Comparison of corneal changes after phacoemulsification using BSS Plus versus Lactated Ringer's irrigating solution:...

Area of Science:

• Ophthalmology
• Surgical Innovation
• Corneal Health

Background:

• Phacoemulsification for cataract removal requires intraocular irrigation solutions.
• Balanced Salt Solution Plus (BSS Plus) and Lactated Ringer's (Ringer) are commonly used.
• Preserving corneal integrity post-surgery is critical.

Purpose of the Study:

• To compare the efficacy of BSS Plus versus Ringer's solution in preserving corneal integrity after phacoemulsification.
• Evaluate the impact on endothelial cell density, cell size variability, and corneal thickness.

Main Methods:

• A randomized controlled trial involving 110 patients undergoing phacoemulsification.
• Patients received either BSS Plus (n=55) or Ringer's (n=55) as the irrigating solution.
• Corneal evaluations included specular microscopy (endothelial cell density and variability) and pachymetry (central corneal thickness) at multiple postoperative time points.

Main Results:

• No significant differences in endothelial cell density reduction or cell size variability between BSS Plus and Ringer's groups at 60 days.
• Central corneal thickness increased postoperatively in both groups, returning to baseline by 60 days, with no significant inter-group difference.
• Correlations between endothelial cell loss and phacoemulsification time/irrigation volume were observed with Ringer's, but not with BSS Plus.

Conclusions:

• Ringer's solution demonstrates similar safety and efficacy to BSS Plus for corneal preservation in routine cataract surgery.
• A trend suggests potential for lower endothelial cell density with Ringer's solution in cases involving prolonged phacoemulsification or high irrigation volumes.
• Further investigation may be warranted for specific surgical scenarios.