Surgical management of ophthalmic abnormalities in Peters plus syndrome: case report

Abstract

PurposeTo report a case of a patient with Peters plus syndrome (PPS) who underwent combined synechiolysis, penetrating keratoplasty, and trabeculectomy.MethodsA four‐year‐old female with bilateral central opacified cornea was referred to our department for corneal transplantation. Slit‐lamp examination demonstrated horizontal nystagmus, bilateral central corneal opacity and iridocorneal adhesion without lenticular involvement, which is characteristic of type I Peters anomaly. Intraocular pressure was 22 mmHg in the right eye and 26 mmHg in the left eye. Posterior segment ultrasonography showed no vitreous or retinal abnormalities. General and systemic examination revealed short stature and developmental delay without any other abnormality. The diagnosis of PPS was clinically made. The patient underwent combined synechiolysis, penetrating keratoplasty, and trabeculectomy of her left eye that was more affected.ResultsSix months postoperatively, corneal graft was clear with normal depth anterior chamber and normal intraocular pressure. For the right eye, the patient was put on antiglaucomatous eye drops while waiting for corneal transplantationConclusionsGlaucoma was proven to be a significant risk factor for graft failure and rejection after penetrating keratoplasty for Peters anomaly(1). In this case, combined surgeries were performed to allow better visual outcome and intraocular pressure control.Bibliography1. Dolezal KA, Besirli CG, Mian SI, Sugar A, Moroi SE, Bohnsack BL. Glaucoma and Cornea Surgery Outcomes in Peters Anomaly. Am J Ophthalmol 2019;208: 367–375.