Our Summary

This research paper looks at how anesthetics are managed in patients with Peters anomaly, a rare eye condition present from birth that causes blurry vision and an opaque cornea. The condition can slow down the development of vision and often requires several doses of anesthetics for various eye exams and cornea transplants.

The researchers reviewed the medical records of 35 kids with Peters anomaly who underwent eye-related procedures at Westchester Medical Center between 2013 and 2018. They found that most patients needed around three procedures, including two exams under anesthesia before and after the cornea transplant, and the transplant itself.

The youngest patient was 39 weeks old at the time of the first exam under anesthesia. The average time patients were under anesthesia for these exams was 31 minutes, while cornea transplants took an average of 104 minutes. After the procedures, patients spent an average of 51 minutes in the recovery room following an exam and 65 minutes after a transplant.

The researchers used a device called a laryngeal mask airway during the exams, which proved successful and did not lead to any complications. They also found that general anesthesia and the process of inserting a tube into the airway were generally well-tolerated by these young patients.

However, they note that healthcare providers should be aware of potential heart and other systemic issues in patients with a more complex form of Peters anomaly, known as Peters plus syndrome. The research also includes two patients with Goldenhar syndrome and Al-Gazali syndrome, conditions that often occur alongside Peters anomaly.

FAQs

  1. How are anesthetics managed in patients with Peters anomaly who require corneal transplants?
  2. What were the findings of the researchers who reviewed the medical records of children with Peters anomaly at Westchester Medical Center?
  3. What potential complications should healthcare providers be aware of in patients with complex forms of Peters anomaly?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to follow all post-operative care instructions provided by the medical team, including using prescribed eye drops and attending follow-up appointments. It is important to protect the eye from injury and avoid activities that could put strain on the transplant site. If any signs of infection or rejection develop, it is crucial to contact the doctor immediately for prompt treatment.

Suitable For

Corneal transplants are typically recommended for patients with conditions such as Peters anomaly, keratoconus, Fuchs’ dystrophy, and corneal scarring from injury or infection. These conditions can cause significant vision impairment and discomfort, making a corneal transplant necessary to restore vision and improve quality of life.

Patients who have not responded to other treatments such as contact lenses, glasses, or medications may also be recommended for a corneal transplant. Additionally, those with severe corneal ulcers, thinning, or irregularities may benefit from this procedure.

Overall, patients who are experiencing significant vision loss, discomfort, or other complications due to corneal conditions are typically recommended for a corneal transplant. It is important for patients to discuss their specific situation with an ophthalmologist to determine if a corneal transplant is the best course of action for them.

Timeline

Overall, the timeline of what a patient experiences before and after a corneal transplant includes:

Before the corneal transplant:

  1. Initial diagnosis of Peters anomaly or related eye condition
  2. Multiple eye exams under anesthesia to assess vision and corneal health
  3. Preparation for corneal transplant surgery, including medical evaluations and consultations with the surgeon
  4. Corneal transplant surgery, which typically takes around 104 minutes

After the corneal transplant:

  1. Recovery period in the hospital, usually around 65 minutes after the surgery
  2. Follow-up appointments with the surgeon to monitor healing and vision improvement
  3. Possible additional procedures or treatments to optimize the transplant’s success
  4. Ongoing care to ensure the long-term health of the transplanted cornea

It is important for patients with Peters anomaly or related conditions to receive specialized care from a team of healthcare providers experienced in managing these complex eye conditions and the associated anesthesia needs.

What to Ask Your Doctor

Some questions a patient should ask their doctor about corneal transplant include:

  1. What is the reason for recommending a corneal transplant in my case?
  2. What are the potential risks and complications associated with a corneal transplant procedure?
  3. How long is the recovery period after a corneal transplant, and what can I expect during this time?
  4. Will I need to take any medications or follow a specific post-operative care routine after the transplant?
  5. How successful are corneal transplants in patients with my specific condition (such as Peters anomaly)?
  6. Are there any alternative treatments or procedures that could be considered instead of a corneal transplant?
  7. What is the expected outcome in terms of improved vision or overall eye health after a corneal transplant?
  8. How many corneal transplants have you performed, and what is your success rate?
  9. What is the long-term prognosis for my vision and eye health following a corneal transplant?
  10. Are there any specific lifestyle changes or precautions I should take after a corneal transplant to protect my eye health?

Reference

Authors: Salik I, Gupta A, Tara A, Zaidman G, Barst S. Journal: Paediatr Anaesth. 2020 May;30(5):577-583. doi: 10.1111/pan.13843. Epub 2020 Mar 16. PMID: 32107814