Surgical Detachment of Irido- and Lenticulocorneal Adhesions in Congenital Corneal Opacity.

PURPOSE: To report anatomical and visual acuity outcomes of surgical detachment of iridocorneal and lenticulocorneal adhesions in pediatric patients with mild to moderate congenital corneal opacity (CCO).

METHODS

An observational study with a longitudinal design including 16 eyes of 10 patients, aged between 8 months and 15 years, with CCO, irido- or lenticulocorneal adhesions and detectable Descemet membrane (DM) reflectivity in anterior segment optical coherence tomography (AS-OCT) images, treated by surgical detachment of iridocorneal or lenticulocorneal adhesions between 2011 and 2025 at the Helsinki University Hospital. The main outcome measures were best-corrected visual acuity (BCVA), anatomical outcome assessed with AS-OCT, and surgical complications.

RESULTS

The median age at surgery was 13 months (range, 5-56), and follow-up time from presentation to the last appointment ranged from 7 to 166 months (median 154). No intraoperative complications were recorded. Of the 11 eyes of 7 patients aged between 13 and 15 years and thereby with completed visual development, 4 had a BCVA of 0.2 to 0.4, 5 of 0.6 to 1.0, and 1 of 1.2 logMAR. One eye was legally blind. The anterior segment anatomy was stable after surgery, showing mild corneal clarification. In a patient who had lenticulocorneal adhesions detached, cataract surgery became timely only after 11 years at the age of 13.

CONCLUSIONS

Surgical detachment of iridocorneal and lenticulocorneal adhesions in mild to moderate CCO with detectable Descemet membrane AS-OCT reflectivity enabled stable anatomical and BCVA outcomes without major complications.