Changes in Central Corneal Thickness and Endothelial Cell Count Following Pediatric Cataract Surgery.

Objective: To evaluate the mean changes in Central Corneal Thickness (CCT) and Endothelial Cell Count (ECC) in eyes after pediatric cataract surgery with foldable intraocular lens using scleral tunnel incision micro-surgical technique.

Study Design: Qausi experimental study.

Place And Duration Of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2011 to March 2012.

Methodology: Fifty-two eyes of 37 children with pediatric cataract were included in the study. Extracapsular Cataract Extraction (ECE) with foldable Intra Ocular Lens (IOL) implantation using sclera tunnel incision was performed in all children. Endothelial Cell Count (ECC) and Central Corneal Thickness (CCT) were recorded before surgery and 1 month, 3 months and 6 months after surgery and the effect of currently practiced surgical technique on ECC and CCT was evaluated.

Results: The mean age at the time of surgery was 8.8 ±2.7 years (range: 4 to 15 years). The postoperative ECC and CCT were significantly different from the pre-operative values. Mean pre-operative ECC was 3175.3 ±218.4 cell/mm2 and in first postoperative month the mean ECC was 3113.4 ±210.8 cell/mm2(p<0.0001). In the 3rd and 6th month postoperative means ECC were 3052 ±202.5 cell/mm2(p<0.0001) and 3015 ±190.6 cell/mm2(p<0.0001), respectively. The mean cell loss at first postoperative month was 1.95% and at 3rd and 6th postoperative month were 3.9% and 5.05%, respectively. Mean pre-operative CCT was 514 ±49.9 µm and first postoperative mean CCT after 1 month was 524.1 ±25 µm (p = 0.084). After the 3rd and 6th months postoperative, mean CCT were 527.3 ±24.6 µm, and 530 ±24.5 µm, respectively. Third and 6th months postoperative means were significantly higher than baseline CCT, p = 0.024 and 0.007, respectively.

Conclusion: Endothelial cell loss with closed chamber micro-surgical technique using scleral tunnel incision is within acceptable limits and within the range of normal ECC in children.