Effect Of Irrigating Solutions On The Corneal Endothelium Following Phacoemulsification: Balanced Salt Solution Versus Ringer Lactate

Introduction: Phacoemulsification surgery results in endothelial damage, which is permanent. Several studies have shown that Balanced Salt Solution (BSS) helps to preserve endothelium better than Ringer Lactate (RL) due to its superior composition. Aims & Objectives: To compare the effects of RL and BSS on the corneal endothelium following phacoemulsification cataract surgery. Methodology: 60 patients were randomly allocated into groups using an envelope system, to RL (n=29) and BSS (n=31). Following phacoemulsification, each patient underwent Central Corneal Thickness (CCT) evaluation by pachymetry at postop day 1, week 1 and week 6. Endothelial Cell Density (ECD), Co-efficient of variation of cells (COV), and Hexagonality of cells (HEX) were studied using specular microscopy at the post-op 6 week period. Results: There was no significant difference in the change in CCT between the RL and BSS groups at post-op day1 , week 1 and week 6 periods respectively (p>0.05). The mean decrease in endothelial cell density was 394.72 cells/mm2 (±189.04) and 337.96 cells/mm2 (±165.30) in the RL and BSS groups respectively (p=0.220). The change in COV was 0.21% (±.03.5) and 1.49 (±3.75) % in the RL and BSS groups ((p=0.081)and the change in hexagonality of cells was -2.62 % (±8.77) and -2.61% (±7.59) in the RL and BSS groups respectively. (p=0.997). There was no significant correlation between the change in ECD/COV/HEX/CCT with respect to effective phaco time/ phacoemulsification volume in either group. Conclusion: Both Ringer Lactate and Balanced salt solution were similar in their ability to protect the endothelium following phacoemulsification surgery