Effects of BSS and BSS+ irrigation solutions on rabbit corneal transendothelial electrical potential difference

Measurements of electrical potential difference across isolated rabbit corneal endothelium (transendothelial electrical potential difference, TEPD) were used to evaluate the effect of two commonly used commercially prepared intraocular irrigation balanced salt solutions, BSS and BSS+, together with our own standard bicarbonate-containing control solution (BS). The highest and most durable TEPD values were obtained by using BSS+; TEPD began at 550 microV, peaked at 600 microV 1 h later, and then decreased slowly down to some 300 microV after about 8 h. Gassing BSS+ with an air/5% CO2 mixture was optimal; gassing it with air reduced the TEPD values slightly, by about 10%. On the other hand, perfusion with BSS gassed with air had a rapid and marked adverse effect; the TEPD, which began at some 500 microV, fell down precipitously to about 50 microV after 1 hour. In contrast, perfusion with BSS on the endothelial side with the addition of BS to the stromal side, both sides being gassed with an air/5% CO2 mixture, maintained the TEPD at levels near those obtained with BSS+. We attribute the adverse effect by BSS to the absence of bicarbonate in it. From these and past results, we conclude that BSS cannot be recommended for intraocular use as a properly balanced saline solution.