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Central corneal endothelial cell counts in children
Insights
Corneal endothelial cell density is stable from age five to 20 in normal eyes. Cataract surgery with intraocular lens (IOL) implantation causes significant cell loss, unlike aspiration alone.
Area of Science:
- Ophthalmology
- Cell Biology
- Biomedical Engineering
Background:
- Corneal endothelial cells (CECs) are crucial for maintaining corneal clarity.
- Understanding CEC density changes with age and during ophthalmic procedures is vital for patient outcomes.
- Previous research has not fully elucidated CEC behavior in pediatric populations or post-intraocular lens (IOL) implantation.
Purpose of the Study:
- To assess corneal endothelial cell density in a normal pediatric population.
- To quantify CEC loss following cataract aspiration versus phacoemulsification with IOL implantation.
- To compare CEC loss in IOL-implanted eyes to their normal fellow eyes.
Main Methods:
- Corneal endothelial cell counts were performed on a cohort of children aged five to 20.
- CEC density was measured before and after cataract surgery (aspiration or phacoemulsification with IOL).
- Cell loss percentages were calculated and compared between surgical groups and against fellow eyes.
Main Results:
- Mean CEC density in normal children (ages 5-20) was 2696 cells/mm².
- Cataract aspiration resulted in an average CEC loss of 7.2% compared to normal.
- Phacoemulsification with IOL implantation led to a 33.3% CEC loss compared to controls, and 38.0% compared to fellow eyes.
Conclusions:
- Corneal endothelial cell density is stable in children aged five to 20.
- Cataract aspiration alone causes minimal CEC loss.
- Intraocular lens implantation significantly increases endothelial cell loss, necessitating further investigation into protective strategies.
Abstract:
Our data indicate that corneal endothelial cell density in a normal eye remains essentially unchanged from ages five to 20. Changes in cell density and morphology during the first five years of life need further investigation. In this study, the mean endothelial cell count of a normal population of children was 2696 cells/mm2. Children undergoing cataract aspiration had a mean cell loss from the normal of 7.2%. The cell loss rates for push-pull aspiration-irrigation or phacoemulsification cataract extraction were not statistically different. The implantation of an intraocular lens was associated with a 33.3% endothelial cell loss when compared to the control or normal population of eyes. A mean loss of 38.0% was noted when the IOL eyes were compared to their normal fellow eyes.