Central corneal thickness and corneal diameter in patients with childhood glaucoma

PURPOSE: To determine and compare the central corneal thickness (CCT) and corneal diameter among groups of patients with childhood glaucomas and assess the relationship between CCT and corneal diameter in these patients. DESIGN: A multicenter observational case series using prospective and retrospective data. METHODS: Patients from the Scheie Eye Institute, Children's Hospital of Philadelphia, and Emory and Vanderbilt Medical Centers with childhood glaucomas were eligible to participate. Retrospective data on CCT and corneal diameter of these patients were collected when available; otherwise, patients were asked to return to the ophthalmology clinics for measurements. Patients with corneal edema or central corneal scarring were excluded. One hundred eighty four glaucomatous eyes from 109 patients (median age=9.0 y; age range=0 to 60 y) were included. RESULTS: The mean CCT (±SE) was 651.1±63.5 μm for aphakic, 528.7±38.5 μm for Axenfeld-Rieger, and 563.4±67.9 μm for 1° infantile eyes. The mean corneal diameter in aphakic, Axenfeld-Rieger, and 1° infantile glaucoma eyes were 11.2±1.0, 12.5±0.9, and 13.2±1.2 mm, respectively. There was a significant difference in CCT and in corneal diameter between aphakic and 1° infantile glaucoma eyes, and between aphakic and Axenfeld-Rieger eyes (P<0.0001). There was a negative correlation between CCT and corneal diameter in all eyes (r=-0.41, P<0.0001). CONCLUSIONS: Patients with aphakic glaucoma are different from those with congenital glaucoma or Axenfeld-Rieger in CCT and corneal diameter. A patient with pediatric glaucoma and a larger corneal diameter was more likely to have a thinner CCT. Attention should be paid to the CCT of patients with childhood glaucomas for interpretation of intraocular pressure.