Peters anomaly. A, Clinical appearance. Note the central corneal opacity (leukoma) with attached iris strands (arrow). The lens is uninvolved. B, Gross photograph of a more severe form of Peters anomaly demonstrates attachment of a cataractous lens to the opacified cornea (adherent leukoma). Note the accompanying peripheral flattening of the corneal curvature and opacification (cornea plana and sclerocornea, respectively). The iris and anterior chamber angle structures are malformed (arrow). C, Low-magnification photomicrograph demonstrates internal ulcer of von Hippel (arrow) with attached iris strands (double arrowhead). Incomplete cleavage of the anterior chamber angle structures (fetal angle deformity) is also present (single arrowhead). D, PAS stain highlights peripheral Descemet membrane (single arrowhead). The central cornea is fibrotic and demonstrates absence of posterior stroma and Descemet membrane (arrow). A fibrotic iris strand (double arrowhead) is attached to the edge of the corneal defect.