Surgical detachment of irido- and lenticulocorneal adhesions in peters anomaly

IF 2.8 3区医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2025-01-19 DOI:10.1111/aos.16942

Elsa-Leea Kotola, Joni A. Turunen, Päivi Lindahl, Kari Krootila, Anna Majander

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Abstract

Aims/Purpose: To report anatomical and visual acuity outcome of surgical detachment of iridocorneal or lenticulocorneal adhesions in pediatric patients with Peters anomaly.

Methods: An observational study of pediatric patients with Peters anomaly treated with surgical detachment of iridocorneal or lenticulocorneal adhesions between 2011 and 2024 at the Helsinki University Hospital. Ocular and extraocular diagnoses, age, sex, best corrected visual acuity (BCVA), intraocular pressure, ocular surgeries, surgical complications, family history, genetics and anterior segment optical coherence tomography data were collected from the medical records.

Results: Fourteen eyes from nine patients underwent the surgery. The median age at the time of surgery was 14 months (range 5-56) and the median follow-up period was 156 months (range 6-166). Of the treated eyes, 12 had iridocorneal adhesions, while two eyes also had lenticulocorneal adhesions. No surgical complications were reported. Anterior segment anatomy and corneal clarity were stable or improved during the follow-up. Among the fourteen eyes, three eyes achieved a BCVA better than 0.3 (Snellen decimal), while none had a BCVA worse than 0.05. BCVA was not available for three treated eyes due to the patients' young age. The following additional ocular conditions were recorded: microphthalmia, cataract, glaucoma, retinal degeneration, nystagmus, corectopia and strabismus. Four eyes underwent further ocular surgeries, such as cataract surgery with intraocular lens implantation, anterior vitrectomy, pupilloplasty, and temporal iridectomy. Five patients had systemic findings. Pathogenic variants in the PITX3 and RARB genes were detected in three patients and one patient, respectively.

Conclusions: This study demonstrates that surgical detachment of irido- and even lenticulocorneal adhesions in Peters anomaly is safe and results stable anatomical and visual acuity outcome over the period of critical visual development.

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手术脱离虹膜和透镜状角膜粘连的彼得斯异常

目的：报道小儿彼得斯畸形患者虹膜角膜脱离或角膜荚状体粘连的解剖和视力结果。方法：对2011年至2024年在赫尔辛基大学医院接受虹膜角膜脱离或角膜荚状体粘连手术治疗的儿童彼得斯畸形患者进行观察研究。从医疗记录中收集眼外诊断、年龄、性别、最佳矫正视力（BCVA）、眼压、眼部手术、手术并发症、家族史、遗传学和前段光学相干断层扫描数据。结果：9例患者14只眼行手术。手术时的中位年龄为14个月（范围5-56），中位随访时间为156个月（范围6-166）。12只眼有虹膜角膜粘连，2只眼有角膜荚状体粘连。无手术并发症报道。在随访期间，前节解剖和角膜清晰度稳定或改善。14只眼中，有3只眼BCVA优于0.3 (Snellen decimal)，没有一只眼BCVA低于0.05。由于患者年龄小，3只接受治疗的眼睛无法使用BCVA。另外还记录了以下眼部情况：小眼、白内障、青光眼、视网膜变性、眼球震颤、矫正斜视和斜视。4只眼睛接受了进一步的眼部手术，如白内障人工晶状体植入术、前玻璃体切除术、瞳孔成形术和颞虹膜切除术。5例患者有全身性发现。分别在3例患者和1例患者中检测到PITX3和RARB基因的致病变异。结论：本研究表明，在彼得斯畸形的关键视力发育时期，手术脱离虹膜粘连甚至透镜状角膜粘连是安全的，并能获得稳定的解剖和视力结果。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.