Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification

J Cataract Refract Surg. 2000 Mar;26(3):392-7. doi: 10.1016/s0886-3350(99)00470-8.


Purpose: To evaluate the effect of irrigation solution and temperature on pupil diameter, corneal endothelium, and corneal pachymetry during and after phacoemulsification.

Setting: Klinik Dardenne, Bonn, Germany.

Methods: Eighty patients who had cataract surgery by phacoemulsification were assigned to 1 of 4 cross-classified groups and had intraoperative irrigation with room-temperature or refrigerated fortified balanced salt solution (BSS Plus) or modified Ringer's solution. Pupil diameters were recorded at different stages during the surgery. Epithelial cell counts and pachymetry were determined before and 1 day after surgery.

Results: The solution temperature did not affect any parameter. The type of solution did not influence endothelial cell loss; however, the solution had a significant effect on corneal pachymetry 1 day postoperatively. The corneas irrigated with BSS Plus were less swollen than the corneas irrigated with Ringer's solution. By day 14, corneal thickness was equal among all groups.

Conclusion: Long-term results were equally favorable in all 4 groups. However BSS Plus induced less short-term corneal swelling than Ringer's solution. From these findings, it appears that BSS Plus may decrease corneal risk in cases with compromised corneas or prolonged surgery.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bicarbonates / administration & dosage*
  • Cell Count
  • Cold Temperature*
  • Corneal Diseases / prevention & control
  • Corneal Stroma / cytology
  • Corneal Stroma / drug effects*
  • Drug Combinations
  • Endothelium, Corneal / cytology
  • Endothelium, Corneal / drug effects*
  • Female
  • Glutathione / administration & dosage*
  • Humans
  • Intraoperative Period
  • Isotonic Solutions / administration & dosage*
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Phacoemulsification*
  • Postoperative Complications / prevention & control
  • Pupil / drug effects*
  • Ringer's Solution
  • Safety
  • Therapeutic Irrigation
  • Treatment Outcome


  • Bicarbonates
  • Drug Combinations
  • Isotonic Solutions
  • Ophthalmic Solutions
  • glutathione-bicarbonate-Ringer solution
  • Ringer's Solution
  • Glutathione