Comparison between Ringer's lactate and balanced salt solution on postoperative outcomes after phacoemulsfication: a randomized clinical trial.
OBJECTIVE
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.


METHODS
Iladevi cataract and IOL research center, Ahmedabad, India.


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 58microm and 97microm in Groups 1 and 2 respectively ( P = 0.01). Increase in CCT at one month was 10microm and 11microm in Groups 1 and 2 respectively ( P = 0.99); increase in CCT at three months was 3microm and 6microm 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.


CONCLUSIONS
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.
Vasavada
Viraj
V
IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India.
Vasavada
Vaishali
V
Dixit
Nirmit V
NV
Raj
Shetal M
SM
Vasavada
Abhay R
AR
D000085:Acetates / Q000008:administration & dosage*; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D002452:Cell Count; D003315:Cornea / Q000473:pathology; D004311:Double-Blind Method; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000008:administration & dosage*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000209:etiology / Q000517:prevention & control*
D000085:Acetates; C030660:BSS solution; D004338:Drug Combinations; D007552:Isotonic Solutions; D008903:Minerals; D009883:Ophthalmic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride