Comparison of endothelial cell changes by specular microscopy between Ringer's and Ringer's lactate during phacoemulsification

Abstract

AIM: To compare the difference between using Ringer's and Ringer's lactate(RL)solutions as irrigating solutions during phacoemulsification and investigate their effect on corneal endothelium.METHODS: This was a prospective interventional double blinded clinical study that included 100 eyes of 100 patients aged between 50 to 65 years suffering from a visually significant age-related cataract and scheduled for routine uncomplicated phacoemulsification. The included eyes were randomly divided into two equal groups(each group included 50 eyes). Group 1 received Ringer's solution and group 2 received Ringer's lactate as an irrigating solution.RESULTS: The first group with Ringer's solution had a mean age of 57.5±8 years and the second group with RL solution had a mean age of 58.6±9 years. After 3mo, endothelial cell density decreased in group 1 by a mean of 8.5%, and in group 2 by a mean of 3.6%(P=0.013). Additionally, central corneal thickness increased in group 1 by a mean of 6.9% and in group 2 by a mean of 1.5%(P=0.006). By correlating the percentage of change in pachymetry and specular microscopic parameters with volume of irrigation solution used, there was no significant correlation.CONCLUSION: The use of Ringer's lactate as an irrigating solution is associated with less endothelial cell loss postoperatively in comparison to Ringer's solution and also associated with decreased postoperative edema.

Keywords

• Ringer's
• Ringer's lactate
• phacoemulsification
• corneal edema
• specular microscopy