Warm balanced salt solution for clearing tear film precipitation during cataract surgery
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Updated: Sep 30, 2026

Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
Published on: April 25, 2025
Clifton S Otto1, Michael A McMann, Vernon C Parmley
1Madigan Army Medical Center, Ophthalmology Service, Tacoma, WA 98431, USA.
Abstract:
Adequate anterior segment visualization during cataract surgery can be hindered when excessive tear film secretions precipitate on the corneal surface before the initial corneal incision is made. In most cases, room-temperature balanced salt solution applied to the corneal surface clears the debris. However, in cases in which tear film precipitates persist after the use of room-temperature balanced salt solution, the application of warm balanced salt solution can provide rapid and sustained dispersion of the precipitates. We present our experience using this technique.
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