title: Presence of free radicals in intracameral agents commonly used during cataract surgery.
abstract: BACKGROUND
  Free radicals are known to cause cellular damage and are present in ophthalmic preparations. Corneal defence mechanisms are bypassed in intra-ocular surgery. We evaluated commonly used intracameral agents to ascertain the presence of free radicals and investigate the possibility of anterior segment and endothelial toxicity.
  
  
  METHODS
  Samples of 19 commonly used intracameral preparations were analysed for total free radical presence on an Instrument Laboratory IL600 using a Randox Kit for Total Antioxidant Status (RANDOX Laboratories Ltd, Crumlin, UK).
  
  
  RESULTS
  Free radical concentrations for the 19 intracameral agents ranged from 0 to 3.59 mmol/l, with median value of 0.34 mmol/l (mean value 0.933±1.19 mmol/l). Phenylephrine had the highest presence of free radicals, which were considerably higher than those for 0.5% hydrogen peroxide at all tested dilutions. Other notable results included cefuroxime (0.61 mmol/l), 2% undiluted lidocaine (0.34 mmol/l) and bevacizumab (0.59 mmol/l).
  
  
  CONCLUSIONS
  The results indicate that free radicals are present in intracameral surgical agents and some are in the order of 0.5% hydrogen peroxide. The risks of endothelial damage must be considered when using multiple intracameral preparations in complicated cataract surgery. Free radicals in intracameral preparations may be a contributing cause in cases of toxic anterior segment syndrome.
authors.affiliation: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK. davidlockington@hotmail.com
authors.forename: David
authors.initials: D
authors.lastname: Lockington
authors.forename: Elisabeth C A
authors.initials: EC
authors.lastname: Macdonald
authors.forename: David
authors.initials: D
authors.lastname: Young
authors.forename: Philip
authors.initials: P
authors.lastname: Stewart
authors.forename: Muriel
authors.initials: M
authors.lastname: Caslake
authors.forename: Kanna
authors.initials: K
authors.lastname: Ramaesh
mesh_terms: D002387:Cataract Extraction; D005609:Free Radicals / Q000032:analysis*; D009883:Ophthalmic Solutions / Q000737:chemistry*; D010656:Phenylephrine / Q000737:chemistry* / Q000494:pharmacology
chemical_list: D005609:Free Radicals; D009883:Ophthalmic Solutions; D010656:Phenylephrine