Comparison between Ringer's lactate and balanced salt solution on postoperative outcomes after phacoemulsfication: A randomized clinical trial

AIM: To compare the effects of balanced salt solution (BSS) and Ringer's lactate (RL) on corneal thickness, endothelial morphology, and postoperative anterior chamber inflammation in eyes undergoing phacoemulsification. SETTING: Iladevi cataract and IOL research center, Ahmedabad, India. MATERIALS AND METHODS: This prospective randomized study comprised 90 consecutive patients with age-related cataract who were randomly assigned to either Group 1 (n = 45) with BSS or Group 2 (n = 45) with RL. Observations made included measurement of central corneal thickness (CCT), presence of anterior chamber flare and cells, endothelial cell loss, and change in coefficient of variation (CV). Data was analyzed using Mann Whitney test and test of proportion. RESULTS: Mean increase in CCT on postoperative Day 1 was 58 µm and 97 µm in Groups 1 and 2 respectively (P = 0.01). Increase in CCT at one month was 10µm and 11µm in Groups 1 and 2 respectively (P = 0.99); increase in CCT at three months was 3 µm and 6 µm in Groups 1 and 2 respectively (P = 0.86). Number of eyes with flare grades in a range of 0 to 3 was statistically higher in Group 2 on postoperative Day 1 (P = 0.004, 0.016, <0.001, 0.047 for Grade 0, 1, 2 and 3 respectively). Number of eyes with cells of Grade 3 on first postoperative day was significantly higher in Group 2 as compared to Group 1 (P = 0.004). Three months postoperatively, endothelial cell loss was 5.5% and 7.8% in Groups 1 and 2 (P = 0.21) and change in CV was 3 and 5.4 in Groups 1 and 2 (P = 0.20) respectively. CONCLUSION: BSS offers a significant advantage over RL in terms of increase in corneal thickness and postoperative inflammation on the first postoperative day in patients undergoing phacoemulsification.