Wavelike epitheliopathy after phacoemulsification: role of in vivo confocal microscopy.
OBJECTIVE
The purpose of this report was to describe an uncommon wavelike epitheliopathy after phacoemulsification in a 59-year-old man with well-controlled diabetes mellitus.


METHODS
Retrospective case report.


RESULTS
A 59-year-old man with a history of well-controlled diabetes mellitus presented to us with irritation and blurring of vision in the right eye of 4-month duration after phacoemulsification with multifocal intraocular lens implantation. Slit-lamp examination revealed a wave-like epitheliopathy in the right cornea, extending nasally from the incision area. Corneal sensation was reduced. Confocal microscopy revealed reduced subbasal nerve plexus and unhealthy corneal epithelium. Topical application of preservative-free lubricants was advised. On follow-up examinations, it was observed that the disappearance of the epitheliopathy correlated with the regeneration of the nerve plexus, as shown by the in vivo confocal microscopy findings.


CONCLUSIONS
This is an isolated case report of a wavelike epitheliopathy after phacoemulsification. The regeneration of the subbasal nerve plexus correlating with the disappearance of the epitheliopathy suggests an element of neurotrophic corneal damage. Other probable mechanisms are discussed along with the in vivo confocal microscopy findings.
Babu
Kalpana
K
Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Center, Bangalore, India. kb_7375@yahoo.co.in
Narasimha Murthy
Ky
K
Ramachandra Murthy
K
K
D003315:Cornea / Q000294:innervation; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology; D019573:Epithelium, Corneal / Q000473:pathology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009882:Ophthalmic Nerve / Q000473:pathology; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies