[Central corneal thickness and endothelial cell density in congenital glaucoma]. / Pachymétrie centrale et comptage cellulaire endothélial dans le glaucome congénital.

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 microm) was significantly thinner than in group A (529+/-32 microm) (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/mm2) was lower than in group A (3,470+/-357 cells/mm2) (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.