Comparison of intraocular irrigating solutions used for pars plana vitrectomy and prevention of endothelial cell loss.

We performed a prospective study of corneal endothelial cell loss following pars plana vitrectomy. Two different intraocular irrigating solutions were used, and the anterior capsule of the lens was removed when performing lensectomy. The central corneal endothelium was photographed with a specular microscope before and at three months after vitrectomy. Endothelial cell loss was calculated using a computer-assisted digitizer. In the 16 aphakic eyes, lactated Ringer's solution caused a significantly greater cell loss (31.1%) with resultant corneal edema when compared to BSS Plus (6.9%). All of the 17 phakic eyes showed minimal cell loss (1.0%) as well as corneal changes regardless of the kind of irrigating solution used. The results suggest that the absence of the lens is a salient factor in corneal endothelial damage during vitrectomy, and that the composition of the intraocular solution used is closely related to this endothelial damage.