Intraocular irrigating solutions. A randomized clinical trial of balanced salt solution plus and dextrose bicarbonate lactated Ringer's solution.
BACKGROUND
Two intraocular irrigating solutions which differ principally by the presence of oxidized glutathione were compared in this randomized, masked, prospective study to discern differences in preservation of endothelial cell size.


METHODS
Sixty-four patients undergoing extracapsular cataract extractions were randomized between two irrigating solution groups, Balanced Salt Solution (BSS) Plus (n = 30) and dextrose bicarbonate lactated Ringer's solution (n = 34). Preoperative and postoperative endothelial specular photomicrographs were analyzed for cell size and hexagonality, and the two groups were compared using repeated measures analysis of variance.


RESULTS
Fifty-eight subjects (91%) completed the 2-month study. Change in cell size for the BSS Plus group (n = 28) (mean +/- standard error, 29.4 +/- 12.3 microns2) was not significantly different from the dextrose bicarbonate lactated Ringer's solution group (n = 30) (27.5 +/- 12.9 microns2) (P = 0.92). Groups did not differ significantly in percent hexagonality (P = 0.57) or in the variability of cell size (P = 0.61).


CONCLUSIONS
The presence of glutathione in BSS Plus and other minor electrolyte differences between the solutions is not more advantageous with regard to endothelial cell size than dextrose bicarbonate lactated Ringer's solution for standard extracapsular cataract surgery. Cost per 500-microliters bottle of BSS plus is $62 compared with $9.80 for dextrose bicarbonate lactated Ringer's solution.
Puckett
T R
TR
Department of Ophthalmology, Winn Army Community Hospital, Ft. Stewart, Georgia.
Peele
K A
KA
Howard
R S
RS
Kramer
K K
KK
D000368:Aged; D001639:Bicarbonates / Q000008:administration & dosage* / Q000191:economics; D002387:Cataract Extraction; D002452:Cell Count; D048429:Cell Size; D004311:Double-Blind Method; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000166:cytology / Q000187:drug effects; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D005978:Glutathione / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage* / Q000191:economics; D007910:Lenses, Intraocular; D008297:Male; D009883:Ophthalmic Solutions / Q000191:economics; D011446:Prospective Studies; D000077325:Ringer's Lactate; D007507:Therapeutic Irrigation / Q000191:economics
D001639:Bicarbonates; D004338:Drug Combinations; D007552:Isotonic Solutions; D009883:Ophthalmic Solutions; D000077325:Ringer's Lactate; C013003:glutathione-bicarbonate-Ringer solution; D005978:Glutathione; D005947:Glucose