[Central corneal thickness and endothelial cell density in congenital glaucoma]

The aim of this study was to compare endothelial cell density and central corneal thickness between eyes with congenital glaucoma and normal eyes.

We conducted a prospective study of pediatric patients between 3 and 18 years of age. Group A comprised 401 normal eyes and group B 69 glaucoma eyes, categorized into three subgroups: 3-4, 5-9, and 10 or more years of age. Measurements were taken using the Topcon SP 2000 specular microscope.

The mean pachymetry in group B (519+/-34 microm) was significantly thinner than in group A (529+/-32 microm) (p<0.05). There was a significant positive correlation with age in the two groups (p<0.05 ANOVA) until the 5- to 9-year-old subgroup. The mean endothelial cell density in group B (2,922+/-553 cells/mm2) was lower than in group A (3,470+/-357 cells/mm2) (p<0.01). There was a significant negative correlation with age in group A (p<0.01 ANOVA).

Corneal distension attributable to intraocular hypertony may explain the thinner pachymetry. In congenital glaucoma, a thinner cornea may tend to lower tonometrically recorded intraocular pressure. Glaucoma seems to be the main factor of the endothelial cell loss.

Central corneal thickness and endothelial cell density should be taken into account when managing congenital glaucoma to avoid undertreatment and to measure endothelial damage.