Optical iridectomy in infant with Peters plus syndrome

Abstract

Introduction: Peters Plus syndrome is a rare genetic condition characterized by ocular, auditory, facial, genitourinary system, cardiac abnormalities and developmental delay. Peters anomaly is the most common ocular dysgenesis causing corneal opacification at birth and severe amblyopia. Systemic malformations, young age and postoperative care contribute to the difficulties in surgical treatment. Methods: A case report Results: A 2-month-old female was referred to our ophthalmology department due to nystagmus and corneal opacities. She was born at 38 weeks‘ gestation. Her birth weight was 2100 grams. She is the first child in the family born after 6 miscarriages. Red reflex screening was not performed due to narrow palpebral fissure. Anterior segment examination under general anesthesia showed corneal opacity in the inferonasal quadrant with iridocorneal adhesion and corectopia in the right eye. Diffuse corneal opacification with minimal view of the anterior segment was seen in the left eye. The intraocular pressure (IOP) was 22.4 mmHg in the right eye and 24.4 mmHg (Icare) in the left eye. Horizontal corneal diameter was 9 mm in both eyes. Other malformed features found in the physical pediatric examination included: micrognathia, narrow nostrils, low position of the ears, brachydactyly, unilateral renal agenesis, ureteral ectopia, atrial septal defect, moderate hearing loss and severe developmental delay. Surgical optical-sector iridectomies were performed in both eyes. IOP was controlled with dorzolamide and timolol drops. Now the patient is 20-month-old. She is following the light and objects with her right eye, left eye is deviated inward. There is small residual horizontal nystagmus. Conclusion: Optical-sector[...].