Impact of morphological variations on preoperative and postoperative central corneal thickness in congenital cataract: a retrospective observational study

TL;DR

This study found that specific types of congenital cataracts and surgery affect corneal thickness in children.

Contribution

The study identifies morphological cataract types linked to thicker corneas and shows surgery increases corneal thickness.

Findings

Cataracts in the 'others' morphology group had significantly thicker preoperative corneal thickness.

Preoperative corneal thickness decreased with increasing age.

Postoperative corneal thickness was significantly higher than preoperative measurements.

Abstract

Central corneal thickness (CCT) has been reported to be thicker in aphakic and pseudophakic eyes after congenital cataract surgery. We aimed to investigate the factors influencing preoperative CCT and changes in CCT after cataract surgery.

We included 62 eyes of 39 patients with congenital cataracts who underwent cataract surgery at Hiroshima University between February 2006 and July 2022. Pre- and postoperative CCT were measured using a noncontact specular microscope or ultrasound pachymeter. Cataracts were categorized into five morphologies: anterior, posterior, nuclear, total, and others (aculeiform, calcific, cortical, lamellar, pulverulent, and membranous). Statistical analyses were conducted using JMP software, with significance set at P < 0.05.

No significant differences in CCT were observed between bilateral and unilateral cataracts or between operated and fellow eyes with unilateral cataracts. However, when cataracts were categorized according to morphology into five categories, namely, anterior cataract, posterior cataract, nuclear cataract, total cataract, and others, the others group exhibited significantly thicker CCT than did the control group (566.6 ± 76.2 µm vs. 525.9 ± 31.2 µm, P = 0.032). Preoperative CCT decreased inversely with age. Postoperative CCT increased significantly compared with preoperative measurements (544.0 ± 35.9 µm vs. 534.5 ± 28.4 µm, P = 0.021).

This study highlights that congenital cataract of specific morphologies, particularly those classified in the others group, affect CCT. Preoperative CCT decreased with age. The increase in postoperative CCT suggests that surgical intervention can affect corneal thickness.

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