Glaucoma and Cornea Surgery Outcomes in Peters Anomaly

ABSTRACT Purpose To conduct a qualitative description of corneal and glaucoma outcomes in Peters Anomaly. Design Retrospective case series Methods Children with Peters Anomaly, who presented between 1982-2017 were included. Visual acuity, intraocular pressure (IOP), survival of corneal grafts and success of glaucoma surgery (defined as IOP of 5-20 mmHg and no additional IOP-lowering surgery or visually devastating complications) were analyzed. Results Fifty-eight eyes of 37 patients (19 males) with Peters Anomaly presented at 0.7±1.5 years of age and had follow-up of 10.2±10.8 years. Twenty-three eyes underwent penetrating keratoplasty (PKP) with an average of 2.0±1.3 grafts/eye. PKP survival at 1-year was 60% [95% CI 41,75], but decreased at 10-years to 34% [95% CI 18,51]. Thirty-four eyes were diagnosed with glaucoma at 2.8±6.4 years of age. Twenty eyes required glaucoma surgery, and the average number of IOP-lowering surgeries was 2.9±2.0 per eye. Glaucoma drainage devices (GDD, 15 eyes) had a 53% success rate. Laser cycloablation (9 eyes, transcleral or endoscopic) had a success rate of 67% with 2.0±1.0 treatments/eye. Trabeculectomy with mitomycin-C (8 eyes) and trabeculotomy (8 eyes) had 25% and 0% success rates, respectively. Fifteen eyes that underwent glaucoma surgery obtained IOP control, and GDD ± cycloablation accounted for 80% of the successes. Eyes that underwent PKP did not show increased rates of glaucoma, higher IOP, or greater necessity for IOP-lowering surgery. Conclusions In Peters Anomaly, PKP shows poor long-term success. Further, over half of eyes with Peters Anomaly have secondary glaucoma that often requires multiple surgeries.