Posterior corneal morphological changes in primary congenital glaucoma.

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Corneal Imaging

Background:

• Primary congenital glaucoma (PCG) is a severe form of glaucoma in infants.
• Understanding corneal changes in PCG is crucial for managing the condition.
• Posterior corneal morphology can be affected by intraocular pressure and surgical interventions.

Purpose of the Study:

• To compare posterior corneal morphology in older treated versus younger untreated children with PCG.
• To utilize anterior segment optical coherence tomography (ASOCT) and intraoperative OCT (iOCT) for detailed imaging.

Main Methods:

• Comparative study analyzing ASOCT images of older PCG children and iOCT images of younger untreated PCG patients.
• Assessment of posterior corneal layers, including Descemet's membrane (DM) and pre-Descemet's layer (PDL).
• Correlation of Haab's striae extent with DM/PDL thickness in the treated group.

Main Results:

• Older treated eyes (87) exhibited DM excrescences, thickened DM, twin protuberances, DM detachment, and PDL changes.
• Haab's striae extent correlated with DM/PDL thickness in treated eyes (P=0.008).
• Younger untreated eyes (53) showed diffuse DM/PDL hyper-reflectivity but no DM tears.

Conclusions:

• Posterior cornea in treated PCG eyes thickens and develops more circumscribed Haab's striae over time.
• These changes may indicate a healing response of the posterior cornea following treatment.
• Significant differences in posterior corneal morphology exist between treated and untreated PCG patients.