Visual Outcome and Corneal Endothelial Cytotoxicity in Patients Exposed to Latex of Calotropis Procera: Long-Term Follow-up

Monday, April 20, 2015: 3:06 PM
Room 3 (San Diego Convention Center)
Kuttappalayam S. Siddharthan, DO, DNB, FRCS
Anita Raghavan, MD
Revathi Rajaraman, MD

To evaluate the visual outcome and corneal endothelial cytotoxicity after Calotropis Procera exposure.

A prospective, consecutive, interventional clinical analysis of 16 eyes of 14 patients who had exposure to Calotropis procera from March 2012 to December 2012. All patients underwent a uncorrected visual acuity examination using Snellen’s test type, intra ocular pressure (IOP) using Non contact tonometry (NCT), a thorough slitlamp biomicroscopy, Specular microscopy, photography and fluorescein staining of the cornea. The outcome measures that were evaluated included best spectacle corrected visual acuity (BSCVA) and endothelial cell density (ECD) at first week and at 6 months follow-up.

The mean age of study population was 50.6 ± 9.6 years. BSCVA improved gradually at 2nd week post intervention, 7(43.8%) eyes had vision 20/40 or better and 5(31.3%) eyes had vision 20/125 – 20/200.There was a statistically significant improvement in vision between the 2nd and 3rd week (p-0.046) post intervention. ECD showed a statistically significant (p-0.011) decrease in the affected eye. Similarly, a statistically significant (p-0.043) decrease was observed in central corneal thickness in the affected eye following a transient increase after the toxicity.  However, cell size did not show a statistically significant difference in the cell size (p-0.928) during the post-intervention period.

Intra corneal penetration of Ushaar latex can lead to transient, decrease in visual acuity and increase in corneal thickness, but causes a permanent endothelial cell loss when followed up over a longer period of time.