The Effect of Phenylephrine on the Cornea

Corneal Toxicity of Xylazine and Clonidine, in Combination with Ketamine, in the Rat

“…In 1990 [11], following the description of the dramatic effect of XYL/KET on the aqueous concentration of glucose [12], the opacification of the lens was recognized as a typical sugar cataract [13,14], suggesting that an osmotic mechanism could also be responsible for corneal decompensation and transient loss of transparency. However, other mechanistic hypotheses cannot be ruled out, including the perturbation of the adrenergic control of corneal hydration and transparency [15][16][17][18] as indicated by the known corneal toxicity of other ·-agonists [19][20][21][22][23]. Corneal toxic effects of clonidine (CLO), another selective · 2 -adrenergic agonist, have been described in the rat [24], but not in humans, despite its wide use as a systemic hypotensive drug and anesthetic adjuvant [25][26][27].…”

Management of Intraocular Floppy Iris Syndrome (IFIS) in Cataract Surgery

“…No clinical signs of corneal edema were reported, but unfortunately the density of endothelial cell was not evaluated. In an early report by Edelhauser et al, a cytotoxic effect on the endothelium of phenylephrine at a concentration of 2.5% was described in cases where the epithelium was removed (Edelhauser et al 1979). In a recent report on corneal endothelial cell changes in cataract patients on tamsulosin we found no association between the intracameral use of 0.25 mL phenylephrine 2.5% (Minims®) in 2 mL BBS and postoperative endothelial cell loss (Storr-Paulsen et al 2013).…”

Effects of Phenylephrine on Bovine Corneal Endothelium in Culture

“…In addition, we showed that significant corneal edema, as well as stromal and endothelial cell vacuolization, is produced in rabbits by topi cally applied solutions of PE as dilute as 2.5 % if the epithelium is denuded before drug application [1,3]. The present study was designed to examine the direct effects of known PE concentrations on monolayers of bovine corneal endothelial cells maintained in tissue culture.…”

“…Phase contrast microscopy and SEM have shown that confluent monolayer cultures of bovine corneal endothelium are very similar to the endothelial layers found in situ on the corneas of rabbits [3] and cats [1]. Incubation of corneal endothelial cell cultures with PE caused uptake of drug into cytoplasmic vacuoles, accompanied by the loss of intercellular adhesion.…”

“…Corneal edema and clouding are frequently noted during surgeries which require repeated topical application of mydriatics andcycloplegics [6], and 2 cases of corneal edema and sloughing of the corneal epithelium following the use of 10% PE have recently been reported to the National Drug Register [7], We have demonstrated that topically applied PE can produce exten sive vacuolization of the corneal epithelium in cats and rabbits [1,3], which could account for epithelial sloughing.…”