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August 1990

Toxic Effects of Detergents on the Corneal Endothelium

Author Affiliations

From the Department of Ophthalmology, Academic Medical Center, University of Amsterdam (Drs Nuyts and Breebaart); the Department of Ophthalmology, Emory University Eye Center, Atlanta, Ga (Dr Edelhauser); and the Department of Morphology, The Netherlands Ophthalmic Research Institute, Amsterdam (Dr Pels).

Arch Ophthalmol. 1990;108(8):1158-1162. doi:10.1001/archopht.1990.01070100114045

• Eighteen patients developed a toxic endothelial cell destruction syndrome following normal intraocular surgery, caused by a detergent residue originating from irrigating cannulas. The residue occurred after the concentration of a detergent solution had been increased from 0.4% to 4%, in combination with insufficient cleaning of the cannulas. Mass spectrometric analysis revealed the detergent to contain a nonionic ethoxylated fatty alcohol (6% vol/vol). Quantitative endothelial vital staining and in vitro corneal endothelial perfusion demonstrated endothelial toxic effects at the 1% and 0.06% level for the detergent and the pure ethoxylated fatty alcohol, respectively. Permeability studies showed that the toxic effects occurred as a result of endothelial barrier breakdown.

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