{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:32:56Z","timestamp":1777984376563,"version":"3.51.4"},"update-to":[{"DOI":"10.12688\/f1000research.170846.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000}},{"DOI":"10.12688\/f1000research.170846.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000}}],"reference-count":17,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Phacoemulsification is one of the most frequent surgeries in the world. However, prolonged use of phacoemulsification machines produces reactive oxygen species which will damage corneal endothelial cells. Ascorbic acid has an antioxidant capacity to neutralize oxidative stress in the anterior chamber. This study will investigate the protective effect of ascorbic acid on corneal endothelial cells in patients with hard nuclear cataracts. Methods This study is a double-blinded randomized controlled trial. Samples will be divided into three groups, and 500 mg vitamin C three times daily (1500 mg\/day), or placebo will be received for seven weeks. Clinical characteristics, ascorbic acid, malondialdehyde, and total antioxidant capacity of patients in serum and aqueous humor will be measured before and after intervention and phacoemulsification. Conclusions Data from this study will reveal the protective effect of oral vitamin C supplementation on the corneal endothelial cells in patients with hard nucleus cataracts. This trial has been registered at ClinicalTrials.gov (identifier: NCT06781970; registered on 17 January 2025). The trial record is available at: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT06781970<\/ns3:p>","DOI":"10.12688\/f1000research.170846.3","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T07:09:08Z","timestamp":1777014548000},"page":"1117","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antioxidant Support for the Corneal Endothelium: Evidence from Vitamin C Supplementation in Hard Cataract Phacoemulsification"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7119-5250","authenticated-orcid":false,"given":"Syska","family":"Widyawati","sequence":"first","affiliation":[{"name":"Ophthalmology, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratna","family":"Sitompul","sequence":"additional","affiliation":[{"name":"Ophthalmology, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7963-8853","authenticated-orcid":false,"given":"Septelia","family":"I Wanandi","sequence":"additional","affiliation":[{"name":"Biochemistry and Molecular Biology, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melva","family":"Louisa","sequence":"additional","affiliation":[{"name":"Pharmacology and Therapeutics, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aria","family":"Kekalih","sequence":"additional","affiliation":[{"name":"Community Medicine, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rina","family":"LDR Nora","sequence":"additional","affiliation":[{"name":"Ophthalmology, Faculty of Medicine Jakarta Jakarta 10430 University of Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","article-title":"Indonesia [Internet].","year":"2026 Jan 29","journal-title":"IAPB Vision Atlas."},{"key":"ref3","first-page":"58-62","article-title":"The evolution of cataract surgery.","volume":"113","author":"G Davis","year":"2016","journal-title":"Mo. Med."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1186\/s12886-021-02203-3","article-title":"Factors impacting cumulative dissipated energy levels and postoperative visual acuity outcome in cataract surgery.","volume":"21","author":"A Bui","year":"2021","journal-title":"BMC Ophthalmol."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"139-142","DOI":"10.18388\/abp.2010_2386","article-title":"Determination of antiradical and antioxidant activity: Basic principles and new insights.","volume":"57","author":"G Tirzitis","year":"2010","journal-title":"Acta Biochim. Pol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"86-90","DOI":"10.1016\/j.sjopt.2017.02.009","article-title":"Age related changes in corneal morphological characteristics of healthy Pakistani eyes.","volume":"31","author":"Q Islam","year":"2017","journal-title":"Saudi J. Ophthalmol."},{"key":"ref7","first-page":"1261-1264","article-title":"Effect of phacoemulsification power on corneal endothelial cell count and corneal thickness in age related cataract surgery.","volume":"14","author":"M Khan","year":"2020","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"167-173","DOI":"10.1001\/jamaophthalmol.2015.4776","article-title":"Global survey of corneal transplantation and eye banking.","volume":"134","author":"P Gain","year":"2016","journal-title":"JAMA Ophthalmol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e10199","DOI":"10.1002\/btm2.10199","article-title":"Analysis of aqueous humor total antioxidant capacity and its correlation with corneal endothelial health.","volume":"6","author":"Y Tsao","year":"2021","journal-title":"Bioeng. Transl. Med."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"943","DOI":"10.3390\/cells9040943","article-title":"Topical ascorbic acid ameliorates oxidative stress-induced corneal endothelial damage via suppression of apoptosis and autophagic flux blockage.","volume":"9","author":"Y Hsueh","year":"2020","journal-title":"Cells."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"112306","DOI":"10.1016\/j.biopha.2021.112306","article-title":"Ascorbic acid ameliorates corneal endothelial dysfunction and enhances cell proliferation via the noncanonical GLUT1-ERK axis.","volume":"144","author":"Y Hsueh","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"151-159","DOI":"10.1111\/vop.12490","article-title":"Effects of intracameral ascorbic acid on the corneal endothelium of dogs undergoing phacoemulsification.","volume":"21","author":"I Padua","year":"2018","journal-title":"Vet. Ophthalmol."},{"key":"ref13","article-title":"The role of ascorbic acid on endothelial cell damage in phacoemulsification.","volume":"7","author":"N Bellarinatasari","year":"2011","journal-title":"Jurnal Oftalmologi Indonesia."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1-7","DOI":"10.1016\/j.ajo.2020.12.024","article-title":"Randomized controlled trial comparing femtosecond laser-assisted with conventional phacoemulsification on dense cataracts.","volume":"229","author":"S Chee","year":"2021","journal-title":"Am J Ophthalmol [Internet]."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3704-3709","DOI":"10.1073\/pnas.93.8.3704","article-title":"Vitamin C pharmacokinetics in healthy volunteers: evidence for a recommended dietary allowance.","volume":"93","author":"M Levine","year":"1996 Apr 16","journal-title":"Proc Natl Acad Sci U S A."},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-023-03162-2","article-title":"Proteomic study of aqueous humour in diabetic patients with cataracts by TMT combined with HPLC-MS\/MS.","volume":"23","author":"W Xu","year":"2023","journal-title":"BMC Ophthalmol [Internet]."},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-023-02875-8","article-title":"Aqueous humor cytokine levels are associated with the severity of visual field defects in patients with primary open-angle glaucoma.","volume":"23","author":"Z Yin","year":"2023","journal-title":"BMC Ophthalmol [Internet]."},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.17239356","article-title":"SPIRIT checklist for \u201cThe Effects of Vitamin C Supplementation on Corneal Endothelial Damage in Hard Cataract Phacoemulsification: an Oxidative Stress Study on Aqueous Humour and Corneal Endothelial Cell Characteristics, A Randomized, Double-Blinded, Clinical Trial\u201d (Version 1) [Checklist].","author":"S Widyawati","year":"2025","journal-title":"Zenodo."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:14:11Z","timestamp":1777958051000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":17,"URL":"https:\/\/doi.org\/10.12688\/f1000research.170846.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.170846.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.170846.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.197958.r478734","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.197958.r478734","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.196193.r456960, Rajesh Choudhary, Shri Shankaracharya College of Pharmaceutical Sciences, Bhilai, Chhattisgarh, 19 Feb 2026, version 2, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/14-1117\/v2#referee-response-456960","order":0,"name":"referee-response-456960","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.197958.r478734, Suraj Kumar Chaurasiya, Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, 05 May 2026, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/14-1117\/v3#referee-response-478734","order":1,"name":"referee-response-478734","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}