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Abstract #19219 Published in IGR 3-1
Effect of Healon5 and 4 other viscoelastic substances on intraocular pressure and endothelium after cataract surgery
Holzer MP; Tetz MR; Auffarth GU; Welt R; Voelcker HEJournal of Cataract and Refractive Surgery 2001; 27: 213-218
PURPOSE: To compare the ophthalmic viscoelastic device (OVD) Healon5 (sodium hyaluronate 2.3%) with four other commonly used OVDs during phacoemulsification and intraocular lens implantation in terms of influence on intraocular pressure (IOP) postoperatively and endothelial cells preoperatively and postoperatively. SETTING: Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany. METHODS: This clinical randomized prospective study, in which patients and observer were masked, comprised 81 eyes. Seventy-four eyes (mean patient age, 71.2 ± 7.8 years (SD)) completed all preoperative and five postoperative examinations. The OVDs used were OcuCoat and Celoftal (hydroxypropyl methylcellulose 2.0%), Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%), Healon GV (sodium hyaluronate 1.4%), and Healon5 (sodium hyaluronate 2.3%). Intraocular pressure was measured by standard Goldmann applanation tonometry preoperatively and four to six, and 24 hours and seven, 30, and 90 days postoperatively. Endothelial cell counts were carried out preoperatively and 90 days postoperatively using a Pro/Koester WFSCM contact endothelial microscope. Exclusion criteria were IOP greater than 21 mmHg at the preoperative examination, age younger than 40 years, significant corneal pathology, and a history or presence of uveitis or pseudoexfoliation syndrome. RESULTS: All groups had increased IOP four hours postoperatively. The Healon5 group had the highest mean pressure (24.9 mmHg), followed by the Viscoat group (23.6 mmHg). The mean IOP in the other OVD groups was less than 22.1 mmHg. These differences were not significant. Twenty-four hours postoperatively, and at all subsequent examinations, mean IOP was below 20 mmHg. The Healon5 group had the lowest mean endothelial cell loss (6.2%), significantly lower than in the other groups (p < 0.02). CONCLUSIONS: Endothelial cell loss was found with all five OVDs, with the lowest being in the Healon5 group, and IOP was increased four to six hours postoperatively. After 24 hours, no significant increases in IOP were noted.
Dr M.P. Holzer, Department of Ophthalmology, Humboldt University Berlin, Campus Virchow Klinikum, Berlin, Germany
Classification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
