A Simple and Easy Method Using Rigid Endoscope to Detect Iridocorneal and Keratolenticular Adhesions in Peters’ Anomaly
A 20-day-old neonatal female was referred to our department because of corneal opacity. The patient was born maturely following an unremarkable pregnancy. Although her right eye (OD) was normal, her left eye (OS) showed a central corneal opacity (fig. ). In both eyes, intraocular pressure was within normal ranges. The anterior chamber structures of the OS could be partially visualized through the clear area. Fundus examination showed a normal appearance of the OD and OS except for the superior periphery, which was difficult to observe because of the corneal opacity. Thus, to examine the anterior chamber in detail, we performed TEI with a previously reported method [, ]. Briefly, the authors used a rigid endoscope with an otoscope 6.0 cm in length and an outer diameter of 4 mm (1215AA; Karl Storz, Tuttlingen, Germany) with a crescent-shaped illuminating tip. A xenon lamp (Xenon Nova 175; Karl Storz) was used as the light source. The endoscope was connected to a digital camera utilizing a 400,000-pixel charge-coupled device image sensor unit, which was connected to a monitor in turn. The patient was placed on a bed in the supine position, and topical anesthetic was instilled into the OS. A spatula was placed between the eyelids, and hydroxyethyl cellulose solution was applied on the corneal surface to protect it and to create an interface that would improve the quality of the image. The endoscope was placed in proximate contact with the cornea and directed such that the angle could be observed. As shown in figure , the iris stroma was adhered toward the back of the opacified area of the cornea, which confirmed the diagnosis.