Changes of corneal central thickness of aphakia following congenital cataract surgery under the first six months of life

Central corneal thickness measurements in phakic, pseudophakic, and aphakic children with ultrasound pachymetry and different non-contact devices

AIMS

Evidence for choosing a satisfactory device for central corneal thickness (CCT) measurement in children particularly pseudophakic and aphakic ones is insufficient. The aim of this study is to compare four differently measured CCTs obtained using ultrasound pachymetry (UP), Pentacam, partial coherence interferometry (PCI), and specular microscopy (SM) in phakic, pseudophakic, and aphakic children and assess the agreement between the six pairs of the methods.

METHODS

Children with history of cataract surgery at age six or younger and phakic children were recruited into this study. CCT was measured using UP (Optikon 2000, Rome, Italy), Pentacam (Oculus Inc, Wetzlar, Germany), PCI (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany), and SM (Topcon SP-3000P; Topcon Corporation, Japan).

RESULTS

One-hundred two eyes (53 phakic, 29 pseudophakic, and 20 aphakic eyes) were included. The mean ages (± SD) of phakic, pseudophakic, and aphakic cases were 9.75 (± 3.3), 9.9 (± 2.3), and 8.2 (± 2.8) years, respectively. The mean CCTs (± SE) for phakic children using Pentacam, PCI, UP, and SM were 549.7 (± 5.0), 546.5 (± 4.5), 565.9 (± 5.5), and 506.2 (± 4.4) μm, respectively, for pseudophakic cases were 570.1 (± 6.4), 565.0 (± 6.1), 571.9 (± 6.3), and 524.3 (± 6.3) μm, respectively, and for aphakic participants were 635.3 (± 14.2), 635.4 (± 14.5), 649.0 (± 13.5), and 589.1 (± 13.3) μm, respectively.

CONCLUSION

Compared to Pentacam and PCI, SM underestimated CCT particularly in phakic and pseudophakic children, whereas UP slightly overestimated CCT especially in phakic and aphakic children. Furthermore, Pentacam and PCI had the closest agreement. By contrast, SM had the poorest agreement with the other three methods.

Prevalence of Corneal Astigmatism and Anterior Segmental Biometry Characteristics Before Surgery in Chinese Congenital Cataract Patients

The prevalence and the distribution characteristics of corneal astigmatism (CA) and anterior segment biometry before surgery in Chinese congenital cataract (CC) patients are not completely understood. This study involved 400 CC patients from the Zhongshan Ophthalmic Center enrolled from February 2011 to August 2015. Data on CA, keratometry, central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by the Pentacam Scheimpflug System. The mean age of patients was 54.27 months, and the ratio of boys to girls was 1.53:1. The mean CA was 2.03 diopters (D), and 39.25% of subjects had CA values ≥2 D. The most frequent (71.8%) diagnosis was with-the-rule astigmatism. Oblique astigmatism was present in 16.2% of cases, and 12% of cases had against-the-rule astigmatism. The mean keratometry measurement of cataractous eyes in bilateral patients was significantly larger than that in unilateral patients. Girls had a larger mean keratometry but a thinner CCT than did boys. The CA, CCT, and ACD of cataractous eyes were significantly larger than those of non-cataractous eyes in unilateral patients. The CA, mean keratometry, CCT, and ACD in CC patients varied with age, gender, and laterality. Fully understanding these characteristics may help inform guidelines and treatment decisions in CC patients.