[Prospective study on the repercussions of oculomotor surgery on children's corneal endothelium].
OBJECTIVE
To compare corneal endothelial cells following strabismus surgery in children.


METHODS
Thirty-four children, 18 boys and 16 girls (mean age, 8.21 years) who had undergone strabismus surgery were included in a prospective study from September 2007 to November 2008. Following non-contact specular microscopy (type Topcon SP 2000P), endothelial cell density (ECD), endothelial pleomorphism (hexagonality (H)) and area cells (polymegethism) were measured in a 3 x 6-cm area. Four groups were established according to the type of surgery: group 1 (n=8), isolated posterior fixation on the medial rectus; group 2 (n=18), posterior fixation with recession of the medial rectus; group 3 (n=19), recession of the lateral rectus muscle; group 4 (n=5), resection of the superior oblique muscle.


RESULTS
The mean preoperative values for ECD, hexagonality (H) and cell areas were 3413.8 cells/mm(2), 68.4 % and 11.62 % for 100 microm(2), 39.56 % for 200 microm(2), 36.66 % for 300 microm(2), 8.78 % for 400 microm(2), 1.59 % for 500 microm(2) and 1.79 % for 600 microm(2), with homogenous distribution. The mean postoperative values were 3391.9 cells/mm(2), 63.95 % (-6.16 %, statistically significant). Postoperatively, we found a nonsignificant increasing percentage for 200 and 300microm(2) and decreasing for 400 and 500 microm(2). Group 1 showed mean pre- and postoperative ECD at 3501.7 + or - 399.7 and 3499.7 + or - 243.28 cells/mm(2), respectively; H was + 0.43 %; group 2 showed 3498.3 + or - 182.8 and 3422.8 + or - 274.2 cells/mm(2), respectively; -13.66 % for H (p=0.039); group 3 had 3238 + or - 385.5 and 3366 + or - 334.4 cells/mm(2), respectively; -3.29 % for H; and group 4 had 3264 + or - 325.36 and 3328 + or - 124.42 cells/mm(2), respectively; -6.2 % for H. A decrease in H was found in group 2 (p<0.0001).


CONCLUSIONS
Strabismus surgery cannot result in a significant decrease in ECD but reveals pleomorphism changes (significant) for the most aggressive procedure.
Denis
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D
Service d'ophtalmologie, hôpital Nord, chemin des Bourrely, 13015 Marseille, France. daniele.denis@ap-hm.fr
Toesca
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E
D002648:Child; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*