Effects of carbonic anhydrase inhibitors on pseudophakic corneal edema

INTRODUCTION: Acetazolamide as inhibitor of carbonic anhydrase, in glaucoma therapy, has an effect on lowering intraocular pressure. In addition to this primary effects, we attempted to determine the effect on the cornea after phacoemulsification. In our study, we determined the effects of systemically applied dose of 500 mg of acetazolamide on the edema, thickness, and corneal morphology after phacoemulsification, with the Anterior Segment Optical Coherence Tomography (AS OCT). MATERIAL AND METHODS: The study included 53 patients who were divided into two groups. Groups were stratified by type of cataract (nuclear), age (62+1.5), preoperative visual acuity (5/60) Snellen table, and preoperative findings on AS-OCT. Phacoemulsification has done the same surgeon, with the same ultrasound probe length using ultrasonic force of the average value of 14 for a period of 72+2.5 seconds. Group of 33 patients were administered systemic acetazolamide at a dose of 250 mg per scheme 01 hours +24 hours after phacoemulsification (group I). Another group of 20 patients did not receive acetazolamide( group II). AS OCT recordings were performed before surgery, 6 hours and 24 hours after surgery. RESULTS: The mean value in both groups was 549+ 9 μm before surgery. Group I had average value of 648+6 μm after 6h, and the mean value was 612+4 μm after 24h. The group II, had a mean thickness of the cornea after 6 hours of 720+5 μm, and after 24 hours 708+4μm. Morphological changes in the tomograms of the group I showed minimal creases Descemet’s membrane. Postoperative visual acuity was 0,6,24h after the surgery in the I group of patients, and 0,3 in the II group. CONCLUSION: In our study the patients who administered systemic acetazolamide had significant reduction of central corneal thickness. The folds of Descemet’s membrane and endothelial dysfunction in AS OCT tomograms showed less structural changes in group I. Significant better postoperative visual acuity in these patients is probably because of the smaller corneal edema after 24 h, which improves patients’ comfort.