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Updated: Mar 2, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Long-term prognosis of Peters anomaly]
S Reichl1, D Böhringer2, O Richter2
1Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland. sabine.reichl@uniklinik-freiburg.de.
Insights
Peters anomaly, a childhood eye condition, has a poor visual prognosis despite surgical interventions. Early referral to visually impaired services is recommended due to high complication risks and limited long-term vision restoration.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Genetics
Background:
- Peters anomaly typically presents in early childhood with central corneal opacities and anterior eye segment dysgenesis.
- Early surgical intervention is often necessary for Peters anomaly to prevent severe amblyopia or manage glaucoma.
Purpose of the Study:
- To evaluate the clinical outcomes of patients with Peters anomaly treated since 2005.
- To emphasize the outcomes based on Peters anomaly subtypes.
Main Methods:
- Retrospective chart review of 23 patients diagnosed with Peters anomaly.
- Kaplan-Meier analysis to assess visual prognosis, keratoplasty indications, and retinal detachment incidence.
Main Results:
- Peters anomaly subtypes: 40% type 1, 50% type 2, 10% Peters plus syndrome.
- High rates of surgical intervention: 40.5% keratoplasty, 43% glaucoma surgery.
- Significant complications: 31% retinal detachment, 15% phthisis bulbi; poor visual acuity (≤0.05) in 50% after 4 years.
Conclusions:
- Peters anomaly has a generally poor visual prognosis with limited long-term functional vision restoration.
- Surgical interventions for Peters anomaly carry a high risk of severe complications.
- Early connection to visually impaired services is crucial for affected children.
Background:
Peters anomaly normally presents in early childhood. Common features are central corneal opacities and dysgeneses of the anterior eye segment. Early surgery is commonly warranted to prevent deep amblyopia or because of severe glaucoma. We herein present the clinical outcomes of all patients treated in the Eye Center of the Albert Ludwigs University of Freiburg since 2005. Emphasis is placed on the Peters subtype.
Methods:
Data were collected retrospectively by means of chart review. Kaplan-Meier analyses were used to estimate visual prognosis, the indication for keratoplasty, and the incidence of retinal detachment.
Results:
A total of 23 patients were identified. Subtype distribution was 40% type 1, 50% type 2, and 10% Peters plus syndrome. Ten patients were female (45%). Mean age at first presentation was 5 years; mean follow-up period censored in terms of eyeball preservation was 2 years (0 months-8 years). At mean follow-up, 40.5% of all patients had undergone at least one keratoplasty (up to six per eye); 43% had undergone glaucoma surgery (cylophotocoagulation, trabeculectomy, implants) at this time. Important complications were retinal detachment (31%) and phthisis bulbi (15%). After 4 years, visual acuity in the better eye was at most 0.05 in every second patient.
Conclusion:
Prognosis of visual acuity in Peters anomaly is poor. It is generally not possible to restore visual function in the long run, i. e., reading-grade visual acuity is rarely achieved. Surgical interventions are associated with a high risk of severe complications. Therefore, the young patients should be connected to institutions for visually impaired persons at an early stage.
