Journal Mobile Options
Table of Contents
Vol. 229, No. 1, 2013
Issue release date: December 2012
Ophthalmologica 2013;229:26–31

The Effects of Topical Coenzyme Q10 and Vitamin E d-α-Tocopheryl Polyethylene Glycol 1000 Succinate after Cataract Surgery: A Clinical and in vivo Confocal Study

Fogagnolo P. · Sacchi M. · Ceresara G. · Paderni R. · Lapadula P. · Orzalesi N. · Rossetti L.
aG.B. Bietti Foundation for the Study and Research in Ophthalmology, IRCCS, Rome, and bEye Clinic, San Paolo Hospital, University of Milan, Milan, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Purpose: To evaluate the postoperative effects of topical coenzyme Q10 + vitamin E d-α-tocopheryl polyethylene glycol 1000 succinate (CoQ10) after cataract surgery. Methods: 40 consecutive patients were randomized to receive CoQ10 or saline solution (SS) twice daily for 9 months after uneventful cataract surgery with a temporal port. Before surgery, on day 14 and at months 3, 6 and 9, they underwent non-invasive break-up time (NIBUT) testing, Schirmer test, BUT, aesthesiometry as well as in vivo confocal microscopy of the subbasal nerve plexus of the cornea (SBP). The density of the subbasal nerves was calculated in the central (CFD) and temporal (TFD) cornea (number of fibres per field). Results: On day 14, surgery reduced CFD and TFD, respectively, by 25–35 and 50%; indices of ocular surface stability were all impaired. The treatment with CoQ10 was associated with faster nerve regeneration than SS (at month 3, CFD +1.5 ± 1.9 vs. +0.2 ± 1.8, p = 0.04, and TFD +2.5 ± 1.7 vs. +1.0 ± 1.6, p = 0.007; at month 6, TFD +2.7 ± 1.9 vs. +1.4 ± 1.5, p = 0.02) and better stability of ocular surface (NIBUT and BUT) throughout the study. No relevant side effects were found, apart from occasional burning in 10% of CoQ10 patients. Conclusions: Changes of the corneal nerves occurring after cataract surgery may influence the integrity of the ocular surface. Treatment with topical CoQ10 has a positive effect in restoring SBP anatomy and ocular surface stability.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Ernster L, Dallner G: Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta 1995;1271:195–204.
  2. Pepe S, Marasco SF, Haas SJ, Sheeran FL, Krum H, Rosenfeldt FL: Coenzyme Q10 in cardiovascular disease. Mitochondrion 2007;7(suppl):S154–S167.
  3. Rosenfeldt FL, Haas SJ, Krum H, et al: Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens 2007;21:297–306.
  4. Soja AM, Mortensen SA: Treatment of congestive heart failure with coenzyme Q10 illuminated by meta-analyses of clinical trials. Mol Aspects Med 1997;18(suppl):S159–S168.
  5. Beal MF, Henshaw DR, Jenkins BG, Rosen BR, Schulz JB: Coenzyme Q10 and nicotinamide block striatal lesions produced by the mitochondrial toxin malonate. Ann Neurol 1994;36:882–888.
  6. Beal MF: Mitochondrial dysfunction in neurodegenerative diseases. Biochim Biophys Acta 1998;1366:211–223.
  7. Ferrante RJ, Andreassen OA, Dedeoglu A, et al: Therapeutic effects of coenzyme Q10 and remacemide in transgenic mouse models of Huntington’s disease. J Neurosci 2002;22:1592–1599.
  8. Matthews RT, Yang L, Browne S, Baik M, Beal MF: Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Proc Natl Acad Sci USA 1998;95:8892–8897.
  9. Folkers K, Simonsen R: Two successful double-blind trials with coenzyme Q10 (vitamin Q10) on muscular dystrophies and neurogenic atrophies. Biochim Biophys Acta 1995;1271:281–286.
  10. Shults CW, Oakes D, Kieburtz K, et al: Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol 2002;59:1541–1550.
  11. Shults CW, Flint Beal M, Song D, Fontaine D: Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson’s disease. Exp Neurol 2004;188:491–494.
  12. Walker FO, Raymond LA: Targeting energy metabolism in Huntington’s disease. Lancet 2004;364:312–313.
  13. Cooper JM, Schapira AH: Friedreich’s ataxia: disease mechanisms, antioxidant and coenzyme Q10 therapy. Biofactors 2003;18:163–171.
  14. Muller LJ, Marfurt CF, Kruse F, et al: Corneal nerves: structure, contents and function. Exp Eye Res 2003;76:521–542.
  15. Dartt DA: Dysfunctional neural regulation of lacrimal gland secretion and its role in the pathogenesis of dry eye syndromes. Ocul Surf 2004;2:76–91.
  16. Perez-Santonja JJ, Sakla H, Cardona C, et al: Corneal sensitivity after photorefractive keratectomy and laser in situ keratomileusis for low myopia. Am J Ophthalmol 1999;127:497–504.
  17. Martin XY, Safran AB: Corneal hypoesthesia. Surv Ophthalmol 1988;33:28–40.
  18. Oliveira-Soto L, Efron N: Morphology of corneal nerves using confocal microscopy. Cornea 2001;20:374–384.
  19. Chylack LT Jr, Leske MC, McCarthy D, Khu P, Kashiwagi T, Sperduto R: Lens opacities classification system II (LOCS II). Arch Ophthalmol 1989;107:991–997.
  20. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL: Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol 2000;118:615–621.
  21. Babu K, Narasimha Murthy K, Ramachandra Murthy K: Wavelike epitheliopathy after phacoemulsification: role of in vivo confocal microscopy. Cornea 2007;26:747–748.
  22. De Cillà S, Ranno S, Carini E, et al: Corneal subbasal nerves changes in patients with diabetic retinopathy: an in vivo confocal study. Invest Ophthalmol Vis Sci 2009;50:5155–5158.
  23. Patel SV, McLaren JW, Hodge DO, Bourne WM: Confocal microscopy in vivo in corneas of long-term contact lens wearers. Invest Ophthalmol Vis Sci 2002;43:995–1003.
  24. Martone G, Frezzotti P, Tosi GM, et al: An in vivo confocal microscopy analysis of effects of topical antiglaucoma therapy with preservative on corneal innervation and morphology. Am J Ophthalmol 2009;147:725–735.
  25. Ranno S, Fogagnolo P, Rossetti L, Orzalesi N, Nucci P: Changes in corneal parameters at confocal microscopy in treated glaucoma patients. Clin Ophthalmol 2011;5:1037–1042.
  26. Darwish T, Brahma A, Efron N, O’Donnell C: Subbasal nerve regeneration after penetrating keratoplasty. Cornea 2007;26:935–940.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50