title: Effect on corneal endothelial cell loss during phacoemulsification: fortified balanced salt solution versus Ringer lactate.
abstract: OBJECTIVE
  To compare the effect of phacoemulsification on the corneal endothelium using fortified balanced salt solution (BSS Plus) and Ringer lactate as the intraocular irrigating solution.
  
  
  METHODS
  P.D. Hinduja Hospital, Mumbai, India.
  
  
  METHODS
  Prospective randomized controlled double-blinded clinical study.
  
  
  METHODS
  Patients with senile cataract up to nuclear grade III were randomized to have phacoemulsification with posterior chamber intraocular lens implantation performed using fortified balanced salt solution (Group A) or Ringer lactate (Group B) as the intraocular irrigating solution. The corneal endothelial cell density (primary outcome) and pachymetry were measured preoperatively and 1 week and 1 and 6 months postoperatively.
  
  
  RESULTS
  Each group comprised 35 eyes (35 patients). The postoperative percentage of endothelial cell loss was not significantly different between the 2 groups at 1 week (P=.582), 1 month (P=.668), or 6 months (5.03% and 8.35% in Group A and Group B, respectively) (P=.483) and was within the limits reported in the literature. The postoperative percentage change in pachymetry was not significantly different between the 2 groups at 1 week (P=.179) or 1 month (P=.170) but was significant at 6 months (P<.001) (-1.59% and 0.54% in Group A and Group B, respectively); however, the mean pachymetry value was near baseline in both groups at 6 months.
  
  
  CONCLUSIONS
  Corneal endothelial cell loss after phacoemulsification with Ringer lactate was similar to that with fortified balanced salt solution over the long term.
authors: P.D. Hinduja Hospital and Medical Research Center, Mumbai, India. drbknayak@gmail.com
authors: Barun K
authors: BK
authors: Nayak
authors: Rashmi O
authors: RO
authors: Shukla
mesh_terms: D001639:Bicarbonates / Q000008:administration & dosage*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis*; D004311:Double-Blind Method; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005978:Glutathione / Q000008:administration & dosage*; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D000077325:Ringer's Lactate; D007507:Therapeutic Irrigation / Q000379:methods
chemical_list: D001639:Bicarbonates; D004338:Drug Combinations; D007552:Isotonic Solutions; D009883:Ophthalmic Solutions; D000077325:Ringer's Lactate; C013003:glutathione-bicarbonate-Ringer solution; D005978:Glutathione