Alpha-Glycerylphosphorylcholine and D-Panthenol Eye Drops in Patients Undergoing Cataract Surgery

Abstract

Cataract surgery is widespread. The surgical procedure is associated with damage to the epithelial barrier and interruption of the corneal innervation. In addition, pathological events sustain signs and symptoms that may persist for a long time. Recently, a fixed combination of alpha-glycerylphosphorylcholine and D-Panthenol (Oftassiale) has been available as eye drops. The present study investigated the effects of an Oftassiale therapy in 20 patients undergoing cataract surgery. A comparison group included 20 patients treated with topical hyaluronic acid. Standard prophylactic and anti-inflammatory treatment was prescribed to all patients. Clinical signs and symptoms were assessed over time. In vivo confocal microscopy (IVCM) was performed accordingly. Oftassiale treatment significantly reduced clinical features and improved IVCM outcomes. In addition, therapy was well-tolerated, and no clinically significant adverse events occurred. In conclusion, this study confirmed that IVCM helps assess the tunnel after cataract surgery due to its ability to provide microscopic details in vivo. Topical therapy with alpha-glycerylphosphorylcholine and D-Panthenol eye drops promoted and stabilized the reepithelialization process. This fixed combination also accelerated and modulated the repair of the corneal innervation. Moreover, this treatment was well-tolerated and safe.

Figure 1

Number of nerve fibers per frames. Compared to baseline, a significant decrease in number of nerve fibers was observed in both treatment groups at postoperative days 1, 30, and 90, with statistically significant between-group differences at 30 and 90 postoperative days.

Figure 2

Number of bead-like formations per frames. The subbasal nervous plexus images showed an increase in the number of bead-like formations per millimeter along subbasal nerves in both groups, but it was significantly higher in Group 2 (control) than in Group 1 after one postoperative month.

Figure 3

At 30 days after surgery, in both groups, IVCM morphological analysis of the cornea at the incision level showed the alterations at the level of the superficial epithelium with cells with a hyper-reflective nucleus (a), black focal areas between hyper-reflective activated keratocytes and Langerhans cell infiltration (b), and dark stromal striae in the posterior stroma (c).

Figure 4

At 30 days after surgery, in both eyes, IVCM images showing a significant reduction in nerve density with an increase in tortuosity and hyper-reflectivity of the fibers (a). The arrows show the presence of number of bead-like formations along the fibers (b).