J Korean Ophthalmol Soc.  2017 Jul;58(7):866-869. 10.3341/jkos.2017.58.7.866.

A Case of Penetrating Keratoplasty and Cataract Surgery for Improving Visual Acuity in Peter's Anomaly

• Jeon SH
• Kim HS
• Na KS

• KMID: 2387163
• DOI: http://doi.org/10.3341/jkos.2017.58.7.866

Abstract

PURPOSE
To report a case of penetrating keratoplasty and cataract surgery for improving visual acuity in an adult with Peters' anomaly.
CASE SUMMARY
A 70-year-old female patient presented with decreased visual acuity for a few years. The patient had a history of Peters' anomaly in both eyes and evisceration surgery of the right eye 4 years prior to presentation. The patient's visual acuity was measured as finger count 20 cm at the time of visitation due to Peters' anomaly and brunescent cataract. In the slit lamp examination, irregular margin corneal opacity with anterior synechiae was observed in the center of the cornea, while the peripheral cornea was relatively normal. Penetrating keratoplasty and cataract surgery were performed, and visual acuity improved by 0.04 at 1 week, 0.04 at 1 month, and 0.16 at 4 months after surgery. Visual acuity was measured using a Snellen chart, and the intraocular pressure was maintained within the normal range of 17-20 mmHg.
CONCLUSIONS
If peripheral corneal invasion is not severe in adults with Peters' anomaly, penetrating keratoplasty and cataract surgery can be performed for the purpose of improving visual acuity.

Keyword

Penetrating keratoplasty; Peters' anomaly

MeSH Terms

Adult
Aged
Cataract*
Cornea
Corneal Opacity
Female
Fingers
Humans
Intraocular Pressure
Keratoplasty, Penetrating*
Reference Values
Slit Lamp
Visual Acuity*

Figure

• 

  Figure 1 Anterior segment photographs of ophthalmic examination. Clinical manifestations of Peters' anomaly before surgery. Irregular margin corneal opacity and anterior synechiae at corneal center with iridodialysis are observed. (A) Clinical finding 6 years before surgery. (B) Clinical finding 2 months before surgery.

• 

  Figure 2 Anterior segment photographs of ophthalmic examination. (A) Clinical finding 5 days after penetrating keratoplasty and superotemporal iridectomy, well attached corneal graft was observed. (B) Clinical finding 2 months after surgery.

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  Figure 3 Photographs of resected corneal tissues in H&E stained (×100). Cornea and iris were tightly attached and Descemet's membrane was invisible.

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