Presence of free radicals in intracameral agents commonly used during cataract surgery

Lockington, D., Macdonald, E.C.A., Young, D., Stewart, P., Caslake, M. and Ramaesh, K. (2010) Presence of free radicals in intracameral agents commonly used during cataract surgery. British Journal of Ophthalmology, 94(12), pp. 1674-1677. (doi: 10.1136/bjo.2009.171009)

Abstract

<b>Background</b>: Free radicals are known to cause cellular damage and are present in ophthalmic preparations. Corneal defence mechanisms are bypassed in intra-ocular surgery. We evaluated commonly used intracameral agents to ascertain the presence of free radicals and investigate the possibility of anterior segment and endothelial toxicity. <b>Methods</b>: Samples of 19 commonly used intracameral preparations were analysed for total free radical presence on an Instrument Laboratory IL600 using a Randox Kit for Total Antioxidant Status (RANDOX Laboratories Ltd, Crumlin, UK). <b>Results</b>: Free radical concentrations for the 19 intracameral agents ranged from 0 to 3.59 mmol/l, with median value of 0.34 mmol/l (mean value 0.933±1.19 mmol/l). Phenylephrine had the highest presence of free radicals, which were considerably higher than those for 0.5% hydrogen peroxide at all tested dilutions. Other notable results included cefuroxime (0.61 mmol/l), 2% undiluted lidocaine (0.34 mmol/l) and bevacizumab (0.59 mmol/l). <b>Conclusion</b>: The results indicate that free radicals are present in intracameral surgical agents and some are in the order of 0.5% hydrogen peroxide. The risks of endothelial damage must be considered when using multiple intracameral preparations in complicated cataract surgery. Free radicals in intracameral preparations may be a contributing cause in cases of toxic anterior segment syndrome.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Caslake, Professor Muriel
• Authors: Lockington, D., Macdonald, E.C.A., Young, D., Stewart, P., Caslake, M., and Ramaesh, K.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: British Journal of Ophthalmology
• ISSN: 0007-1161
• ISSN (Online): 1468-2079
• Published Online: 19 July 2010