Clinical evaluation of the effect of acetylcholine on the corneal endothelium.
A transient corneal edema is often seen after the injection of acetylcholine solution in the anterior chamber during cataract surgery. Ninety eyes of 90 patients scheduled for extracapsular cataract extraction with posterior chamber intraocular lens implantation were randomly assigned to two groups: one which received acetylcholine solution in the anterior chamber and one, a control group, which received only external conjunctival pilocarpine drops as a miotic. At three days, endothelial folds (P = .04) and corneal edema (P = .01) were more pronounced in the acetylcholine group; at seven days, endothelial folds were more severe (P = .04) in the acetylcholine group. At 30 days, the acetylcholine group showed a 37.2% increase (P = .01) of the endothelial cell area, whereas the control group showed a 7.08% increase. The difference between the groups was statistically significant (P = .05). Anterior chamber fluorophotometry at 30 days showed an increase of the corneal transfer coefficient that was higher but not significant in the acetylcholine group. We suggest caution in the intraoperative use of acetylcholine solution, particularly in those eyes showing a preoperative compromise of the endothelium.
Istituto Scientifico Ospedale S, Raffaele, Clinica Oculistica dell'Universita di Milano, Italy.
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Scialdone
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Fantaguzzi
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Locatelli
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D000109:Acetylcholine / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D003316:Corneal Diseases / Q000150:complications*; D004487:Edema / Q000150:complications*; D004728:Endothelium, Corneal / Q000187:drug effects*; D005260:Female; D005470:Fluorometry; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D010781:Photography; D010862:Pilocarpine / Q000494:pharmacology; D011183:Postoperative Complications; D011897:Random Allocation; D013997:Time Factors
D010862:Pilocarpine; D000109:Acetylcholine