The aim of this study is to evaluate central corneal thickness (CCT),and endothelial cell density (ECD) and its morphology in patients with previous congenital cataract surgery with or without IOL,and to see whether the age at the time of surgery affects central corneal thickness.

CCT measurement and specular microscopy including endothelial cell density (ECD),endothelial cell coefficient of variation (CV),and hexogonality of corneal endothelial cells (Hex) were performed on 65 aphakic and pseudophakic eyes of 38 patients who had previously undergone congenital cataract surgery before the age of six,and the data were compared with 54 eyes belonging to an age-matched control group.CCT was measured with ultrasound pachymetry,and endothelial cell density,and its morphology was measured with specular microscopy.

The mean CCT of aphakic eyes (638.5±60.7 µm) was greater than control (572.5±50.4µm, p<0.0001) and psuedophakic eyes (549.7±69.6 µm, p<0.0001).Mean ECD in aphkakic eyes (3482.75±912.24)was greater than psuedophakic eyes (3010.2±410.9, p<0.0001)but was not different from control eyes(3218.8±282.8, p=0.17). Mean CV in aphakic eyes(32.5±15.6)was greater than psuedophakic(25.9±7.7, p=0.01)and control eyes(25.5±5.2, p=0.01).Mean Hex in aphakic eyes (57.95±32.53) was smaller than control eyes (75.6±13.4, p<0.05).When we consider aphakic and psuedophakaic eyes as one group,the central corneal thickness is reversely correlated with age at the time of surgery(r=-0.5, P<0.0001).

Although the corneal ECD of aphakic eyes was not significantly different from control eyes,the CCT of aphakic eyes was significantly more than control and pseudophakic eyes.Hence, it appears that endothelial cell loss is not the cause of increased CCT after cataract surgery in childhood.The abnormality of the corneal endothelial cell characteristics of aphakic eyes, compared to normal and psuedophakic eyes, may play a role in increasing CCT after congenital cataract surgery. The inverse relationship between age at the time of surgery and CCT indicates that this could be the main cause of increased CCT after cataract surgery in childhood.