Abstract：
BACKGROUND: To evaluate anterior synechiae after penetrating keratoplasty (PK) in patients with Peters\' anomaly using anterior segment optical coherence tomography (OCT).
METHODS: A retrospective cross-sectional study was performed. The medical records of patients diagnosed with Peters\' anomaly who underwent PK between 2013 and 2018 were reviewed. In addition to basic ophthalmic examinations, images of anterior segment structures were obtained via spectral-domain OCT at baseline and during the postoperative follow-up period. The profiles of postoperative anterior synechiae and multiple potential risk factors were analyzed.
RESULTS: Seventy-one eyes of 58 patients, aged 5 to 23 months, were included. Various extent of postoperative anterior synechiae was observed in 59 eyes (83.1%). OCT findings revealed graft-host junction synechiae, peripheral anterior synechiae, and a combination of both. Disease severity and malposition of the internal graft-host junction were significantly associated with the formation of postoperative synechiae. Multivariate regression analysis found that preexisting iridocorneal adhesion [odds ratio (OR) = 16.639, 95% confidence interval (CI) 1.494-185.294, p = 0.022] was positively correlated with postoperative anterior synechiae, whereas anterior chamber depth (OR = 0.009, 95% CI 0.000-0.360, p = 0.012) and graft size (OR = 0.016, 95% CI 0.000-0.529, p = 0.020) were negatively correlated with postoperative synechiae. In addition, quadrants of preexisting iridocorneal adhesion and width of the host corneal bed were identified as risk factors for increased postoperative anterior synechiae.
CONCLUSIONS: Anterior synechiae following PK is a relatively common occurrence in Peters\' anomaly patients and is found to be associated with preexisting iridocorneal adhesion, a shallow anterior chamber, small graft size, graft-host junction malposition, and graft closer to the corneal limbus. These data indicate the need for careful consideration when performing PK on these patients.
METHODS: A retrospective cross-sectional study was performed. The medical records of patients diagnosed with Peters\' anomaly who underwent PK between 2013 and 2018 were reviewed. In addition to basic ophthalmic examinations, images of anterior segment structures were obtained via spectral-domain OCT at baseline and during the postoperative follow-up period. The profiles of postoperative anterior synechiae and multiple potential risk factors were analyzed.
RESULTS: Seventy-one eyes of 58 patients, aged 5 to 23 months, were included. Various extent of postoperative anterior synechiae was observed in 59 eyes (83.1%). OCT findings revealed graft-host junction synechiae, peripheral anterior synechiae, and a combination of both. Disease severity and malposition of the internal graft-host junction were significantly associated with the formation of postoperative synechiae. Multivariate regression analysis found that preexisting iridocorneal adhesion [odds ratio (OR) = 16.639, 95% confidence interval (CI) 1.494-185.294, p = 0.022] was positively correlated with postoperative anterior synechiae, whereas anterior chamber depth (OR = 0.009, 95% CI 0.000-0.360, p = 0.012) and graft size (OR = 0.016, 95% CI 0.000-0.529, p = 0.020) were negatively correlated with postoperative synechiae. In addition, quadrants of preexisting iridocorneal adhesion and width of the host corneal bed were identified as risk factors for increased postoperative anterior synechiae.
CONCLUSIONS: Anterior synechiae following PK is a relatively common occurrence in Peters\' anomaly patients and is found to be associated with preexisting iridocorneal adhesion, a shallow anterior chamber, small graft size, graft-host junction malposition, and graft closer to the corneal limbus. These data indicate the need for careful consideration when performing PK on these patients.
摘要：
背景：使用眼前节光学相干断层扫描（OCT）评估Peters异常患者的穿透性角膜移植术（PK）后的前粘连。
方法：进行回顾性横断面研究。回顾了2013年至2018年间接受PK的Peters异常患者的医疗记录。除了基本的眼科检查，在基线和术后随访期间,通过谱域OCT获得眼前节结构图像.分析术后前粘连的情况及多种潜在危险因素。
结果：58例患者的71只眼，5至23个月，包括在内。59眼（83.1％）观察到不同程度的术后前粘连。OCT发现显示移植物-宿主连接粘连，外周前粘连，以及两者的结合。疾病的严重程度和内部移植物-宿主交界处的错位与术后粘连的形成显着相关。多因素回归分析发现，预先存在的虹膜角膜粘连[比值比（OR）=16.639，95％置信区间（CI）1.494-185.294，p=0.022]与术后前粘连呈正相关。而前房深度（OR=0.009，95％CI0.000-0.360，p=0.012）和移植物大小（OR=0.016，95％CI0.000-0.529，p=0.020）与术后粘连呈负相关。此外,先前存在的虹膜角膜粘连的象限和宿主角膜床的宽度被确定为术后前粘连增加的危险因素。
结论：PK后的前粘连在Peters异常患者中相对常见，并且发现与先前存在的虹膜角膜粘连有关，浅前房,移植物尺寸小，移植物-宿主连接错位，并移植到更靠近角膜缘的地方。这些数据表明在对这些患者进行PK时需要仔细考虑。
方法：进行回顾性横断面研究。回顾了2013年至2018年间接受PK的Peters异常患者的医疗记录。除了基本的眼科检查，在基线和术后随访期间,通过谱域OCT获得眼前节结构图像.分析术后前粘连的情况及多种潜在危险因素。
结果：58例患者的71只眼，5至23个月，包括在内。59眼（83.1％）观察到不同程度的术后前粘连。OCT发现显示移植物-宿主连接粘连，外周前粘连，以及两者的结合。疾病的严重程度和内部移植物-宿主交界处的错位与术后粘连的形成显着相关。多因素回归分析发现，预先存在的虹膜角膜粘连[比值比（OR）=16.639，95％置信区间（CI）1.494-185.294，p=0.022]与术后前粘连呈正相关。而前房深度（OR=0.009，95％CI0.000-0.360，p=0.012）和移植物大小（OR=0.016，95％CI0.000-0.529，p=0.020）与术后粘连呈负相关。此外,先前存在的虹膜角膜粘连的象限和宿主角膜床的宽度被确定为术后前粘连增加的危险因素。
结论：PK后的前粘连在Peters异常患者中相对常见，并且发现与先前存在的虹膜角膜粘连有关，浅前房,移植物尺寸小，移植物-宿主连接错位，并移植到更靠近角膜缘的地方。这些数据表明在对这些患者进行PK时需要仔细考虑。
