INTRAOCULAR IRRIGATING SOLUTIONS - A RANDOMIZED CLINICAL-TRIAL OF BALANCED SALT SOLUTION PLUS AND DEXTROSE BICARBONATE LACTATED RINGERS SOLUTION

Background: Two intraocular irrigating solutions which differ principa lly by the presence of oxidized glutathione were compared in this rand omized, masked, prospective study to discern differences in preservati on of endothelial cell size. Methods: Sixty-four patients undergoing e xtracapsular cataract extractions were randomized between two irrigati ng solution groups, Balanced Salt Solution (BSS) Plus (n = 30) and dex trose bicarbonate lactated Ringer's solution (n = 34). Preoperative an d postoperative endothelial specular photomicrographs were analyzed fo r cell size and hexagonality, and the two groups were compared using r epeated measures analysis of variance. Results: Fifty-eight subjects ( 91%) completed the 2-month study. Change in cell size for the BSS Plus group (n = 28) (mean +/- standard error, 29.4 +/- 12.3 mu m(2)) was n ot significantly different from the dextrose bicarbonate lactated Ring er's solution group (n = 30) (27.5 +/- 12.9 mu m(2)) (P = 0.92). Group s did not differ significantly in percent hexagonality (P = 0.57) or i n the variability of cell size (P = 0.61). Conclusion: The presence of glutathione in BSS Plus and other minor electrolyte differences betwe en the solutions is not more advantageous with regard to endothelial c ell size than dextrose bicarbonate lactated Ringer's solution for stan dard extracapsular cataract surgery. Cost per 500-ml bottle of BSS plu s is $62 compared with $9.80 for dextrose bicarbonate lactated Ringer' s solution.