Comparison of corneal changes after phacoemulsification using BSS plus versus lactated Ringer's irrigating solution: A prospective randomised trial

David R. Lucena, Maria S.A. Ribeiro, André Messias, Harley E.A. Bicas, Ingrid Scott, Rodrigo Jorge

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background/aims: To compare two intraocular irrigating solutions, Balanced Salt Solution Plus (BSS Plus) versus. Lactated Ringer's (Ringer), for the preservation of corneal integrity after phacoemulsification. Methods: 110 patients undergoing phacoemulsification were randomised to either BSS Plus (n=55) or Ringer (n=55) as the irrigating solution. Patients were examined at baseline and at 1, 8, 15, 30 and 60 days postoperatively. Evaluations included specular microscopy to evaluate endothelial cell density (ECD) and endothelial cell size variability (CV), and corneal pachymetry for central corneal thickness (CCT) measurement. Results: Groups were well balanced regarding baseline ECD, CV and CCT (p>0.05). There was no statistically significant difference between ECD reduction in group BSS Plus 13.1±2.0% and Ringer 9.2±1.9% (p<0.05) at day 60 or in any study visit. There was no statistically significant difference between CV increase in group BSS Plus 23.0±3.0% and Ringer 20.2±4.0% (p<0.05) at day 60 or in any study visit. CCT was significantly increased (p<0.05) at 1, 8, 15 and 30 days postoperatively, returning to baseline at 60 days in both groups. There was no significant difference in CCT increase in both groups at any visit. Interestingly, there were statistically significant correlations between ECD loss and phacoemulsification time (p<0.0001) and ECD loss and irrigation solution volume (p<0.0001) in the Ringer group, but not in the BSS Plus group. Conclusions: Ringers solution was similar to BSS Plus for corneal preservation in atraumatic cataract surgery. However, our study demonstrates that there is a trend towards lower postoperative endothelial cell density for surgeries with longer phacoemulsification time and higher irrigation volumes if Ringer is used. Trial registration number NCT00801358.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalBritish Journal of Ophthalmology
Volume95
Issue number4
DOIs
StatePublished - Jan 1 2011

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Phacoemulsification
Endothelial Cells
Salts
Cell Count
Cell Size
Corneal Pachymetry
Ringer's solution
Ringer's lactate
glutathione-bicarbonate-Ringer solution
Cataract
Microscopy

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Lucena, David R. ; Ribeiro, Maria S.A. ; Messias, André ; Bicas, Harley E.A. ; Scott, Ingrid ; Jorge, Rodrigo. / Comparison of corneal changes after phacoemulsification using BSS plus versus lactated Ringer's irrigating solution : A prospective randomised trial. In: British Journal of Ophthalmology. 2011 ; Vol. 95, No. 4. pp. 485-489.
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abstract = "Background/aims: To compare two intraocular irrigating solutions, Balanced Salt Solution Plus (BSS Plus) versus. Lactated Ringer's (Ringer), for the preservation of corneal integrity after phacoemulsification. Methods: 110 patients undergoing phacoemulsification were randomised to either BSS Plus (n=55) or Ringer (n=55) as the irrigating solution. Patients were examined at baseline and at 1, 8, 15, 30 and 60 days postoperatively. Evaluations included specular microscopy to evaluate endothelial cell density (ECD) and endothelial cell size variability (CV), and corneal pachymetry for central corneal thickness (CCT) measurement. Results: Groups were well balanced regarding baseline ECD, CV and CCT (p>0.05). There was no statistically significant difference between ECD reduction in group BSS Plus 13.1±2.0{\%} and Ringer 9.2±1.9{\%} (p<0.05) at day 60 or in any study visit. There was no statistically significant difference between CV increase in group BSS Plus 23.0±3.0{\%} and Ringer 20.2±4.0{\%} (p<0.05) at day 60 or in any study visit. CCT was significantly increased (p<0.05) at 1, 8, 15 and 30 days postoperatively, returning to baseline at 60 days in both groups. There was no significant difference in CCT increase in both groups at any visit. Interestingly, there were statistically significant correlations between ECD loss and phacoemulsification time (p<0.0001) and ECD loss and irrigation solution volume (p<0.0001) in the Ringer group, but not in the BSS Plus group. Conclusions: Ringers solution was similar to BSS Plus for corneal preservation in atraumatic cataract surgery. However, our study demonstrates that there is a trend towards lower postoperative endothelial cell density for surgeries with longer phacoemulsification time and higher irrigation volumes if Ringer is used. Trial registration number NCT00801358.",
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Comparison of corneal changes after phacoemulsification using BSS plus versus lactated Ringer's irrigating solution : A prospective randomised trial. / Lucena, David R.; Ribeiro, Maria S.A.; Messias, André; Bicas, Harley E.A.; Scott, Ingrid; Jorge, Rodrigo.

In: British Journal of Ophthalmology, Vol. 95, No. 4, 01.01.2011, p. 485-489.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of corneal changes after phacoemulsification using BSS plus versus lactated Ringer's irrigating solution

T2 - A prospective randomised trial

AU - Lucena, David R.

AU - Ribeiro, Maria S.A.

AU - Messias, André

AU - Bicas, Harley E.A.

AU - Scott, Ingrid

AU - Jorge, Rodrigo

PY - 2011/1/1

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N2 - Background/aims: To compare two intraocular irrigating solutions, Balanced Salt Solution Plus (BSS Plus) versus. Lactated Ringer's (Ringer), for the preservation of corneal integrity after phacoemulsification. Methods: 110 patients undergoing phacoemulsification were randomised to either BSS Plus (n=55) or Ringer (n=55) as the irrigating solution. Patients were examined at baseline and at 1, 8, 15, 30 and 60 days postoperatively. Evaluations included specular microscopy to evaluate endothelial cell density (ECD) and endothelial cell size variability (CV), and corneal pachymetry for central corneal thickness (CCT) measurement. Results: Groups were well balanced regarding baseline ECD, CV and CCT (p>0.05). There was no statistically significant difference between ECD reduction in group BSS Plus 13.1±2.0% and Ringer 9.2±1.9% (p<0.05) at day 60 or in any study visit. There was no statistically significant difference between CV increase in group BSS Plus 23.0±3.0% and Ringer 20.2±4.0% (p<0.05) at day 60 or in any study visit. CCT was significantly increased (p<0.05) at 1, 8, 15 and 30 days postoperatively, returning to baseline at 60 days in both groups. There was no significant difference in CCT increase in both groups at any visit. Interestingly, there were statistically significant correlations between ECD loss and phacoemulsification time (p<0.0001) and ECD loss and irrigation solution volume (p<0.0001) in the Ringer group, but not in the BSS Plus group. Conclusions: Ringers solution was similar to BSS Plus for corneal preservation in atraumatic cataract surgery. However, our study demonstrates that there is a trend towards lower postoperative endothelial cell density for surgeries with longer phacoemulsification time and higher irrigation volumes if Ringer is used. Trial registration number NCT00801358.

AB - Background/aims: To compare two intraocular irrigating solutions, Balanced Salt Solution Plus (BSS Plus) versus. Lactated Ringer's (Ringer), for the preservation of corneal integrity after phacoemulsification. Methods: 110 patients undergoing phacoemulsification were randomised to either BSS Plus (n=55) or Ringer (n=55) as the irrigating solution. Patients were examined at baseline and at 1, 8, 15, 30 and 60 days postoperatively. Evaluations included specular microscopy to evaluate endothelial cell density (ECD) and endothelial cell size variability (CV), and corneal pachymetry for central corneal thickness (CCT) measurement. Results: Groups were well balanced regarding baseline ECD, CV and CCT (p>0.05). There was no statistically significant difference between ECD reduction in group BSS Plus 13.1±2.0% and Ringer 9.2±1.9% (p<0.05) at day 60 or in any study visit. There was no statistically significant difference between CV increase in group BSS Plus 23.0±3.0% and Ringer 20.2±4.0% (p<0.05) at day 60 or in any study visit. CCT was significantly increased (p<0.05) at 1, 8, 15 and 30 days postoperatively, returning to baseline at 60 days in both groups. There was no significant difference in CCT increase in both groups at any visit. Interestingly, there were statistically significant correlations between ECD loss and phacoemulsification time (p<0.0001) and ECD loss and irrigation solution volume (p<0.0001) in the Ringer group, but not in the BSS Plus group. Conclusions: Ringers solution was similar to BSS Plus for corneal preservation in atraumatic cataract surgery. However, our study demonstrates that there is a trend towards lower postoperative endothelial cell density for surgeries with longer phacoemulsification time and higher irrigation volumes if Ringer is used. Trial registration number NCT00801358.

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