Role of Cold Balanced Salt Solution (BSS) in the Prophylaxis of Cystoid Macular Edema After Cataract Surgery: A Prospective Randomized Study

Figures & data

Table 1 Preoperative Clinical Characteristics of Eyes in Group 1 Receiving Intraoperative Irrigating Solution at Room Temperature (~20.0±0.1°C) and in Group 2 Receiving Cold Intraoperative Irrigating Solution (2.7±0.1°C)

Parameters	Group 1 (n=50)	Group 2 (n=50)	p-Value
Axial length (mm)	23.5±7.2	23.7±8.1	0.09
ACD (mm)	3.5±0.5	3.4±0.6	0.21
Endothelial cell count (n)	2453.1±275	2471±289	0.08
BCVA (logMAR)	0.53±0.22	0.52±0.26	0.41
IOP (mmHg)	14.5±2	14.9±2.7	0.27
Central subfield macular thickness (μm)	216.9±7.9	217.5±8.3	0.21
Temporal inner	296.3±11.7	294.1±12.4	0.09
Nasal inner	299.6±9.1	300.7±7.9	0.17
Superior inner	297.4±9.2	299.4±9.5	0.07
Inferior inner	288.4±8.9	287.7±8.2	0.15
Temporal outer	250.6±10.5	254.9±12.9	0.06
Nasal outer	282.6±6.4	284.9±6.4	0.09
Superior outer	292.9±3.8	294.5±4.9	0.12
Inferior outer	272.4±6.7	273.8±7.3	0.18
Total macular volume (mm^3)	8.63±0.29	8.61±0.32	0.79

Note: All data are expressed as mean ± standard deviation.

Abbreviations: ACD, anterior chamber depth; BCVA, best corrected visual acuity; logMAR, logarithm of the minimum angle of resolution; IOP, intraocular pressure.

Table 2 Spectral Domain Optical Coherence Tomography (SD-OCT) Thickness at Baseline, and 1 and 4 Weeks Post-Phacoemulsification in the Two Cohorts. Group 1: Eyes Receiving Intraoperative Irrigating Solution at Room Temperature (~20.0±0.1°C) and Group 2: Eyes Receiving Cold Intraoperative Irrigating Solution (2.7±0.1°C)

Parameters	Group 1 (n=50)				Group 2 (n=50)				p-Value Intergroup Comparison (Group 2 vs 1)
	Baseline	1 Week	4 Weeks	p-Value Intragroup Comparison (Group 1)	Baseline	1 Week	4 Weeks	p-Value Intragroup Comparison (Group 2)
Central subfield macular thickness (μm)	216.9±7.9	223.4±9.9	217.1±8.5	0.02^a	217.5±8.3	220.8±7.9	217.2±8.4	0.03^c	0.03^e
95% CI	213.3–220.5	218.3–220.5	213.5–221.2	0.19^b	213.9–221.2	218–223.3	213.6–220.7	0.04^d	0.07^f
Temporal inner	296.3±11.7	301.2±10.1	291.6±13.9	0.02^a	294.1±12.4	220.8±7.9	291.8±14.2	0.02^c	0.11^e
95% CI	293.1–299.4	298.4–304.5	287.4–295.2	0.18^b	290.1–298.3	217.6–223.7	287.4–295.3	0.18^d	0.28^f
Nasal inner	299.6±9.1	303.6±9.2	299.6±9.6	0.03^a	300.7±7.9	303.6±8.3	299.9±9.2	0.06^c	0.14^e
95% CI	295.7–303.1	300.1–306.9	295–303.2	0.71^b	297.6–303.8	300.2–306.9	296.2–303.1	0.12^d	0.31^f
Superior inner	297.4±9.2	304±10.7	301±15.7	0.02^a	299.4±9.5	306±11.2	300.2±16.1	0.02^c	0.02^e
95% CI	294.1–300.5	301.2–307.5	298.6–304.2	0.09^b	296.2–302.8	302.4–309.8	294.3–305.2	0.08^d	0.11^f
Inferior inner	288.4±8.9	302.3±17.8	291.1±15.7	<0.0001^a	287.7±8.2	303.9±12.4	290.4±11.6	<0.0001^c	0.09^e
95% CI	284.8–291.9	297.7–306.8	288.7–293.9	0.05^b	284.1–290.3	298.5–308.7	286.3–294.8	0.04^d	0.12^f
Temporal outer	250.6±10.5	254.1±12.3	250.1±10.6	<0.0001^a	254.9±12.9	258.2±15.9	255.1±12.9	<0.0001^c	0.03^e, f
95% CI	247.2–253.6	250.5–259.3	247.3–252.9	0.07^b	250.2–259.7	253.1–262.8	250.1–259.9	0.13^d
Nasal outer	282.6±6.4	288.1±7.2	283.3±8.0	0.03^a	284.9±6.4	286.2±7.9	283.8±8.9	0.06^c	0.01^e
95% CI	278.7–285.6	285.2–290.8	280.1–286.5	0.12^b	282.2–287.1	284.1–288.7	279.5–288.2	0.09^d	0.33^f
Superior outer	292.9±3.8	294.5±6.5	292.5±5.2	0.16^a	294.5±4.9	295.3±6.9	294.5±5.5	0.19^c	0.21^e
95% CI	290.1–295.4	291.2–297.4	289.4–295.1	0.36^b	292.3–297.1	294.2–298.7	291.5–297.7	0.44^d	0.11^f
Inferior outer	272.4±6.7	274.2±9.3	273.3±7.6	0.22^a	273.8±7.3	274.9±9.8	273.8±8.3	0.17^c	0.23^e
95% CI	268.9–275.2	271.1–277.5	270.2–276.5	0.39^b	270.4–277.1	271.3–279.2	270.1–277.9	0.59^d	0.38^f
Total macular volume (mm^3)	8.63±0.29	8.74±0.27	8.65±0.29	<0.0001^a	8.62±0.32	8.67±0.3	8.65±0.33	0.02^c	0.001^e
95% CI	8.58–8.72	8.66–8.82	8.56–8.73	0.76^b	8.51–8.72	8.58–8.73	8.55–8.74	0.79^d	0.24^f

Notes: All data are expressed as mean ± standard deviation and 95% confidence interval (95% CI). p-Value: ^a1 week vs baseline and ^b4 weeks vs baseline Group 1; ^c1 week vs baseline and ^d4 weeks vs baseline Group 2; ^eGroup 2 vs Group 1 1 week vs baseline, and ^fGroup 2 vs Group 1 4 weeks vs baseline. Bold characters indicate significant p-values (p<0.05).

Table 3 Visual Acuity and Safety Parameters at Baseline, and 1 and 4 Weeks Post-Phacoemulsification in the Two Cohorts. Group 1: Eyes Receiving Intraoperative Irrigating Solution at Room Temperature (~20.0±0.1°C) and Group 2: Eyes Receiving Cold Intraoperative Irrigating Solution (2.7±0.1°C)

Parameters	Group 1 (n=50)				Group 2 (n=50)				p-Value Intergroup Comparison (Group 2 vs 1)
	Baseline	1 Week	4 Weeks	p-Value Intragroup Comparison (Group 1)	Baseline	1 Week	4 Weeks	p-Value Intragroup Comparison (Group 2)
BCVA (logMAR)	0.53±0.22	0.12±0.18	0.08±0.2	<0.0001^a, b	0.52±0.26	0.14±0.22	0.1±0.24	<0.0001^c, d	0.67^e
									0.59^f
95% CI	0.48–0.57	0.06–0.18	0.04–0.16		0.44–0.59	0.08–0.2	0.06–0.2
IOP (mmHg)	14.5±20	14.8±2.4	14.6±2.3	0.17^a	14.9±2.7	15.1±2.9	14.8±2.7	0.21^c	0.71^e
95% CI	13.7–15.3	13.8–15.5	13.8–15.4	0.09^b	13.6–15.5	13.9–16.2	13.9–16	0.36^d	0.77^f
Endothelial cell count (n)	2453.1±275	2108±277	2123±283	<0.0001^a, b	2471±289	2267.1±259	2288.6±28	<0.0001^c, d	<0.0001^e, f
					2419–2521	2212–2309	2251–2324
95% CI	2411–2512	2051–2159	2055–2164

Notes: All data are expressed as mean ± standard deviation and 95% confidence interval (95% CI). p-Value: ^a1 week vs baseline and ^b4 weeks vs baseline Group 1; ^c1 week vs baseline and ^d4 weeks vs baseline Group 2; ^eGroup 2 vs Group 1 1 week vs baseline; and,^fGroup 2 vs Group 1 4 weeks vs baseline. Bold characters indicate significant p-values (p 0.05).