We aimed to describe the use of topical ascorbic acid (AA) in a patient with reduced endothelial cells density (ECD) who was scheduled for phakic intraocular lens (pIOL) implantation. A 28-year-old woman presenting with dry eye and reduced ECD would like to have her high myopia (spherical equivalence >−15.0 D) corrected. The procedure of laser refractive surgery or even pIOL was not indicated for the reduced ECD of 1865/mm2 in the right eye and 2188/mm2 in the left eye, as well as level 3 dry eye. Fortunately, the ECD increased to 3144/mm2 in the right eye and 2538/mm2 in the left eye after topical AA was prescribed for one year preoperatively and one month postoperatively, with concomitant improvement of dry eye to level 1. Finally, bilateral pIOL implantation was performed smoothly and no sign of corneal decompensation was found postoperatively. Three months postoperatively, the ECD showed a satisfactory level of 2983/mm2 in the right eye and 3003/mm2 in the left eye. In conclusion, topical AA instillation might increase and maintain the density of central human corneal endothelial cells (HCECs) even after pIOL implantation.
Keywords: ascorbic acid; corneal endothelium; endothelial cell density; phakic intraocular lens.