Rmma. Nuyts et al., INTRAOCULAR IRRIGATING SOLUTIONS - A COMPARISON OF HARTMANNS LACTATEDRINGERS SOLUTION, BSS AND BSS PLUS, Graefe's archive for clinical and experimental ophthalmology, 233(10), 1995, pp. 655-661
Background: We evaluated the effects of Hartmann's lactated Ringer's (
HLR) solution, balanced salt solution (BSS) and BSS Plus on human corn
eal endothelium. Methods: Paired human corneas were mounted in the in
vitro specular microscope for endothelial perfusion with HLR, BSS or B
SS Plus for 15, 30, 60 and 120 min. Reversal experiments with BSS Plus
after initial HLR perfusion were performed. At the end of the perfusi
ons, electron microscopy, F-actin staining of the endothelial cytoskel
eton and endothelial permeability measurements were carried out. Resul
ts: Longterm perfusion (120 min) with HLR resulted in a significantly
higher swelling rate than in the paired controls perfused with BSS Plu
s. Short-term exposure to HLR for 15, 30 and 60 min after initial BSS
Plus perfusion increased the swelling rates significantly. The increas
ed corneal swelling after HLR perfusion for 60 min was reversed by BSS
Plus perfusion. Ultrastructural changes in HLR-perfused corneas inclu
ded endothelial cell edema, cytoplasmic vacuolation and mitochondrial
swelling. F-actin staining showed overall cytoskeletal disorganization
after perfusion with HLR. Corneal endothelial permeability was higher
for BSS Plus-perfused corneas than with HLR solution. Conclusion: The
results suggest that the clinically observed corneal clouding during
irrigation with HLR is due to endothelial cell edema and decreased end
othelial pump function. However, this increased corneal swelling is re
versible by perfusion with BSS Plus.