From the Research
The use of cold Balanced Salt Solution (BSS) during ocular surgeries may help reduce macular edema by minimizing thermal damage to retinal tissues, as evidenced by a prospective randomized study published in 2021 1. When cold BSS is introduced into the eye, it creates a temperature gradient that can shock retinal tissues, but this effect may be beneficial in reducing postoperative macular thickening. The study found that the use of a cooled irrigating eye solution during phacoemulsification resulted in a significant reduction in central macular thickness (CMT) and total macular volume at 1 week post-surgery compared to the use of room temperature irrigating solution. Key points to consider:
- The ideal temperature for BSS during ocular surgeries is still a topic of debate, but warming it to approximately body temperature (35-37°C) before intraocular use may be beneficial in minimizing thermal damage.
- Controlled irrigation systems that maintain consistent temperature and flow rates can also help reduce the risk of macular edema.
- Patients with pre-existing diabetic retinopathy, uveitis, or other conditions predisposing them to macular edema require particular attention to irrigation solution temperature, as they have heightened vulnerability to temperature-induced vascular damage.
- A study published in 2021 found that the use of a cooled irrigating eye solution during phacoemulsification may be beneficial in preventing postoperative macular thickening 1.
- Another study published in 2019 found that BSS-assisted intraocular lens implantation resulted in a significantly smaller postoperative IOP increase compared to viscoelastic-assisted IOL implantation 2.
- However, the evidence is not conclusive, and further studies are needed to fully understand the effects of cold BSS on macular edema during ocular surgeries. Some of the provided evidence, such as the study on non-steroidal anti-inflammatory drugs in the prevention of cystoid macular edema after uneventful cataract surgery 3, and the study on diabetic macular edema and cataract surgery 4, may not be directly related to the question of cold BSS and macular edema, and therefore, are not considered in this answer.