Benzalkonium chloride corneal toxicity post-cataract surgery

  • Keith Ong University of SydneyRoyal North Shore HospitalRyde HospitalDalcross Adventist Hospital
  • Leonard Ong Macquarie University Hospital, Chatswood Private Hospital
Keywords: benzalkonium chloride (BAK), cataract surgery, corneal toxicity

Abstract

Two patients with presumed benzalkonium chloride (BAK) corneal toxicity after routine cataract surgery are presented. Patient 1 had corneal stroma and Descemet’s membrane folds. Patient 2 had moderate superficial punctate epithelial erosions (SPEE). They were on Chlorsig, Maxidex, and Acular eye drops tds postoperatively. The corneas of these two patients improved when BAK was removed or minimized from the postoperative eye drop regimen. Two vials of 1 ml dexamethasone 4mg/ml for injection were added to Chlorsig 10 ml bottle to substitute for Maxidex eye drops.

BAK toxicity should be suspected when the cornea is not as clear as expected postoperatively. A practical way to eliminate BAK from postoperative eye drops is described, and would be useful until pharmaceuticals mass-produce BAK-free steroid eye drops economically.

Author Biography

Keith Ong, University of SydneyRoyal North Shore HospitalRyde HospitalDalcross Adventist Hospital

University of Sydney - Lecturer

Royal North Shore Hospital, Ryde Hospital, Dalcross Adventist Hospital - Ophthalmic Surgeon

References

Gasset AR. Benzalkonium chloride toxicity to the human cornea. Am J Ophthalmol. 1977;84(2):169-171.

Barki WH, Tahir M. Effects of topical benzalkonium chloride on corneal epithelium. Biomedica. 2007;23:65-70.

Urrego-Diaz JA, Frias-Ordonez JS, Figueroa-Echandia G, Duran-Silva G:. Acute corneal edema without epithelial compromise. A case report and literature review. Rev Fac Med. 2017;54(32):513-519.

Published
2020-01-17
How to Cite
Ong, K., & Ong, L. (2020). Benzalkonium chloride corneal toxicity post-cataract surgery. Asian Journal of Ophthalmology, 17(1), 56-60. https://doi.org/10.35119/asjoo.v17i1.620