IDIOPATHIC TRACTIONAL CORECTOPIA

Four infants were referred for congential unilateral corectopia. In ea ch case, the abnormal position of the pupil was caused by a fibrous st ructure that tethered the iris pupillary margin to the peripheral corn ea. No patients showed characteristics of intrauterine infection, Rieg er anomaly, ectopia lentis et pupillae, or iris coloboma. Amblyopia wa s not present in any of the patients. Three children demonstrated prog ression of the corectopia in the first 6 months of life. Two who devel oped shallow anterior chambers were treated surgically, one with an Nd :YAG laser and the other with incisional surgery. The third was treate d with medical mydriasis. All four children have had favorable visual outcomes to date. The origin of the tethering strands is unclear but m ay be related to incomplete regression of vessels from the embryologic vascular system. We recommend medical or surgical intervention for un ilateral corectopia when the pupillary aperture is displaced periphera l to the central visual axis or when the position of the iris threaten s angle structures. Prophylactic occlusion therapy may also be indicat ed.