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Penetrating Keratoplasty in Infants With Peters Anomaly: Visual and Graft Outcomes
1Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Corneal graft survival and visual outcomes after penetrating keratoplasty (PK) in infants with Peters anomaly (PA) were favorable, with 73% graft clarity. Key factors influencing vision included corneal vascularization and lens abnormalities.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Peters anomaly (PA) is a congenital corneal defect impacting infant vision.
- Penetrating keratoplasty (PK) is a surgical option for corneal opacity in infants.
Purpose of the Study:
- To evaluate corneal graft survival and visual outcomes following primary PK in infants with PA.
- To identify prognostic factors for visual acuity after PK in this population.
Main Methods:
- A retrospective study included 37 eyes of 29 infants with PA undergoing primary PK before age one.
- Visual acuity was assessed using Teller Acuity Cards; graft survival was analyzed using Kaplan-Meier methods.
- Prognostic factors were analyzed using the chi-squared test.
Main Results:
- 73% of corneal grafts maintained full clarity at a mean follow-up of 18 months.
- 67.6% of infants achieved visual acuity above ambulatory levels; 48.6% achieved >20/260.
- Vascularized PA I and PA II showed lower rates of achieving >20/260 visual acuity compared to non-vascularized PA I (P=0.030).
Conclusions:
- Primary PK in infants with PA demonstrates good graft survival and visual potential.
- Corneal vascularization and lens abnormalities are significant risk factors impacting visual outcomes.
- Early surgical intervention appears beneficial, with no significant difference in outcomes based on age at surgery ( <6 months vs. >6 months).
Purpose:
To determine the prevalence of survival of corneal grafts and visual outcomes of primary penetrating keratoplasty (PK) in infants with Peters anomaly (PA) in Beijing, China.
Methods:
Twenty-nine patients (37 eyes) with PA who underwent PK before the age of 1 year were included. Optical correction for all eyes and occlusion therapy of amblyopia for a unilateral opacity were performed 2 weeks after suture removal. All infants underwent assessment of visual acuity after surgery using Teller Acuity Cards. Survival probabilities were estimated using the Kaplan-Meier method and log-rank test. Visual outcomes and prognosis factors were analyzed using the χ2 test.
Results:
The mean age of 29 infants undergoing primary PK was 5.7 ± 2.3 months. The mean follow-up duration was 18.0 ± 3.0 months. Twenty-seven (73.0%) of 37 grafts retained full clarity at final follow-up. Visual acuity above ambulatory was achieved in 67.6% (25/37) and >20/260 was achieved in 48.6% (18/37) of cases. Of all surgical indications, vascularized PA I (50.0%, 6/12) and PA II (18.2%, 2/11) showed a lower proportion achieving visual acuity >20/260 than nonvascularized PA I (71.4%, 10/14) (P = 0.030 < 0.05). There was no significant difference in the prevalence of graft survival and vision outcome between infants younger than 6 months and older than >6 months.
Conclusions:
For infants with PA who underwent PK, the prevalence of graft survival and visual acuity were related mainly to the indication. The main risk factors were corneal vascularization and an abnormal lens.
