Encountering the clinical complexity of type II Peters anomaly management approaches: a case report

Anterior segment dysgenesis exerts its influence on a diverse array of ocular structures, encompassing the cornea, iris, ciliary body, anterior chamber and lens. We present a 20-month-old boy with bilateral corneal opacity. The visual acuity (VA) was 6/480 in both eyes. Upon examination, we found bilateral central corneal opacity with keratolenticular adhesions, anterior lens dislocation and opacification, aniridia. The clinical findings indicate diagnosis features of type II Peters anomaly (PA). Lens aspiration combined with adhesiolysis on the left eye (LE) was performed to address cataract-induced visual axis obstruction and prevent corneal decompensation from keratolenticular adhesions. We contemplated on prioritizing surgery for the LE initially due to the less severe corneal opacity compared to the right eye (RE). Further evaluations are required to determine the visual enhancement and the necessity of additional procedures. The management of type II PA proved to be a challenging experience. Cautious manipulation and extensive counseling can prevent further corneal decompensation.