title: Corneal Endothelial Cell Density in Children: Normative Data From Birth to 5 Years Old.
abstract: OBJECTIVE
  To establish a normative database of endothelial cell density (ECD) using in vivo specular microscopy in children under 5 years old.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Specular microscopy was performed during a clinic visit in cooperative children in the standard upright position. In uncooperative children, specular microscopy was performed in the lateral decubitus position under general anesthesia, before surgery for other reasons. Corneal diameter (CD) was measured in children undergoing general anesthesia and was stratified according to age.
  
  
  RESULTS
  One hundred and eighteen eyes of 118 patients were included in the study. The mean patient age was 2.6 ± 1.4 years (range 0.1-5 years) and the mean ECD was 3746 ± 370 cells/mm2(range 3145-5013 cells/mm2). The mean CD under 2 years of age was 11.85 ± 0.57 mm (n = 40, range 10.50-12.75 mm). Up to 2 years of age, ECD was more inversely correlated with CD than with age (r = -0.61, P < .0001; r = -0.38, P = .01, respectively). In contrast, after the age of 2 years, the ECD was inversely correlated with age but not with CD (r = -0.27, P = .02; r = -0.24, P = .2). Between the first and second year of life, the rate of ECD decrease was significantly higher than between 2 and 5 years of age (8.2%, 334 cells/mm2vs 2.7%, 100 cells/mm2a year, respectively).
  
  
  CONCLUSIONS
  In the first 2 years of life there is a rapid decline in ECD, which is likely related to growth in CD and hence surface area. After the cornea reaches adult size, the ECD decreases at a rate similar to that reported in adults.
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Uri
authors.initials: U
authors.lastname: Elbaz
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kamiar
authors.initials: K
authors.lastname: Mireskandari
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Tehrani
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carl
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Muhammad Saad
authors.initials: MS
authors.lastname: Khan
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Williams
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: asim.ali@sickkids.ca.
authors.forename: Asim
authors.initials: A
authors.lastname: Ali
mesh_terms: D002452:Cell Count; D002675:Child, Preschool; D003316:Corneal Diseases / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018613:Microscopy, Confocal; D011379:Prognosis