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28.04.2018 | Cornea | Ausgabe 9/2018

Graefe's Archive for Clinical and Experimental Ophthalmology 9/2018

Outcome of optical iridectomy in Peters anomaly

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 9/2018
Autoren:
Oriel Spierer, Kara M. Cavuoto, Sirinya Suwannaraj, Craig A. McKeown, Ta Chen Chang
Wichtige Hinweise
Presented at the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) Annual Meeting, March 25–29, 2015.

Abstract

Purpose

Optical iridectomy creates a defect in the iris to allow an alternative clear visual axis in cases of central corneal opacities occluding the pupillary axis. The purpose of this study is to evaluate the outcomes of optical sector iridectomy in children with Peters anomaly.

Methods

Retrospective case series. The medical records of all patients diagnosed with Peters anomaly who underwent optical iridectomy during the years 2002–2014 were reviewed. Data collection included surgical and visual acuity outcomes.

Results

Twenty-nine eyes (22 patients) were included in the study. Mean age at the time of surgery was 15.6 ± 26.3 months. Eighteen (81.8%) patients had bilateral disease. No intraoperative complications occurred. A red reflex was obtained in 28 (96.6%) eyes after surgery. Mean visual acuity improved from 2.5 ± 0.3 to 1.8 ± 0.6 in logMAR (p < 0.001). Vision improved in 21 (72.4%) eyes, remained stable in 5 (17.2%) eyes, and deteriorated in 3 (10.3%) eyes. Postoperatively visual acuity improved significantly in the patients with the bilateral disease (p < 0.05), but not in the unilateral group (p = 0.056). Mean follow-up time was 41.6 ± 43.8 months. During the follow-up period, five (17.2%) eyes were diagnosed with glaucoma, two (6.9%) eyes underwent PK, one (3.4%) eye underwent an additional sector iridectomy, and one (3.4%) eye underwent keratoprosthesis.

Conclusions

In this largest series published of optical iridectomy for Peters anomaly, it was found to be a safe procedure. Improvement in visual acuity is expected, particularly in bilateral cases. The utility of optical iridectomy in unilateral cases necessitates further studies.

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