Reversible cataract after exposure to distilled water: a case report

BACKGROUND: To report a case of a reversible cataract after intracameral infusion of distilled water during full-thickness astigmatic keratotomy. CASE PRESENTATION: A 20-year-old male whose bilateral anterior chambers were exposed to distilled water during astigmatic keratotomy developed bilateral corneal edema, inflammation of the anterior chambers, and an anterior subcapsular cataract in the right eye. After 1 month of topical administration of 0.1% prednisolone acetate and 5% NaCl, the bilateral inflammation of the cornea and anterior chambers cleared; endothelial cell density decreased by 41.1% in the right eye and 12.7% in the left eye. The cataract in the right eye decreased centripetally. Small incision lenticule extraction surgery was performed at 2 months after the astigmatic keratotomy; the patient’s uncorrected distance visual acuity 3 months later was 20/25 in both eyes. CONCLUSIONS: This case suggests that a cataract that develops as a result of instantaneous intracameral exposure to distilled water is reversible.