• Glaucoma, Pediatric Ophth/Strabismus

    Review of: Glaucoma and Cornea Surgery Outcomes in Peters Anomaly

    Dolezalb K, Besirlia C, Mian S, et al. American Journal of Ophthalmology, December 2019

    This paper describes the corneal and glaucoma outcomes among patients with Peters anomaly.

    Study design

    This retrospective study included 37 patients (58 eyes) who presented with Peters anomaly between 1982 and 2017. Success of glaucoma surgery was defined as IOP between 5 and 20 mm Hg with no additional IOP-lowering surgery or visually devastating complications.

    Outcomes

    Thirty-four eyes (59%) were diagnosed with glaucoma at, on average, 2.8 years (range birth to 29 years). Twenty eyes required glaucoma surgery, with most requiring multiple surgical interventions. Angle surgery appeared to be ineffective for long-term IOP control. The highest success (80%) came from glaucoma drainage devices, with or without cycloablation. Penetrating keratoplasty had a 10-year survival rate of 34% and did not increase the rate of glaucoma; 11 eyes had chronic graft failure or extrusion of keratoprosthesis.

    Limitations

    This study is limited by its retrospective, observational study design as well as by variability in follow-up time and disease severity at presentation.

    Clinical significance

    There is a high rate of glaucoma associated with Peters anomaly, which is often diagnosed during childhood. Many patients with glaucoma secondary to Peters anomaly require IOP-lowering surgery. Glaucoma drainage devices, with or without cycloablation, showed the highest success while penetrating keratoplasty had low long-term success and is frequently complicated by graft failure.