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D.L. MacKersie, R.I. Cho, R.L. Goodman, J.M. Jumper; Comparison of BSS Plus TM and Dextrose-Bicarbonate-Lactated Ringers Solution for Intraocular Irrigation During Phacoemulsification . Invest. Ophthalmol. Vis. Sci. 2003;44(13):230.
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Purpose: To compare BSS Plus TM and Dextrose-Bicarbonate-Lactated Ringers (DBLR) as irrigation solutions for phacoemulsification cataract extraction and lens implantation. Methods: Forty-two patients were evaluated in a prospective, randomized, double-blinded clinical trial of BSS Plus TM (n = 20) and DBLR (n = 22). Central corneal specular microscopy and pachymetry were obtained preoperatively and on postoperative days 7 and 90. The amount of irrigation solution used, phacoemulsification energy and time, intraoperative corneal clarity, and surgical complications were recorded. Results: There was no statistically significant difference in the volume of irrigation solution used, or in the phacoemulsification time or energy required between the two groups. One case (DBLR) required an anterior vitrectomy with anterior chamber IOL implantation, and intraoperative corneal edema was noted. There was no significant difference in the change in endothelial cell density between patients receiving BSS Plus TM (mean ± SD, -416.5 ± 442.8 cells/mm2) and DBLR (-369.8 ± 533.4 cells/mm2) (p = 0.8). There was no significant difference in the change in endothelial cell size, percent hexagonality, coefficient of variation, or corneal thickness between the two groups. Conclusions: The minor electrolyte differences and lack of glutathione in DBLR compared to BSS Plus TM does not appear to have a detrimental effect on the corneal endothelium. Given the affordability of DBLR, it should be considered as an alternative irrigation solution during standard phacoemulsification cataract extraction and lens implantation.
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