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Ma M, Wang M, Zhang X, Shao Y, Li X. Effects of a fortified balanced salt solution and Ringer's lactate solution on anterior chamber inflammation after phacoemulsification in diabetes. J Cataract Refract Surg 2024; 50:352-359. [PMID: 37962173 DOI: 10.1097/j.jcrs.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/05/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To compare the effects of a fortified balanced salt solution (fSS) and Ringer's lactate solution (Ringer) on anterior chamber (AC) inflammation in patients undergoing phacoemulsification. SETTING Tianjin Medical University Eye Hospital, Tianjin, China. DESIGN Prospective masked controlled trial. METHODS 80 patients (40 patients with regular cataract and 40 cataract patients with diabetes mellitus [DM]) were randomized to receive either fSS (n = 40) or Ringer's solution (n = 40). Anterior-segment optical coherence tomography was used to evaluate AC cells and flare. Transepithelial electrical resistance (TEER) and zonula occludens-1 (ZO-1) immunofluorescence were used for tight junction examination. Monocytic leukemia cell line (Tohoku Hospital Pediatrics-1 [THP-1]) transmigration assay was performed to observe the effects of the 2 perfusates on the inflammatory response in vitro. RESULTS In patients with regular cataracts, postoperative AC cells and flare on the 1st and 7th days were not significantly different between the Ringer and fSS groups. However, in cataract patients with DM, AC cells were higher in the Ringer group than in the fSS group ( P = .003) on postoperative day 1. The AC flare was also significantly higher in the Ringer group than in the fSS group ( P < .0001). No significant differences between the groups were observed on day 7. Compared with Ringer, fSS increased the TEER value and ZO-1 content and reduced the adhesion of THP-1 cells. CONCLUSIONS The results of this study indicated that early postoperative AC inflammation is more severe in patients with cataracts and DM. In addition, fSS attenuates inflammation by protecting the blood-aqueous barrier and inhibiting the exudation of inflammatory cells.
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Affiliation(s)
- Mingming Ma
- From the Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Yıldız SÇ, Seyyar SA, Saygılı O, Kimyon S, Mete A, Güngör K. Effect of Irrigation Solution Temperature on the Corneal Endothelial Functions in Posterior Vitrectomy: Room Temperature Versus Cooled. Eye Contact Lens 2023; 49:296-300. [PMID: 37171496 DOI: 10.1097/icl.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE To compare the effects of cooled and room temperature irrigation on the preoperative and early postoperative corneal endothelial parameter values in posterior vitrectomy. MATERIALS AND METHODS In this prospective, randomized, comparative study, 68 patients underwent a standard 3-port, 23-G posterior vitrectomy operation by a single surgeon. Cooled irrigation solution was applied to 36 patients during surgery (group 1), and room temperature irrigation solution was applied to 32 patients (group 2). The patients were also divided into four groups according to their history of noncomplicated cataract surgery (phakic or pseudophakic) and the types of tamponade used (silicone or gas). The central corneal thickness (CCT), endothelial cell density (ECD), mean cell area (MCA), hexagonal cell percent, and coefficient of variation of cell area (CV) parameter values of the groups at preoperative and postoperative 1 month were compared. RESULTS There were no statistically significant differences between the preoperative and postoperative corneal parameter values in groups 1 and 2 ( P >0.05). However, it was remarkable that the percentage of preoperative-postoperative change in all the corneal parameter values was higher in group 2. When the results of the subgroup analyses of the patients who were pseudophakic and used gas tamponade (Group D) in group 2 were examined, it was determined that the negative effects were significantly higher in the postoperative values for the ECD, MCA, CV, and CCT parameters compared with the preoperative values ( P <0.05). CONCLUSION In patients with pseudophakia and gas tamponade, cooled irrigation was found to be more advantageous for corneal parameters.
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Affiliation(s)
- Seda Çeri Yıldız
- Ophthalmology Department (S.Ç.Y.), Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey; and Ophthalmology Department (S.A.S., O.S., S.K., A.M., K.G.), Gaziantep University Hospital, Gaziantep, Turkey
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Wenzel DA, Schultheiss C, Druchkiv V, Hellwinkel OJC, Spitzer MS, Schultheiss M, Casagrande M, Steinhorst NA. Effect of elevated irrigation bottle height during cataract surgery on corneal endothelial cells in porcine eyes. BMC Ophthalmol 2023; 23:211. [PMID: 37170242 PMCID: PMC10173645 DOI: 10.1186/s12886-023-02954-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 04/29/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Cataract surgery induces corneal endothelial cell loss (ECL). This study investigates the relationship between bottle height (BH) and ECL induced due to irrigation and aspiration (I/A) in cataract surgery and quantifies protective effects of intraoperatively used ophthalmic viscoelastic substances. METHODS Intermittent I/A without phacoemulsification was performed in porcine eyes for 10 min with varying BHs of 100 cm (BH100), 125 cm (BH125), 150 cm (BH150) or no treatment (control, no I/A). Additionally, in one group a dispersive ophthalmic viscoelastic substance was injected into the anterior eye chamber before treatment with I/A at a BH of 150 cm (BH150 + V). After exposure of the corneal endothelium to I/A, the corneas were prepared to split corneal buttons on day 0 and cultivated for 15 days. Endothelial cell density (ECD) was analyzed blinded on days 1, 8 and 15. RESULTS Relative ECL significantly correlated with irrigation BH (control (n = 13): -9.69 ± 6.03% (average ± standard deviation); BH100 (n = 12): -9.69 ± 4.81%-p = 1.000; BH125 (n = 14): -19.44 ± 7.30% - p < 0.001; BH150 (n = 13): -21.99 ± 6.70%-p < 0.001). I/A-induced ECL was significantly decreased by the injection of ophthalmic viscoelastic, as BH150 + V (n = 14; -10.92 ± 4.09%-p = 1.000) showed a cell loss comparable to the control group. CONCLUSIONS ECL is altered by I/A BH and reduced when viscoelastic substances are used.
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Affiliation(s)
- Daniel A Wenzel
- University Eye Hospital, Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany.
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Constanze Schultheiss
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf J C Hellwinkel
- Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin S Spitzer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schultheiss
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Casagrande
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Meduri A, Oliverio GW, Bergandi L, De Salvo G, Frisina R, Mazzotta C, Aragona P. Role of Cold Balanced Salt Solution (BSS) in the Prophylaxis of Cystoid Macular Edema After Cataract Surgery: A Prospective Randomized Study. Clin Ophthalmol 2021; 15:2519-2526. [PMID: 34168425 PMCID: PMC8216722 DOI: 10.2147/opth.s304146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose To evaluate the postoperative effect on central retinal macular thickness of a cooled irrigating eye solution used during cataract surgery. Patients and Methods In this prospective, single-center study, 100 eyes of 50 patients (26 males and 24 females) were evaluated with spectral domain optical coherence tomography (SD-OCT) before and after phacoemulsification for senile cataract. Eyes were randomly divided into two groups based on the irrigating solution used during surgery: Group 1, 50 eyes received intraoperative irrigating solution at room temperature (~20.0±0.1°C); and Group 2, 50 fellow eyes received cold intraoperative irrigating solution (2.7±0.1°C). Changes in central macular thickness (CMT) were evaluated in both groups by SD-OCT macular raster scan for the nine Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields and total macular volume, performed pre-surgery, and 1 and 4 weeks post-surgery. Results Despite there being no significant differences in variables between the two groups preoperatively, significant increases in CMT were observed at 1 week after surgery in both groups (p=0.02 and p=0.03, respectively), as well as in total macular volume (p<0.0001 and p=0.02, respectively). Inter-subgroup analysis showed a significant reduction in CMT (p=0.03) and total macular volume (p=0.001) at 1 week post-surgery in Group 2 compared to Group 1, whereas no significant differences were observed at 4 weeks. Conclusion The use of a cooled irrigating eye solution during phacoemulsification may be beneficial in preventing the possible development of postoperative macular thickening. Further clinical studies may support this finding.
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Affiliation(s)
- Alessandro Meduri
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
| | - Giovanni William Oliverio
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
| | | | - Gabriella De Salvo
- Eye Unit, University Hospital Southampton Foundation Trust, Southampton, UK
| | - Rino Frisina
- Department of Neurosciences - Ophthalmology, University of Padova, Padua, Italy
| | - Cosimo Mazzotta
- Departmental Ophthalmology Unit, Alta Val d'Elsa Hospital, Siena, Italy.,Siena Crosslinking Center, Siena, Italy
| | - Pasquale Aragona
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
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Meduri A, Bergandi L, Oliverio GW, Rechichi M, Acri G, Perroni P, Silvagno F, Aragona P. The cold eye irrigation BSS solution used during phacoemulsification reduces post-surgery patients discomfort preventing the inflammation. Eur J Ophthalmol 2021; 32:11206721211018377. [PMID: 34011203 DOI: 10.1177/11206721211018377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to assess whether the intraoperative use of the cold eye irrigation balanced salt solution (BSS) could have a protective effect in preventing the anterior chamber flare and conjunctival hyperemia and, thus, in reducing patients discomfort after phacoemulsification. MATERIALS AND METHODS About 214 patients were enrolled and randomly divided into: patients whose eye were irrigated with BSS at ~ 20°C (Group 1) and patients whose eye were irrigated with BSS at 2.7°C (Group 2). Anterior chamber flare, visual analogue score and conjunctival hyperemia were evaluated at 1, 3, 5, and 30 days after surgery. RESULTS In patients of Group 2 the anterior chamber flare, the visual analogue score and the conjunctival hyperemia, used as parameters to evaluated clinical inflammation, at 1 day after surgery were significantly lower than those in Group 1 who received BSS solution at operating room temperature (p < 0.001), while at day 3, 5, and 30 there were not any significant differences. CONCLUSION Our study provided evidence supporting the efficacy of the treatment with cold irrigation solution on reduction of anterior chamber flare, pain and conjunctival hyperemia already at 1 day after phacoemulsification, suggesting that cooling procedure was fully effective at controlling early post-operative inflammation.
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Affiliation(s)
- Alessandro Meduri
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
| | | | - Giovanni William Oliverio
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
| | - Miguel Rechichi
- Centro Polispecialistico Mediterraneo, Sellia Marina, Catanzaro, Italy
| | - Giuseppe Acri
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
| | - Pietro Perroni
- Department of Ophthalmology, Oftalmico Hospital, ASST-Fatebenefratelli-Sacco, Milano, Italy
| | | | - Pasquale Aragona
- Biomedical, Dental and Morphological and Functional Images Sciences Department, University of Messina, Messina, Italy
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Kunzmann BC, Wenzel DA, Bartz‐Schmidt KU, Spitzer MS, Schultheiss M. Effects of ultrasound energy on the porcine corneal endothelium - Establishment of a phacoemulsification damage model. Acta Ophthalmol 2020; 98:e155-e160. [PMID: 31469490 DOI: 10.1111/aos.14235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/07/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to establish a standardized in vitro phacoemulsification damage model for future investigations of the effects of phacoemulsification, surgical devices, protective ophthalmic viscoelastic devices (OVDs), irrigation solutions and other aspects related to cataract phacoemulsification surgery on the corneal endothelium using porcine eyes. METHODS Thirty-four porcine eyes were randomly assigned to three groups (phacoemulsification (n = 13), irrigation (n = 9), control (n = 12)). A total of 5 min of ultrasound energy with intermittent irrigation/aspiration was applied in the eyes of the phacoemulsification group. The eyes of the irrigation group received the identical treatment, but without the application of ultrasound energy. The control group was left untreated. All eyes were then prepared to split corneal buttons followed by 15 days of cultivation. Endothelial cell density (ECD) was assessed blinded on day 15. RESULTS Endothelial cell density declined significantly more until day 15 in the phacoemulsification group (2567 ± 317/267 cells/mm² (median ± 25%/75%-quartiles), -32.5 ± 7.0/6.4%) compared to the irrigation (3450 ± 350/383 cells/mm², -11.8 ± 5.3/2.6%; p < 0.001) and the control group (3650 ± 288/258 cells/mm², -10.2 ± 3.2/4.6%; p < 0.001). CONCLUSION The phacoemulsification damage model presented in this study is sensitive to phacoemulsification energy and may reliably be used to investigate various factors involved in phacoemulsification with regard to their influence on corneal endothelial cells. This method is able to replace animal experiments or in vitro cell culture experiments that often do not translate well to the in vivo situation in humans.
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Affiliation(s)
- Berenike C. Kunzmann
- University Eye Hospital Centre for Ophthalmology University Hospital Tübingen Tübingen Germany
| | - Daniel A. Wenzel
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Karl U. Bartz‐Schmidt
- University Eye Hospital Centre for Ophthalmology University Hospital Tübingen Tübingen Germany
| | - Martin S. Spitzer
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Maximilian Schultheiss
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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Bozic M, Stojkovic M, Knezevic M, Marjanovic I, Bobic-Radovanovic A. Is the Use of Refrigerated Fixed Combination of Dorzolamide 2%–Timolol 0.5% (COSOPT) Associated with Less Ocular Discomfort: A Pilot Study. J Ocul Pharmacol Ther 2018; 34:642-646. [DOI: 10.1089/jop.2018.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marija Bozic
- Department of Ophthalmology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- Department of Glaucoma, Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia
| | - Milenko Stojkovic
- Department of Ophthalmology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- Department of Glaucoma, Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia
| | - Miroslav Knezevic
- Department of Ophthalmology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- Department of Glaucoma, Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia
| | - Ivan Marjanovic
- Department of Ophthalmology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- Department of Glaucoma, Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia
| | - Anica Bobic-Radovanovic
- Department of Ophthalmology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- Department of Glaucoma, Clinical Center of Serbia, University Eye Hospital, Belgrade, Serbia
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Leon P, Umari I, Mangogna A, Zanei A, Tognetto D. An evaluation of intraoperative and postoperative outcomes of torsional mode versus longitudinal ultrasound mode phacoemulsification: a Meta-analysis. Int J Ophthalmol 2016; 9:890-7. [PMID: 27366694 DOI: 10.18240/ijo.2016.06.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/18/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate and compare the intraoperative parameters and postoperative outcomes of torsional mode and longitudinal mode of phacoemulsification. METHODS Pertinent studies were identified by a computerized MEDLINE search from January 2002 to September 2013. The Meta-analysis is composed of two parts. In the first part the intraoperative parameters were considered: ultrasound time (UST) and cumulative dissipated energy (CDE). The intraoperative values were also distinctly considered for two categories (moderate and hard cataract group) depending on the nuclear opacity grade. In the second part of the study the postoperative outcomes as the best corrected visual acuity (BCVA) and the endothelial cell loss (ECL) were taken in consideration. RESULTS The UST and CDE values proved statistically significant in support of torsional mode for both moderate and hard cataract group. The analysis of BCVA did not present statistically significant difference between the two surgical modalities. The ECL count was statistically significant in support of torsional mode (P<0.001). CONCLUSION The Meta-analysis shows the superiority of the torsional mode for intraoperative parameters (UST, CDE) and postoperative ECL outcomes.
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Affiliation(s)
- Pia Leon
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Ingrid Umari
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Alessandro Mangogna
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Andrea Zanei
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
| | - Daniele Tognetto
- University Eye Clinic of Trieste, Ospedale Maggiore, Trieste 34125, Italy
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Reuschel A, Bogatsch H, Barth T, Wiedemann R. Comparison of endothelial changes and power settings between torsional and longitudinal phacoemulsification. J Cataract Refract Surg 2010; 36:1855-61. [PMID: 21029892 DOI: 10.1016/j.jcrs.2010.06.060] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 06/15/2010] [Accepted: 06/15/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the intraoperative and postoperative outcomes of conventional longitudinal phacoemulsification and torsional phacoemulsification. SETTING Department of Ophthalmology, University of Leipzig, Germany. DESIGN Randomized single-center clinical trial. METHODS Eyes with senile cataract were randomized to have phacoemulsification using the Infiniti Vision System and the torsional mode (OZil) or conventional longitudinal mode. Primary outcomes were corrected distance visual acuity (CDVA) and central endothelial cell density (ECD), calculated according to the Conference on Harmonisation-E9 Guidelines in which missing values were substituted by the median in each group (primary analysis) and the loss was then calculated using actual data (secondary analysis). Secondary outcomes were ultrasound (US) time, cumulative dissipated energy (CDE), and percentage total equivalent power in position 3. Postoperative follow-up was at 3 months. RESULTS The mean preoperative CDVA was 0.41 logMAR in the torsional group and 0.38 logMAR in the longitudinal group, improving to 0.07 logMAR postoperatively in both groups. The mean ECD loss was 7.2% ± 4.6% in the torsional group (72 patients) and 7.1% ± 4.4% in the longitudinal group (76 patients), with no statistically significant differences in the primary analysis (P = .342) or secondary analysis (P = .906). The mean US time, CDE, and percentage total equivalent power in position 3 were statistically significantly lower in the torsional group (98 patients) than in the longitudinal group (94 patients) (P<.001). CONCLUSION The torsional mode was as safe as the longitudinal mode in phacoemulsification for age-related cataract.
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Affiliation(s)
- Anna Reuschel
- Department of Ophthalmology, University of Leipzig, Leipzig, Germany
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Yeniad B, Corum I, Ozgun C. The effects of blunt trauma and cataract surgery on corneal endothelial cell density. Middle East Afr J Ophthalmol 2010; 17:354-8. [PMID: 21180438 PMCID: PMC2991455 DOI: 10.4103/0974-9233.71604] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. MATERIALS AND METHODS In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subgroup (n = 19) in which subjects underwent standard phacoemulsification with intraocular lens implantation and complicated surgery subgroup (n = 12) in which subjects underwent cataract surgery other than standard phacoemulsification. The ECD of the traumatic cataract group and the control group was compared preoperatively and at 3 months or later postoperatively. A P value less than 0.05 was considered statistically significant. RESULTS The ECD in the eyes with traumatic cataract was 13.1% lower than that for healthy eyes preoperatively (P = 0.043). Postsurgical ECD decreased by 16.7% in complicated surgery subgroup and 11.9% in uncomplicated surgery subgroup (P = 0.049) after 3 months postoperatively. The ECD decreased by 10.8% in the control group (P = 0.489). CONCLUSIONS Patients with cataracts due to blunt trauma had a decreased endothelial cell count, which was significantly aggravated by cataract surgery. The loss of corneal endothelium cells due to surgery depends on the surgical approach.
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Affiliation(s)
- Baris Yeniad
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Isik Corum
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Cahit Ozgun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Vasavada V, Vasavada V, Dixit NV, Raj SM, Vasavada AR. Comparison between Ringer's lactate and balanced salt solution on postoperative outcomes after phacoemulsfication: a randomized clinical trial. Indian J Ophthalmol 2009; 57:191-5. [PMID: 19384012 PMCID: PMC2683448 DOI: 10.4103/0301-4738.49392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim: To compare the effects of balanced salt solution (BSS) and Ringer's lactate (RL) on corneal thickness, endothelial morphology, and postoperative anterior chamber inflammation in eyes undergoing phacoemulsification. Setting: Iladevi cataract and IOL research center, Ahmedabad, India. Materials and Methods: This prospective randomized study comprised 90 consecutive patients with age-related cataract who were randomly assigned to either Group 1 (n = 45) with BSS or Group 2 (n = 45) with RL. Observations made included measurement of central corneal thickness (CCT), presence of anterior chamber flare and cells, endothelial cell loss, and change in coefficient of variation (CV). Data was analyzed using Mann Whitney test and test of proportion. Results: Mean increase in CCT on postoperative Day 1 was 58 µm and 97 µm in Groups 1 and 2 respectively (P = 0.01). Increase in CCT at one month was 10µm and 11µm in Groups 1 and 2 respectively (P = 0.99); increase in CCT at three months was 3 µm and 6 µm in Groups 1 and 2 respectively (P = 0.86). Number of eyes with flare grades in a range of 0 to 3 was statistically higher in Group 2 on postoperative Day 1 (P = 0.004, 0.016, <0.001, 0.047 for Grade 0, 1, 2 and 3 respectively). Number of eyes with cells of Grade 3 on first postoperative day was significantly higher in Group 2 as compared to Group 1 (P = 0.004). Three months postoperatively, endothelial cell loss was 5.5% and 7.8% in Groups 1 and 2 (P = 0.21) and change in CV was 3 and 5.4 in Groups 1 and 2 (P = 0.20) respectively. Conclusion: BSS offers a significant advantage over RL in terms of increase in corneal thickness and postoperative inflammation on the first postoperative day in patients undergoing phacoemulsification.
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Affiliation(s)
- Viraj Vasavada
- IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India
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