Toxic effects of detergents on the corneal endothelium.
Eighteen patients developed a toxic endothelial cell destruction syndrome following normal intraocular surgery, caused by a detergent residue originating from irrigating cannulas. The residue occurred after the concentration of a detergent solution has been increased from 0.4% to 4%, in combination with insufficient cleaning of the cannulas. Mass spectrometric analysis revealed the detergent to contain a nonionic ethoxylated fatty alcohol (6% vol/vol). Quantitative endothelial vital staining and in vitro corneal endothelial perfusion demonstrated endothelial toxic effects at the 1% and 0.06% level for the detergent and the pure ethoxylated fatty alcohol, respectively. Permeability studies showed that the toxic effects occurred as a result of endothelial barrier breakdown.
Department of Ophthalmology, University of Amsterdam, The Netherlands.
R M
RM
Nuyts
H F
HF
Edelhauser
E
E
Pels
A C
AC
Breebaart
D055598:Chemical Phenomena; D002621:Chemistry; D003902:Detergents / Q000506:poisoning*; D004350:Drug Residues; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D005233:Fatty Alcohols; D006801:Humans; D066298:In Vitro Techniques; D008855:Microscopy, Electron, Scanning; D010477:Perfusion; D010539:Permeability; D013194:Staining and Labeling; D013501:Surface-Active Agents / Q000506:poisoning*
D003902:Detergents; D005233:Fatty Alcohols; D013501:Surface-Active Agents