Abstract
Introduction: While flat keratometry contributes to the hyperopia and associated refractive accommodative esotropia that is part of recessive cornea plana, whether or not axial lengths are abnormally short in the disease is unclear. In this study we assess this possibility.
Methods: Prospective (2010-2012) axial length measurement (IOLmaster; Carl Zeiss, Oberkochen, Germany) of affected right eyes and comparison to right eyes with refractive accommodative esotropia only. Keratometry and refraction were also performed.
Results: For eight affected right eyes (age 10-12 years; seven families) axial length ranged from 21.46-24.80 mm (mean 23.34). Best corrected visual acuity ranged from 20/25 to 20/50, keratometry from 25.33-39.80 diopters (D) [mean 31.80], and refraction from +2.00 to +14.00 D (mean +7.22). For 50 control right eyes (age 4-12 years), axial length ranged from 19.87-23.66 mm (mean 21.6). Best-corrected visual acuity was 20/25 or better, keratometry ranged from 39.81-46.25 D (mean 42.42), and refraction from +2.25 to +8.00 D (mean 4.71). Axial lengths were longer in the affected group (2-tailed unpaired t-test p value 0.000005) despite greater hyperopia (2-tailed unpaired t-test p value 0.001).
Conclusions: Despite greater hyperopia, axial lengths were longer in eyes with recessive cornea plana, evidence that axial lengths are not shortened by the disease. Keratometry in children with cornea plana was below the range of controls and was the major factor underlying the phenotype's hyperopia.