title: A retrospective pilot study to assess the impact of strabismus surgery on the corneal endothelium in children.
abstract: OBJECTIVE
  To investigate if strabismus surgery has an impact on the corneal endothelium in children.
  
  
  METHODS
  Fourteen children who had undergone uncomplicated strabismus surgery an average of 41 months previously (range 24-73 months) were compared with a group of age-matched (range 5-12 years) and refractive error (RE)-matched (range -4.74 to +4.25 D) children. Following noncontact specular microscopy, areas of at least 100 cells were measured, the number of sides for each cell recorded, and endothelial cell density (ECD) calculated from the area measures. Corneal diameter was measured with a clinical rule, corneal curvature with a manual keratometer, central corneal thickness (CCT) by ultrasound pachometry, and IOP by non-contact tonometry.
  
  
  RESULTS
  The average ECD (+/-S.D.) in the post-surgery group was 4467+/-627 cells mm(-2), which was significantly higher (p < 0.02) than in the control group (3781+/-452 cells mm(-2)). This was because the average endothelial cell area in the surgery group was significantly smaller than in the control group (p < 0.005; 252+/-25 microm2 vs 296+/-29 microm2). Differences in cell areas were slightly greater for smaller cells (-15.7% for five-sided cells, -15.6% for six-sided cells, -14.3% for seven-sided cells and -13.8% for eight-sided cells). The cell differences appear to be related to both a slightly smaller corneal diameter (11.00+/-0.52 mm vs. 11.21+/-0.58 mm) and a slightly higher CCT (0.528+/-0.033 mm vs. 0.515+/-0.032 mm) in the post-operative group.
  
  
  CONCLUSIONS
  The endothelial mosaic in children after strabismus surgery can show a higher than expected ECD value and slight cell pleomorphism. These signs indicate that there might be differences in eye growth and endothelial inflammatory stress associated with uneventful strabismus surgery.
authors.affiliation: Department of Vision Sciences, Glasgow Caledonian University, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Doughty
authors.forename: Lesley
authors.initials: L
authors.lastname: Watson
mesh_terms: D017677:Age Distribution; D048429:Cell Size; D002648:Child; D002675:Child, Preschool; D004728:Endothelium, Corneal / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods; D010865:Pilot Projects; D011184:Postoperative Period; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*