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Intraocular irrigating solutions. Their effect on the corneal endothelium
Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 1, 1975
Summary
Balanced salt solutions with bicarbonate, glutathione, and adenosine best protect the corneal endothelium from swelling and degeneration during intraocular surgery. Other solutions caused significant cell damage.
Area of Science:
- Ophthalmology
- Corneal Science
- Surgical Irrigation Solutions
Background:
- The corneal endothelium is vital for maintaining corneal clarity.
- Intraocular surgery requires irrigating solutions that minimize endothelial damage.
- Previous solutions have shown varying degrees of toxicity.
Purpose of the Study:
- To evaluate the effects of different intraocular irrigating solutions on corneal endothelial cells.
- To identify irrigating solutions that preserve endothelial ultrastructure.
- To compare the protective qualities of various solutions.
Main Methods:
- Utilized a specular microscope perfusion system.
- Examined rabbit and monkey corneas.
- Employed scanning and transmission electron microscopy for ultrastructural analysis.
Main Results:
- 0.9% saline caused rapid swelling (60-90 µm/hr) and severe endothelial cell degeneration.
- Lactated Ringer solution led to slower swelling (37-40 µm/hr) and progressive degeneration.
- Balanced salt solution resulted in less swelling (24-31 µm/hr) with severe changes after two hours.
- Ringer solution with bicarbonate, glutathione, and adenosine prevented swelling and showed minimal ultrastructural damage for up to six hours.
Conclusions:
- Intraocular irrigating solutions significantly impact corneal endothelial integrity.
- A specific Ringer solution formulation (with bicarbonate, glutathione, and adenosine) offers superior protection.
- This optimized solution minimizes corneal edema and endothelial cell damage during ocular procedures.