A comparative study of intraocular irrigating solutions: effects on electroretinography readings during closed vitrectomy in humans

Abstract

The effects of intraocular irrigating solutions on electroretinography have been extensively studied in animal models, but effects on human electroretinography have not been reported. This study examined the effects of two commercially available irrigating solutions, S-MA2 (Opeguard MA) and DE-057 (BBS-Plus) on 30-Hz flicker electroretinography during closed vitrectomy in humans. Eight eyes of 8 patients were examined. All patients underwent a simple vitrectomy without treatment of proliferative membrane. For 30-Hz flicker electroretinography recording, a contact lens with a built-in light-emitting diode was sterilized and used as both a stimulus source and a recording electrode. Replacing S-MA2 with DE-057 decreased the electroretinography amplitude from 55.8 +/- 15.2 to 45.5 +/- 13.2 microV (mean +/- SEM). Changing the irrigation solution from DE-057 back to S-MA2 increased the amplitude from 45.5 +/- 13.2 to 59.9 +/- 17.3 microV. However, these changes were not statistically significant. Replacing S-MA2 with DE-057 significantly increased the peak time from 50.1 +/- 1.5 to 57.6 +/- 1.3 msec (p < 0.001). This change was reversible; after changing from DE-057 back to S-MA2, the peak time of flicker electroretinography significantly decreased from 57.6 +/- 1.3 to 49.0 +/- 2.1 msec (p < 0.01). Thus intraoperative 30-Hz electroretinography showed delayed peak time during irrigation with DE-057, as compared with S-MA2. The lower potassium concentration and higher glucose concentration of S-MA2, as compared with DE-057, may be the cause of such electroretinography changes.

Intraocular Temperature Distribution in Eyes Undergoing Different Types of Surgical Procedures during Vitreous Surgery

“…The ERG changes may also be related to other unidentified factors rather than just the temperature. Vitrectomy causes changes in electrolytes and osmolality as well as indirect mechanical changes of the retina which may contribute to the ERG changes [ 30 , 31 , 32 ]. Rinkoff et al suggested that vitreoretinal surgeons should avoid warming irrigation solutions to levels above room temperature to minimize light damage to the retina [ 33 ].…”

Electroretinographic evaluations of retinal function before, just after and after intravitreal injections

“…The ERG changes may also be related to other unidentified factors rather than just by the IOP. The intravitreal injections may cause changes in the electrolytes and osmolality as well as the temperature which may contribute to the ERG changes 52 53 54 .…”