The Effects of Topical Coenzyme Q After Cataract Surgery. A Clinical and Confocal Study

Purpose:To evaluate the postoperative effects of topical coenzyme Q in patients who underwent cataract surgery. Methods:20 consecutive patients who underwent uneventful cataract surgery (3.2-mm temporal incision, phacoemulsification + IOL in the bag) were treated with topical antibiotics and corticosteroids for 2 weeks after surgery and, thereafter, with topical coenzyme Q or saline solution twice daily for 3 months. Patients received full eye examination and the following examinations before surgery and at days 14, 90: Schirmer test (ST), Break-up time (BUT), aestesiometry (AE), in vivo confocal microscopy of the cornea. The density of the sub-basal nerves was calculated in the central (CND) and temporal (TND) cornea. Results:Before surgery ST was 12±3 mm, BUT 11±2 sec, AE 58±2 mm, CND 7.1±2.6, TND 6.0±2.4. At day 14, a small decrease of ST, BUT, AE was found (2±1 mm, 1±1 sec and 8±3 mm respectively; P>0.05 compared with baseline), whereas a significant reduction in CND (-2.3±2.1, P=0.003), and TND (-2.4±1.9, P=0.001) was shown. At day 90, ST, BUT, AE were similar compared with baseline (P>0.05), whereas there were higher CND (6.6±3.1) and TND (5.0±3.1) compared with day 14 (P=0.01 and 0.05 respectively). Conclusions:Our results confirm that even uneventful cataract surgery leads to relevant changes of the corneal nerves which may influence ocular surface function. From our short-term data, a 3-month treatment with topical coenzyme Q had a positive effect in restoring the normal anatomy of the sub-basal nerve plexus. Longer follow-up and comparison with controls are needed to provide confirmation of these findings.