Journal of American Association for Pediatric Ophthalmology and Strabismus
Major articleCataract surgery for congenital cataract: Endothelial cell characteristics, corneal thickness, and impact on intraocular pressure
Section snippets
Patients and methods
Thirty-one eyes of 17 patients (8 boys and 9 girls) with a mean age of 12.7±6.6 years who had undergone limbal approach lensectomy/anterior vitrectomy for congenital cataract were evaluated. These included 14 bilateral and 3 unilateral cataract extractions. The mean age at the time of the cataract operation was 19.58 ± 19.08 (range, 2-72) months. The mean time of follow-up between cataract surgery and assessments was 10.7 ± 6.08 years. All of the selected patients had clear corneas with
Results
Table 1 shows corneal thickness, endothelial characteristics, and intraocular pressure in eyes with congenital cataract extraction and controls.
The mean corneal thickness of eyes with extracted congenital cataract (632 ± 45 μm) was significantly greater than that of control eyes (546 ± 33 μm; p < 0.001). There was no significant difference in the corneal endothelial cell counts among the operated eyes (3454 ± 450 cells/mm2) and the control eyes (3470 ± 527 cells/mm2, p = 0.93). There was no significant
Discussion
Congenital cataracts interfere with normal visual development and represent an important problem in pediatric ophthalmology.1 Early removal of visually significant cataracts is probably the most important factor in determining the visual outcome of these eyes.1 However, early lens removal induces anatomic and physiologic changes in eyes with extracted congenital cataract.2, 3
Our results showed that the corneas of the eyes with extracted congenital cataract were significantly thicker than the
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Central corneal thickness and intraocular pressure changes after congenital cataract surgery with intraocular lens implantation in children younger than 2 years
2017, Journal of Cataract and Refractive SurgeryCitation Excerpt :There is an inverse relationship between age at surgery and an increase in CCT.5 Another factor attributed to damaging the corneal endothelium is the surgical stress that may increase CCT.4,11 However, children usually have soft cataracts, and I/A of lens material should not cause significant damage.
Corneal Changes in Children after Unilateral Cataract Surgery in the Infant Aphakia Treatment Study
2015, OphthalmologyCitation Excerpt :These data have several implications. Previous studies have reported EC loss after pediatric cataract surgery, with cell loss rates ranging from 0% to 9.2% with lens removal by the anterior approach.2,16–20 However, the surgical techniques (phacoemulsification vs. vitrector), length of follow-up, and use of IOLs varied in these studies.
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2011, American Journal of OphthalmologyCitation Excerpt :Our findings agree with others who have reported on the significantly thicker corneas of aphakic/pseudophakic eyes compared to age-matched controls17 and fellow eyes.12 Interestingly, in a small case-control study of endothelial cell characteristics, corneal thickness, and IOP in children after congenital cataract removal, the authors reported no significant difference in endothelial characteristics of postoperative vs phakic age- and sex-matched control eyes, although the eyes after cataract removal did show lower endothelial cell counts.18 When considering corneal diameter, we found smaller HCD in the affected eyes of children with unilateral cataract compared to the unaffected fellow eyes prior to any surgery.
Changes in central corneal thickness after congenital cataract surgery
2010, Journal of Cataract and Refractive SurgeryCitation Excerpt :In their series, only 2 primary pseudophakia patients were included. Nilforushan et al.5 report that the corneas in eyes with extracted congenital cataract were significantly thicker than in normal control eyes. They found no significant difference in the corneal endothelial cell count or morphology between operated eyes and normal eyes.
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None of the authors have any financial interest in the subject matter of this article.