Clinical comparison of ocular irrigation fluids following chemical injury

This study tested the hypothesis that four ocular irrigating solutions were equally irritating during copious irrigation. We conducted a prospective, double-blind study of patients with chemical exposure to the eye. Each underwent cross-over irrigation with all of the following in random order: normal saline (NS), lactated Ringer's (LR), normal saline adjusted to pH 7.4 with sodium bicarbonate (NS + Bicarb), and Balanced Saline Solution Plus (BSS Plus, Alcon Laboratories, Fort Worth, TX). Compared with traditional NS and LR, NS + Bicarb tended to be more comfortable. BSS Plus was statistically superior (P less than .05) to NS and preferred over LR and NS + Bicarb. Three patients demanded discontinuance of NS or NS + Bicarb infusions. All solutions had comparable normalization of conjunctival pH and degree of injection. Alternate solutions including BSS Plus should be considered for use in those patients whose poor tolerance to normal saline threatens to delay or interrupt eye irrigation following a chemical injury.