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Case Reports
. 2019 Mar 6;7(5):642-649.
doi: 10.12998/wjcc.v7.i5.642.

Perioperative topical ascorbic acid for the prevention of phacoemulsification-related corneal endothelial damage: Two case reports and review of literature

Chia-Yi Lee  1 , Hung-Ta Chen  2 , Yi-Jen Hsueh  3 , Hung-Chi Chen  3 , Chieh-Cheng Huang  4 , Yaa-Jyuhn James Meir  5 , Chao-Min Cheng  4 , Wei-Chi Wu  3
Affiliations
Case Reports

Perioperative topical ascorbic acid for the prevention of phacoemulsification-related corneal endothelial damage: Two case reports and review of literature

Chia-Yi Lee et al. World J Clin Cases. .

Abstract

Background: The current case report describes successful phacoemulsification with the aid of perioperative topical ascorbic acid (AA) in two patients with corneal endothelial disorders to prevent postoperative corneal endothelial decompensation.

Case summary: Two eyes of two patients underwent phacoemulsification with pre-existing corneal endothelial disorders including Fuchs corneal endothelial dystrophy (Patient 1) and endotheliitis (Patient 2). Topical AA was applied to both patients at least one month before and after with a frequency of four times per day. After the surgery, both eyes improved best-corrected visual acuity (BCVA) and there was limited human corneal endothelial cell loss without signs of corneal endothelial decompensation, such as deteriorated BCVA or persistent corneal edema during the follow-up of at least two years.

Conclusion: Perioperative administration of topical AA may be an alternative therapy to the triple procedure in patients expecting to undergo cataract surgery.

Keywords: Ascorbic acid; Case report; Endotheliitis; Fuchs corneal endothelial dystrophy; Human corneal endothelial cell; Phacoemulsification.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The corneal endothelium condition before and after cataract surgery in the left eye of Patient 2. A: Preoperative corneal appearance via silt-lamp biomicroscope; B: Preoperative corneal endothelial cell density via specular microscope; C: Postoperative corneal appearance via silt-lamp biomicroscope; D: Postoperative corneal endothelial cell density via specular microscope.
Figure 2
Figure 2
The appearance of Fuchs endothelial corneal dystrophy in Patient 1. A: External eye appearance and guttate formation (left bracket) in the right eye; B: External eye appearance and guttate formation (left bracket) in the left eye.
Figure 3
Figure 3
The corneal endothelium condition before and after cataract surgery in the left eye of Patient 1. A: Preoperative corneal appearance via silt-lamp biomicroscope; B: Preoperative corneal endothelial cell density via specular microscope; C: Postoperative corneal appearance via silt-lamp biomicroscope; D: Postoperative corneal endothelial cell density via specular microscope.
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