CORNEAL EDEMA FROM AN INTRAOCULAR IRRIGATING SOLUTION CONTAINING BENZALKONIUM CHLORIDE

An intraocular irrigating solution developed in India (Irrisol) has be en reported to cause immediate corneal edema when used during cataract surgery. The purpose of this study was to evaluate this intraocular i rrigating solution for endothelial toxicity and compare it to balanced salt solution (BSS), a similar irrigating solution used in the United States. Human and rabbit corneas were mounted for in vitro specular m icroscopy and endothelium perfused with Irrisol and BSS. The results o f this study showed that Irrisol caused immediate corneal swelling, wi th marked destruction of the corneal endothelial cells when observed w ith scanning and transmission electron microscopy. Further analysis sh owed that the Irrisol had a lower surface tension (35 dynes/cm) compar ed to BSS (73 dynes/cm). High-performance liquid chromatographic (HPLC ) analysis confirmed that the lower surface tension and the endothelia l damage were due to the addition of benzalkonium chloride (BAC) (0.00 9%) in the Irrisol intraocular irrigating solution.