Related Experiment Video
Updated: Jun 13, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
[Prospective study on the repercussions of oculomotor surgery on children's corneal endothelium]
1Service d'ophtalmologie, hôpital Nord, chemin des Bourrely, 13015 Marseille, France. daniele.denis@ap-hm.fr
Insights
Strabismus surgery in children did not significantly decrease corneal endothelial cell density (ECD). However, the most aggressive surgical procedures showed significant changes in cell shape and size, indicating increased pleomorphism.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Science
Background:
- Strabismus surgery aims to correct eye alignment in children.
- Corneal endothelial cells are crucial for maintaining corneal clarity and function.
- Assessing the impact of strabismus surgery on corneal endothelium is important for understanding potential long-term effects.
Purpose of the Study:
- To evaluate changes in corneal endothelial cells after strabismus surgery in pediatric patients.
- To compare corneal endothelial cell density (ECD), hexagonality (H), and polymegethism across different surgical approaches.
Main Methods:
- A prospective study included 34 children undergoing strabismus surgery.
- Non-contact specular microscopy was used to measure ECD, H, and polymegethism.
- Patients were categorized into four groups based on the specific surgical procedure performed.
Main Results:
- Overall, strabismus surgery did not lead to a statistically significant decrease in mean ECD.
- A significant decrease in hexagonality (H) was observed postoperatively, indicating increased cell shape variability.
- The most aggressive surgical procedure (posterior fixation with medial rectus recession) showed a statistically significant decrease in H (p=0.039).
Conclusions:
- Strabismus surgery in children does not typically cause a significant reduction in corneal endothelial cell density.
- Surgical interventions can lead to significant changes in corneal endothelial cell morphology (pleomorphism), particularly with more invasive procedures.
- Further research may be warranted to explore the clinical significance of these morphological changes.
Purpose:
To compare corneal endothelial cells following strabismus surgery in children.
Methods:
Thirty-four children, 18 boys and 16 girls (mean age, 8.21 years) who had undergone strabismus surgery were included in a prospective study from September 2007 to November 2008. Following non-contact specular microscopy (type Topcon SP 2000P), endothelial cell density (ECD), endothelial pleomorphism (hexagonality (H)) and area cells (polymegethism) were measured in a 3 x 6-cm area. Four groups were established according to the type of surgery: group 1 (n=8), isolated posterior fixation on the medial rectus; group 2 (n=18), posterior fixation with recession of the medial rectus; group 3 (n=19), recession of the lateral rectus muscle; group 4 (n=5), resection of the superior oblique muscle.
Results:
The mean preoperative values for ECD, hexagonality (H) and cell areas were 3413.8 cells/mm(2), 68.4 % and 11.62 % for 100 microm(2), 39.56 % for 200 microm(2), 36.66 % for 300 microm(2), 8.78 % for 400 microm(2), 1.59 % for 500 microm(2) and 1.79 % for 600 microm(2), with homogenous distribution. The mean postoperative values were 3391.9 cells/mm(2), 63.95 % (-6.16 %, statistically significant). Postoperatively, we found a nonsignificant increasing percentage for 200 and 300microm(2) and decreasing for 400 and 500 microm(2). Group 1 showed mean pre- and postoperative ECD at 3501.7 + or - 399.7 and 3499.7 + or - 243.28 cells/mm(2), respectively; H was + 0.43 %; group 2 showed 3498.3 + or - 182.8 and 3422.8 + or - 274.2 cells/mm(2), respectively; -13.66 % for H (p=0.039); group 3 had 3238 + or - 385.5 and 3366 + or - 334.4 cells/mm(2), respectively; -3.29 % for H; and group 4 had 3264 + or - 325.36 and 3328 + or - 124.42 cells/mm(2), respectively; -6.2 % for H. A decrease in H was found in group 2 (p<0.0001).
Discussion-Conclusion:
Strabismus surgery cannot result in a significant decrease in ECD but reveals pleomorphism changes (significant) for the most aggressive procedure.
