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D. R. Lucena, A. V. Messias, M. A. Lucena, I. U. Scott, R. Jorge; Comparison of Corneal Changes After Fhacoemulsification Using BSS Plus versus Lactated Ringer`s Irrigating Solution: A Prospective Randomized Trial. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2906.
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Two intraocular irrigating solutions (BSS Plus versus Lactated Ringer's) were compared in this prospective, randomized, masked trial to investigate for differences in preservation of corneal integrity after phacoemulsification cataract surgery.
One hundred and ten patients undergoing phacoemulsification were randomized to surgery with either Balanced Salt Solution (BSS) Plus (n = 55) or lactated Ringer's as the irrigating solution (n = 55). Patients underwent comprehensive ophthalmic evaluations at baseline and at 1, 8, 15, 30 and 60 days postoperatively. Evaluations included Snellen best-corrected visual acuity (BCVA), specular microscopy and corneal pachymetry. Main outcome measures included endothelial cell density (ECD) and central corneal thickness (CCT); secondary outcome measures included number of anterior chamber cells and flare grade.
One hundred patients completed all study visits. Treatment groups were well-balanced with respect to cataract density, preoperative visual acuity, phacoemulsification time and amount of irrigation solution employed during surgery. Mean (±SEM) baseline ECD was 2836 ± 355 cells/mm and 2728 ± 501 cells/mm in the BSS Plus and Lactated Ringer's groups, respectively (p=0.1092). Mean ECD was significantly (p<0.05) reduced in both groups at 1, 8, 15, 30 and 60 days postoperatively. There was no significant difference between the groups in mean ECD at any of the study visits. Mean (± SEM) baseline CCT was 516 ± 4 µm and 513 ± 4 µm in the BSS Plus and Lactated Ringer's groups, respectively (p=0.3364). Mean CCT was significantly (p<0.05) increased in both groups at 1, 8, 15 and 30 days postoperatively, returning to baseline at 60 days. There was no significant difference between the groups in mean CCT, number of anterior chamber cells, and mean flare grade at any of the study visits. There was no case of endophthalmitis during the study.
Corneal changes after phacoemulsification cataract surgery were similar regardless of whether BSS Plus or lactated Ringer's was used as the irrigating solution.
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