Extensive bilateral corneal edema 6 weeks after cataract surgery: Keratopathy due to Asclepias physocarpa: a case report
Matsuura K, Hatta S, Terasaka Y and others. BMC ophthalmology, January 2017.
Read the paper Free to read · doi:10.1186/s12886-017-0400-z
What this paper is about
A 74-year-old man developed swelling in both corneas six weeks after routine cataract surgery. It was initially taken for a postoperative infection.
The cause was balloon plant latex. Milkweed sap had reached eyes that had recently been operated on, and the cardenolides blocked the pump that keeps the cornea clear.
Summarised here from the abstract below. Not the authors’ words.
Abstract
BackgroundSurgeons may be unaware of the ability of plant toxins to cause corneal damage. Therefore, corneal damage following intraocular surgery due to plant toxins may be misdiagnosed as postoperative infection.Case presentationA 74-year-old man presented with hyperemia and reduced visual acuity in both eyes 6 weeks after uneventful cataract surgery. We observed extensive hyperemia and corneal stromal edema with Descemet's folds in both eyes. After obtaining a detailed patient history, we diagnosed plant toxin-induced corneal edema due to Asclepias physocarpa, which can induce corneal edema by inhibiting the Na+/K+ ATPase activity of the corneal endothelium. Antimicrobial and steroid eye drops and an oral steroid were prescribed accordingly. Symptons began to improve on day 3 and had almost completely resolved by day 6. At 1 month, the patient had fully recovered without any sequelae.ConclusionThe correct diagnosis was possible in the present case as symptoms were bilateral and the patient was able to report his potential exposure to plant toxins. However, if the symptoms had been unilateral and the patient had been unaware of these toxins, he may have undergone unnecessary surgical interventions to treat non-existent postoperative endophthalmitis.
Abstract reproduced from the published paper, which is licensed CC BY. Copyright remains with the authors.
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Milkweed USA. (2026). Extensive bilateral corneal edema 6 weeks after cataract surgery: Keratopathy due to Asclepias physocarpa: a case report (listing). Retrieved DATE, from https://milkweedusa.com/research/extensive-bilateral-corneal-edema-6-weeks-after-cataract-surgery-2017/
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title = {Extensive bilateral corneal edema 6 weeks after cataract surgery: Keratopathy due to Asclepias physocarpa: a case report (listing)},
author = {{Milkweed USA}},
year = {2026},
url = {https://milkweedusa.com/research/extensive-bilateral-corneal-edema-6-weeks-after-cataract-surgery-2017/},
note = {Accessed DATE}
}