Abstract
Purpose: :
to investigate if strabismus surgery has an impact on the corneal endothelium in children
Methods: :
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.
Results: :
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).
Conclusions: :
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.
Keywords: cornea: endothelium • strabismus: treatment • anatomy