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D. Denis, E. Toesca, H. Proust; To Assess the Impact of the Strabismus Surgery on Corneal Endothelium in Children. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4691.
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to investigate if strabismus surgery has an impact on the corneal endothelium in children
70 children, 38 boys and 32 girls who had undergone uncomplicated strabismus surgery were included from september 2007 to november 2008. The mean age was 8,1 years. The medical history of intra-ocular surgery, endocular pathology and the carriers of lenses were excluded. Following non-contact specular microscopy (type Topcon ® SP 2000 P), endothelial cell density (ECD) and endothelial pleomorphism (hexagonality) were measured in an area of 3 x 6 cm by the same operator in pre and post-surgery; The surgical procedure was realized by the same surgeon. 4 groups were established according to the type of surgery: group 1: recession of the medial recti with Faden operation; group 2: isolated Faden operation on the medial recti; group 3: recession of the lateral rectus muscle; group 4: resection of the superior oblique muscle.
the average ECD in pre-surgery was 3351 [± 544,36] cells mm2 and in post-surgery 3329 [± 825,7] cells mm2; the cellular changes (density, pleomorphism (hexagonality)) were: group 1: -180 cells / mm2 [317; 69], -18,3 % of hexagonality, group 2: -16,6 cells / mm2 [241; 175], no change of hexagonality, group 3: -106 cells / mm2 [659; 249], -2 % of hexagonality, group 4: -77,5 cells / mm2 [101; 60], -7% of hexagonality. A statistically significant decrease of the hexagonality was found in the group 1: (P < 0,005).
ischemia (anterior ciliary arteries section) and/or post-operative inflammation that occurred after surgery are both possible hypotheses.The strabismus surgery cannot result in a statistically significant decrease in ECD but reveal pleomorphism changes for the most aggressive procedure. It is important to confirm these first results.
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