Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.642
Peer-review started: November 19, 2018
First decision: December 29, 2018
Revised: January 16, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: March 6, 2019
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.
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.
Perioperative administration of topical AA may be an alternative therapy to the triple procedure in patients expecting to undergo cataract surgery.
Core tip: Perioperative topical ascorbic acid (AA) was instilled in two patients with low corneal endothelial cell density who were scheduled for cataract surgery. After the surgery, both patients showed improved visual acuity without corneal decompensation. Perioperative topical AA is promising for prevention of corneal endothelial dysfunction in high-risk patients undergoing phacoemulsification; it may be considered as an alternative therapy.