Central corneal thickness and endothelial cell density in congenital glaucoma

Purpose: The aim of this study was to compare endothelial cell density and central corneal thickness between eyes with congenital glaucoma and normal eyes. Materials and methods: 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. Results: The mean pachymetry in group B (519 +/- 34 mu m) was significantly thinner than in group A (529 +/- 32 mu m) (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/mm(2)) was lower than in group A (3,470 +/- 357 cells/mm(2)) (P<0.01) There was a significant negative correlation with age in group A (p<0.01 ANOVA). Discussion: 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. Conclusion: Central corneal thickness and endothelial cell density should be taken into account when managing congenital glaucoma to avoid undertreatment and to measure endothelial damage.