Endothelial cell repopulation after intracameral acetic acid irrigation.

A significant, but transient corneal edema followed inadvertent intracameral irrigation of acetic acid in two patients. Since postsurgical corneal edema generally indicates corneal endothelial dysfunction, the effects of acetic acid on corneal endothelium were studied in the cat where the endothelial regenerative capacity is thought to be comparable to that of humans. The anterior chambers of feline eyes were irrigated with 0.25% acetic acid or balanced salt solution in a double-masked manner. Marked corneal opacification and thickening were evident following exposure to the acetic acid but did not occur following irrigation with balanced salt solution alone. Following intracameral acetic acid irrigation, a few endothelial cells were found in the anterior chamber angle but could not be found on Descemet's membrane. Over an 8-week period gradual repopulation of Descemet's membrane by endothelial cells occurred, first in the periphery and later in the central cornea, coincident with resolution of corneal edema.

Potassium-wasting nephropathy secondary to chemotherapy simulating Bartter's syndrome.

A patient with a potassium wasting nephropathy secondary to chemotherapy simulating Bartter's syndrome is described. A 64-year-old woman with diffuse histiocytic lymphoma developed persistent hypokalemia following a course of Cytoxan (cyclophosphamide), Adriamycin (doxorubicin), vincristine, and prednisone (CHOP)-Bleo. The diagnosis of a functional Bartter's syndrome was concluded following evaluation of serial plasma renins, aldosterone levels, and urinary electrolytes. Evidence is suggestive that a subpopulation of patients receiving chemotherapy may develop a functional Bartter's syndrome, and it is important to consider this diagnosis in patients who develop hypokalemia subsequent to chemotherapy introduction.