Positive effects of using ringer lactate in small incision cataract surgery without viscoelastic

Santhanalakshmi R; Karthick S

Volume : VII, Issue : VIII, August - 2018

Positive effects of using ringer lactate in small incision cataract surgery without viscoelastic

Santhanalakshmi R, Karthick S

Abstract :

Purpose: To study the advantages of using ringer lactate instead of viscoelastic substance for implantation of intraocular lens (IOL) in small incision cataract surgery (SICS).

Methods: A prospective, randomized, interventional study was performed in which 100 patients of senilecataract were included. The patients were randomly divided in two groups; one in whom IOL was implanted in ringer lactate (ringer group) and other in which viscoelastic substance Hydroxypropyl Methylcellulose (visco group) was used for implantation of IOL. The outcome was evaluated on safety, efficacy, postoperative intraocular pressure (IOP), postoperative reaction, endothelial cell count and surgical time.

Results: The mean post operative IOP at 6, 24 and 48 hrs in ringer lactate group was 15.67, 13.07 and12.07 mmHg and in viscoelastic group 21.93, 18.30 and 13.53 mmHg respectively. The difference between the groups was significant (p value <0.0001). The mean post operative reaction at 24 and 48 hrs in ringer group was 1.50 and 0.71 and in visco group 1.97 and 1.20 respectively (p value < 0.0001). Regarding position of IOLs, the two groups were comparable chi square value =0.218; p value >.05). The mean endothelial cell loss in viscogroup was 136.55 cells (5.49%), and in ringer group it was 227.03 cells (9.2%) (p>0.05). The mean surgical time in visco group was5.86 � 0.53 minutes and in ringer group, the same was 4.97 � 0.34 minutes (p value < 0.0001). There was no intra-operative complication in any group.

Conclusion: A small modification in one step of SICS can significantly control spikes of IOP with significantly lesser post operative reaction. With some experience, implantation of IOL in the bag under a continuous irrigation of ringer lactate is safe, accurate and less time consuming method without any significant extra loss of endothelial cells.