Abstract
Abstract: :
Purpose:To examine the protective role of glutathione and ascorbic acid added to Balanced Salt Solution, in reducing corneal endothelial cell loss secondary to free radicals damage, by high–energy ultrasonic energy during phacoemulsification surgery. Methods:Four groups of 8 rabbits were exposed to prolonged phacoemulsification, activated within the anterior chamber in a stationary position . The four groups differed only in the composition of the irrigating solutions as follows: group I: 10–2 M of ascorbic acid, group II:10–3M of GSSG, group III: Balanced Salt Solution Plus® and group IV: control group, regular BSS®. Specular microscopy was performed prior to surgery, and at one, two and three weeks post–surgery.. Results:The highest endothelial cell loss was recorded in the control group IV (BSS) with a mean cell loss of 20% (SE = 0.24), followed by group III (BSS Plus ) – 10.7% (SE = 0.31), group II (GSSG) – 7.7% (SE = 0.27) and group I (ascorbic acid) – 0.8% (SE = 0.27). The differences between the four groups were highly significant ( p=0.001). No significant difference were found between cell counts at 1,2 and 3 weeks in any of the groups (P= 0.52) Conclusions:Ascorbic acid and glutathione added to the irrigation solution during phacoemulcification demonstrated a clear protective effect on the endothelial corneal cells. This suggests that the ill effect of the high intensity ultrasonic energy is primarily mediated by the formation of free radicals. Ascorbic acid is a safe and highly potent scavenger and should be further investigated in clinical settings.
Keywords: antioxidants • cataract • anterior segment