Wavelike epitheliopathy after ohacoemulsification - Role of in vivo confocal microscopy

Purpose: The purpose of this report was to describe an uncommon wavelike epitheliopathy after phacoemulsification in a 59-year-old mail 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 fight eye of 4-month duration after phacoemulsification with multifocal intraocular lens implantation. Slit-lamp examination revealed a wavelike 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. Oil 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 all isolated case report of a wavelike epitheliopathy after phacoemulsification. The regeneration of the subbasal nerve plexus correlating with the disappearance of the epitheliopathy suggests all element of neurotrophic corneal damage. Other probable mechanisms are discussed along with the in vivo confocal microscopy findings.