Central Corneal Thickness in Pediatric Glaucoma

Purpose: To compare the central corneal thickness (CCT) of children with and without glaucoma and to estimate the effect CCT may have on the intraocular pressure (IOP) assessment of children. Patients and Methods: CCT and IOP measurements were performed in an unmasked fashion in 34 consecutive children with glaucoma and 28 consecutive children without glaucoma. Patients with corneal edema or extensive corneal scarring were excluded. lOPs in the pediatric glaucoma group were corrected for CCT using a linear algorithm; adjustments of 3 mm Hg or more were considered clinically significant. Results: Mean CCT for eyes with glaucoma was 610.2 ± 121.9 μm; for the control eyes, mean CCT was 555.6 ± 38.4 μm (P <.001). Mean CCT was 543.3 ± 66.9 μm for eyes with primary congenital glaucoma, 591.9 ± 23.1 μm for those with Sturge-Weber syndrome, 662.7 ± 68.7 μm for those with aphakic glaucoma, 754.5 ± 92.6 μm for those with aniridia, and 820.6 ± 133.7 μm for those with microcornea (P <.001). Applying a correction formula for IOP with CCT adjustment, the adjusted IOP was overestimated by ≥ 3 mm Hg in 14 (41.2%) eyes and underestimated by ≥ 3 mm Hg in 5 (14.7%) eyes. Conclusions: The mean CCT was higher for the pediatric glaucoma group than for the control group. However, the CCTs varied significantly depending on the specific diagnoses. CCT was estimated to have a clinically significant effect on IOP measurements in more than half of the patients with pediatric glaucoma. Pachymetry results should be considered in the management of these patients.