Posters

Role of sectoral optical iridectomy in the management of peters anomaly: a case report, literature review

Poster Details

First Author: B.Shahin UK

Co Author(s): H. Shaheen   F. Shahin                 

Abstract Details

Purpose:

The aim of this paper is to present a case and outcome of an infant with peters anomaly type 1 who underwent bilateral sectoral optical iridectomy. We also aim to investigate the role and efficacy of optical iridectomy in the management of peters anomaly, this was achieved by conducting a review of published literature.

Setting:

The index case was a patient who was seen in NHS Lanarkshire and joint management with NHS Greater Glasgow and Clyde and Birmingham Children’s Hospital, UK.

Methods:

We present a case of a newborn infant who presented on day 1 of life with bilateral corneal opacification who subsequently underwent bilateral sectoral optical iridectomy, with resultant clearance of visual axis. Peters anomaly is a rare form of anterior segment dysgenesis which could  treated it could result in the development of dense amblyopia. Two broad management options are described in the literature which either involves optical sectoral peripheral iridectomies or early corneal grafts. A pubmed search was performed using the following keywords; peters anomaly and peripheral iridectomy. Nine papers were identified, with only two papers fitting the search criteria.

Results:

Of the two identified papers, paper 1 by Spieler et al,  involved a retrospective review of patients with peters anomaly who underwent optical iridectomy during a 12-year period. It included a total of 29 eyes, with mean follow-up of 42 months, which showed that 6.9% of eye required keratoplasties and 3.4% required a repeat peripheral iridectomy.  Paper 2 by Jünemann et al, included a retrospective review of 20 eyes for patients with peters anomaly over a 12-year period with mean follow-up of 3 years and 6 months. Results showed that marked visual improvement was noted in 47% of cases.

Conclusions:

Optical sectoral peripheral iridectomies provides a useful less invasive first step in the management of peters anomaly. Patients who fail to achieve sufficient corneal clearance, can then be considered for penetrating keratoplasties. Current research is limited to smaller retrospective review of cases and this is largely due to the rare profile of such patients and difficulty in setting larger studies. Although results are promising further research is required to further ascertain the efficacy of peripheral iridectomies in comparison to early corneal grafting in preventing the development of severe irreversible amblyopia.

Financial Disclosure:

None