Objective: To describe a new manifestation of Peters' anomaly.

Methods: We managed four infants with an unusual form of Peters' anomaly. One eye of each patient had a thickened and scarred cornea, mimicking a corneal staphyloma, protruding anteriorly from the corneal plane. The other eye of each patient ranged from normal to having severe ocular anomalies. A corneal transplant was performed in each case.

Results: Follow-up ranged from 1 to 3 years. Three eyes maintained graft clarity for at least 1 year. Each of these eyes developed vision. Two of these eyes developed glaucoma. The one eye with graft failure developed an inoperable retinal detachment. The histopathology of each corneal button showed changes consistent with Peters' anomaly.

Conclusions: These corneas demonstrated characteristics of both Peters' anomaly and congenital anterior staphyloma. Despite their severe anomalies, surgery successfully restored a more normal cosmetic appearance in all four eyes and vision in three eyes.