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Peters anomaly: A 5-year experience.

Irim Salik1, Abhishek Gupta1, Arjun Tara1

  • 1Department of Anesthesiology, New York Medical College, Westchester Medical Center, Valhalla, NY, USA.

Paediatric Anaesthesia
|February 29, 2020
PubMed
Summary

Pediatric patients with Peters anomaly require multiple anesthetics for eye procedures. Laryngeal mask airway use in infants under 3 months for eye exams under anesthesia was safe and effective, with no airway complications.

Keywords:
ageairwaycardiaccongenital anomalies & syndromescongenital heart diseasegeneral anesthesiaophthalmology

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Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Pediatrics

Background:

  • Peters anomaly is a rare congenital eye malformation causing corneal opacity and vision impairment.
  • It necessitates repeated anesthetic procedures for diagnosis and treatment, including corneal transplantation.
  • Associated genetic syndromes like Peters plus syndrome can present multisystemic implications.

Purpose of the Study:

  • To review anesthetic management for ophthalmologic procedures in pediatric patients with Peters anomaly.
  • To evaluate the safety and efficacy of laryngeal mask airway use in infants.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing ophthalmologic procedures for Peters anomaly (2013-2018).
  • Analysis of anesthetic techniques, duration, and postoperative outcomes.
  • Inclusion of Peters anomaly types I, II, and Peters plus syndrome.

Main Results:

  • 35 patients reviewed; 30 required an average of three procedures.
  • Laryngeal mask airway use for examinations under anesthesia (31 min avg.) showed no adverse events in infants <3 months.
  • Corneal transplant anesthesia averaged 104 min with endotracheal intubation.

Conclusions:

  • General anesthesia and airway manipulation are generally well-tolerated in infants with Peters anomaly.
  • Laryngeal mask airway is a safe option for eye examinations under anesthesia in infants under 3 months.
  • Perioperative providers must consider multisystemic implications, especially in Peters plus syndrome.