Prospective evaluation of corneal endothelial cell loss after pediatric cataract surgery

Purpose: To study the alterations in endothelial cell count and morphology after pediatric cataract surgery using currently practiced techniques. Setting: L.V. Prasad Eye Institute, Hyderabad, India. Methods: In a prospective nonrandomized series comprising 20 eyes of 14 children with congenital or developmental cataract, endothelial cell loss from cataract surgery was evaluated. Mean patient age was 9.3 years (range 5 to 15 years). Extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation was performed in 11 eyes (Group 1). Primary posterior capsulotomy and anterior vitrectomy were performed with ECCE and IOL implantation in 9 eyes (Group 2). Noncontact specular microscopy was done preoperatively and 6 to 8 and 24 to 36 weeks postoperatively. Endothelial cell loss, alteration in the coefficient of variation, and the change in the number of hexagonal cells were determined by semiautomated analysis of endothelial pictures. Results: Mean endothelial cell loss was 198.39 cells/mm² (5.28%) in Group 1 and 295.17 cells/mm² (7.50%) in Group 2 at 24 to 36 weeks. There was no statistically significantly difference in alteration in endothelial cell count and morphology between the 2 groups. Conclusions: The results suggest that endothelial cell loss with currently practiced techniques of pediatric cataract surgery is within acceptable limits.