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Cataract surgery for congenital cataract: Endothelial cell characteristics, corneal thickness, and impact on intraocular pressure

https://doi.org/10.1016/j.jaapos.2006.08.017Get rights and content

Purpose

To investigate whether central corneal thickness (CCT), endothelial cell characteristics, and intraocular pressure (IOP) are affected in patients with previous congenital cataract surgery and to focus on their clinical significance.

Methods

CCT and IOP measurements and specular microscopy were performed in 31 eyes of 17 cases of extracted congenital cataracts and 40 eyes of 20 age- and sex-matched participants as control group. The mean of three pachymetry measurements of the central cornea was taken as CCT. IOP was checked using an applanation tonometer.

Results

The mean corneal thickness of the eyes with extracted congenital cataract (632 ± 45 μm) was significantly greater than that of the control eyes (546 ± 33 μm; p < 0.001). There was no significant difference in the corneal endothelial cell count, coefficient of variation (CV), and mean cell area (AVG) of endothelial cells between operated eyes and the control group. The mean measured IOP in the operated group (22.8 ± 3.3 mm Hg) was significantly greater than IOP in controls (14.1±1.8 mm Hg, p < 0.001).

Conclusions

Although the corneas were clinically clear and there was no significant difference in endothelial characteristics of eyes with extracted congenital cataract and controls, central corneas of operated eyes were significantly thicker than those of controls. To differentiate the actual glaucoma from ocular hypertension in these patients, the central corneal thickness measurement should strongly be considered.

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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None of the authors have any financial interest in the subject matter of this article.

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