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Published on: October 1, 2007
Toxic endothelial cell destruction from intraocular benzalkonium chloride
H Liu1, I Routley, K D Teichmann
1Orana Eye Centre, Dubbo, New South Wales, Australia.
Journal of Cataract and Refractive Surgery
|November 16, 2001
Summary
Accidental intraocular use of balanced salt solution (BSS) preserved with benzalkonium chloride caused severe corneal edema in 12 patients after phacoemulsification surgery. This complication highlights the toxicity of benzalkonium chloride to the corneal endothelium.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ocular Toxicology
Background:
- Phacoemulsification is a common cataract surgery technique.
- Corneal edema is a potential complication following intraocular surgery.
- Balanced salt solution (BSS) is frequently used during ophthalmic procedures.
Purpose of the Study:
- To report a series of cases of corneal edema after phacoemulsification.
- To identify the cause of persistent corneal edema in these patients.
Main Methods:
- Retrospective case series of 12 patients.
- Analysis of cases from a single surgical list at a rural Australian hospital.
- Investigation of the cause of persistent corneal edema post-phacoemulsification.
Main Results:
- 19 cases of persistent corneal edema were identified after phacoemulsification.
- Inadvertent intraocular use of BSS preserved with benzalkonium chloride was identified as the cause.
- Edema resolved in only 1 patient after 6 months.
Conclusions:
- Benzalkonium chloride is highly toxic to the corneal endothelium, even at concentrations used extraocularly.
- Preventing inadvertent intraocular administration of preserved solutions is critical.
- Strict safety measures are necessary to avoid similar complications in ophthalmic surgery.
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