3 · Anticollagenolytics & anti-melt agents
Vitamin C (ascorbic acid) — anti-melting in burns
Review — modulators of corneal healing › 3 · Anticollagenolytics & anti-melt agents › Vitamin C (ascorbic acid) — anti-melting in burns
Vitamin C (ascorbic acid) — anti-melting in burns
Topical ~10% (compounded) and/or high-dose systemic
Oxford II (experimental) · III–IV (human)
Moderate–Strong (burns)
Present · classic
Mechanism of actionCofactor of prolyl/lysyl hydroxylases → collagen synthesis and cross-linking by keratocytes; potent antioxidant. The corneal ascorbate pool collapses after an alkali burn (ciliary body injury) → repletion restores collagen repair and reduces ulceration/perforation.
IndicationsAlkali/acid/thermal burns (classic anti-melting protocol with citrate, doxycycline, corticosteroid, lubricants); ischemic injuries with stromal thinning.
Route & dosageTopical ascorbate 10% every 1–2 hours + oral ascorbic acid (500 mg–2 g/day, up to 1–2 g four times daily in historical protocols). Often combined with topical citrate 10%.
Level of evidenceOxford II (classic controlled animal studies) · Scale: Moderate–Strong for prevention of burn-related melting (observational human data).
| FDA | Oral vitamin C = OTC supplement; topical ophthalmic ascorbate = compounded. |
|---|---|
| EU MA | No dedicated eye drop (compounded). |
| France | Topical ascorbate as a compounded preparation; oral form available. Standard burn protocol. |
| USA / Asia | Compounded (topical); oral form available. |
Key studies: Pfister & Paterson, IOVS 1976 (prevention of ulceration/perforation, alkali burns) — PMID 992963; "Ascorbic acid in alkali burns," Ophthalmology 1980 — PMID 7243199.