters' anomaly and brunescent cataract. In the slit lamp examination, irregular margin corneal opacity with anterior synechiae was observed in the center of the cornea, while the peripheral cornea was relatively normal. Penetrating keratoplasty and cataract surgery were performed, and visual acuity improved by 0.04 at 1 week, 0.04 at 1 month, and 0.16 at 4 months after surgery. Visual acuity was measured using a Snellen chart, and the intraocular pressure was maintained within the normal range of 17-20 mmHg.

Conclusions

If peripheral corneal invasion is not severe in adults with Peters' anomaly, penetrating keratoplasty and cataract surgery can be performed for the purpose of improving visual acuity.

Keywords: Penetrating keratoplasty, Peters' anomaly

Figures and Tables

Figure 1

Anterior segment photographs of ophthalmic examination. Clinical manifestations of Peters' anomaly before surgery. Irregular margin corneal opacity and anterior synechiae at corneal center with iridodialysis are observed. (A) Clinical finding 6 years before surgery. (B) Clinical finding 2 months before surgery.

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Figure 2

Anterior segment photographs of ophthalmic examination. (A) Clinical finding 5 days after penetrating keratoplasty and superotemporal iridectomy, well attached corneal graft was observed. (B) Clinical finding 2 months after surgery.

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Figure 3

Photographs of resected corneal tissues in H&E stained (×100). Cornea and iris were tightly attached and Descemet's membrane was invisible.

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Notes

Conflicts of Interest The authors have no conflicts to disclose.

References

1. Shigeyasu C, Yamada M, Mizuno Y, et al. Clinical features of anterior segment dysgenesis associated with congenital corneal opacities. Cornea. 2012; 31:293–298.
2. Kurilec JM, Zaidman GW. Incidence of Peters anomaly and congenital corneal opacities interfering with vision in the United States. Cornea. 2014; 33:848–850.
3. Yoshikawa H, Sotozono C, Ikeda Y, et al. Long-term clinical course in eyes with Peters anomaly. Cornea. 2017; 36:448–451.
4. Zaidman GW, Flanagan JK, Furey CC. Long-term visual prognosis in children after corneal transplant surgery for Peters anomaly type I. Am J Ophthalmol. 2007; 144:104–108.
5. Kim YW, Choi HJ, Kim MK, et al. Clinical outcomes of penetrating keratoplasty in patients five years or younger. J Korean Ophthalmol Soc. 2013; 54:704–708.
6. Rubin SE, Marcus CH. Glaucoma in childhood. Ophthalmol Clin North Am. 1996; 9:215–228.
7. Stone DL, Kenyon KR, Green WR, Ryan SJ. Congenital central corneal leukoma (Peters' anomaly). Am J Ophthalmol. 1976; 81:173–193.
8. Yang LL, Lambert SR, Drews-Botsch C, Stulting RD. Long-term visual outcome of penetrating keratoplasty in infants and children with Peters anomaly. J AAPOS. 2009; 13:175–180.
9. Yang LL, Lambert SR, Lynn MJ, Stulting RD. Long-term results of corneal graft survival in infants and children with peters anomaly. Ophthalmology. 1999; 106:833–848.
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