Purpose: Corneal changes are prevalent in eyes with primary congenital glaucoma (PCG). This study aimed to describe corneal irregularity and high-order aberrations (HOAs) in PCG eyes.
Materials and methods: The study consecutively enrolled 61 PCG eyes (of 39 participants with PCG) and 61 age-matched control eyes (of 61 healthy participants). Participants underwent corneal topography, best spectacle-corrected visual acuity (BSCVA), and fundus photography. Corneal irregularity and HOAs were derived from topographic data and evaluated over central 4 and 6 mm diameter zones. Variables were compared between PCG and control eyes. Percentages of PCG eyes with abnormal corneal irregularity and HOAs were calculated.
Results: The median ages of PCG and control participants were 8.8 and 8.6 years, respectively. Irregularity and total HOAs across both 4 and 6 mm zones were greater in PCG than in control eyes. The median irregularity of PCG eyes was 2 to 5 times that of the controls, whereas, their median total HOAs were approximately twice those of the controls. Thirty-nine (64%), 53 (87%), and 40 (66%) PCG eyes had abnormal (either 4 or 6 mm zone) anterior irregularity, posterior irregularity, and total HOAs. Similar percentages were observed among eyes with a cup-to-disc ratio <0.6 (n=28). Among 13 eyes with cup-to-disc ratio <0.6 but abnormal 4 mm total corneal HOAs, 9 (69%) had BSCVA<20/25, whereas only 1 of 7 (14%) had BSCVA<20/25 among eyes with normal HOAs.
Conclusions: Abnormal corneal irregularity and HOAs are common in PCG eyes, even in those with limited optic nerve damage. These abnormalities relate to compromised visual outcomes.