Clinical study on the corneal epithelial dysfunction after cataract extraction

Abstract

Objective: To study the clinical manifestations, diagnosis and treatment of corneal epithelial dysfunction after cataract extraction. Methods: Fifteen cases diagnosed as corneal epithelial dysfunction after cataract extraction between November 2014 and September 2016 were retrospectively analyzed, mainly including clinical manifestations, characteristics of morphological changes imaged by in vivo laser confocal microscopy, management and therapeutic effects. Results: There were 6 (40%) males and 9 (60%) females with an average age of 66±7 years (59 to 86 years). Three patients had meibomian gland dysfunction. The clinical manifestations of corneal epithelial dysfunction after cataract extraction were corneal epithelial permeability increase, limitations of epithelial edema, corneal epithelial dot staining, corneal epithelial defects and ulceration. In vivo laser confocal microscopy showed enhanced reflection of the nucleus of the corneal basal cells, abnormal cell structure and decreased cell density. The morphology of corneal sub-basal nerve plexus was disordered and diminutive. After the therapy of protecting corneal epithelium and promoting healing, all 15 cases were cured completely. Conclusions: The early characteristics of cataract extraction-related corneal epithelial dysfunction are edema of the corneal epithelium and dot staining. Delayed diagnosis and treatment may result in filamentous keratitis and corneal ulcers. Timely use of corneal epithelium protection medicine may contribute to a favorable prognosis. (Chin J Ophthalmol, 2017, 53:188-192).