The Effect of Vitrectomy Infusion Solutions on Postoperative Electroretinography and Retina Histology

Abstract

PurposeA prospective, randomised, masked study comparing three different intraocular infusion solutions used during vitrectomy on postoperative electroretinography (ERG) and retinal histology of rabbit eyes.Methods, materials and animalsTwelve rabbit eyes were used with each group of three intraocular infusion solutions: Lactated Ringers (LR), balanced salt solution (BSS) and balanced salt solution-plus (BSS-Plus).ResultsAt 24 hours postoperatively, the ERG values were 36%, 68% and 75% of the normal values for LR, BSS and BSS-Plus, respectively. At 72 hours postoperatively, the ERG values were 50%, 84% and 100% of the normal values for LR, BSS and BSS-Plus, respectively. At 72 hours postoperatively, 3/12, 10/12 and 12/12 of the vitrectomised eyes had regained normal-value ERGs for LR, BSS, and BSS-Plus eyes, respectively. At 1 week postoperatively, 4/12 and 12/12 of LR and BSS eyes, respectively, had normal ERGs. The number of LR eyes regaining normal ERG values was 4/12, 6/12 and 9/12, measured at 1, 4 and 15 weeks postoperatively, respectively.Retina histologyAt 15 weeks follow-up, histopathology was performed on several rabbit eyes. Histological examination of LR-irrigated eyes showed 2/7 normal retinas, whereas 5/7 showed changes that ranged from vacuoles in the inner retina to numerous vacuoles in both the outer and inner retina with disruption of the inner nuclear layer. The histology of BSS-infused and BSS-Plus-infused rabbit eyes was normal.ConclusionLR solution, when used during vitrectomy, has a more prolonged negative effect on ERG than BSS and BSS-Plus. Histological changes seen in LR eyes may explain the ERG results.

Structure of the chorioretinal complex in the rabbit eye after vitrectomy. Report 2. Vitreous cavity irrigation with different temperature solutions for 60 minutes

“…In the LR eyes, 2 had normal retinas and 5 of 7 had histological changes in the inner and outer retina that included vacuolization of either the inner or outer retina or both up to complete disruption. Each of the two retinas from BSS-irrigated and BSS-Plus-irrigated eyes demonstrated no gross histological abnormalities [4]. In our current study, disorganization of the cells of the INL and edema in the PHL were observed in both the 22°C and 5°C groups.…”

“…In their recent paper [4], Dayem et al compared the effect of three different intraocular infusion solutions (room-temperature Lactated Ringers (LR), balanced salt solution (BSS) and balanced salt solution-plus (BSS-Plus)) used during vitrectomy on postoperative retinal histology of 11 rabbit eyes. The first of the relevant key features of their technique that can be emphasized is the use of the 20-G armamentarium.…”

“…In addition, toxic effects of dyes used during vitrectomy on the retinal neuroepithelium [3]. Moreover, irrigating solutions of various compositions have been reported to negatively affect electrophysiological and structural retinal characteristics after vitrectomy [4], and mechanical damage to the inner retina from air infusion during vitrectomy have been described [5]. Intraocular pressure rise and systemic arterial pressure decrease during vitreoretinal surgery can cause a dangerous decrease in perfusion pressure resulting in intraoperative ischemic retinal and optic nerve damage [6].…”

Potential Adverse Effect of Ultrasound on the Electroretinogram of Retina and the Protective Role of Different Types of Antioxidants

“…Another suggestion for the protection of topical ascorbic acid was that the cavitationinduced epithelial damage was the main reason for corneal permeability increase [25]. In turn, the extent of the infusion fluid/retina interaction will mediate by vitreous through either diffusion and/or hydration, the topical treatment came into contact with the retina [26]. In prolonged ultrasound exposure, topical vitamin C can do both dissipate heat and serve as free-radical scavengers to counteract the detrimental effects of US on the retina and minimizing the electrophysiology changes.…”

Retinal and optic nerve functional activity after vitrectomy for vitreomacular traction syndrome

“…Однако, несмотря на успешность хирургического лечения ВМТС, функциональные исходы после ВЭ нередко оказываются неудовлетворительными [5,6]. В ранее проведённых нами исследованиях, а также по данным других авторов, одна из возможных причин угнетения функционального состояния сетчатки заключается в воздействии комплекса неблагоприятных факторов ВЭ как физической (вибрационное воздействие наконечника витреотома на сетчатку, удаление мембран), так и химической (воздействие различных красителей, заменителей стекловидного тела) природы [7][8][9][10]. Безусловно, в акте зрения важны как анатомическая, так и функциональная сохранность всех звеньев зрительного нервного пути, поэтому изучение влияния ВЭ при ВМТС на функциональную активность сетчатки и зри тельного нерва с применением электрофизиологических методик представляет актуальную научную задачу.…”