A Prospective Randomized Study on the Role of Viscoadaptive OVD Healon5 Versus Combining Viscodispersive-Viscocohesive OVDs (Soft-Shell Technique) in Protecting the Corneal Endothelium During Phacoemulsification of Hard Cataract
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- Category: Vol. 79, December 2011
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A Prospective Randomized Study on the Role of Viscoadaptive OVD Healon5 Versus Combining Viscodispersive-Viscocohesive OVDs (Soft-Shell Technique) in Protecting the Corneal Endothelium During Phacoemulsification of Hard Cataract,AHMED E.M. HABIB
Abstract
Purpose: To evaluate the efficacy of the viscoadaptive OVD Healon5 in protecting the corneal endothelium during phacoemulsification of hard cataract as compared to using the dispersive-cohesive soft-shell technique in which the dispersive OVD Viscoat is combined with the cohesive OVD Provisc during surgery.
Methods: In this prospective randomized study, 30 eyes of 22 patients underwent phacoemulsification using either Healon5 (Group A, 15 eyes) or the dispersive-cohesive soft-shell technique (Group B, 15 eyes) with Viscoat and Provisc. All patients had age-related cataract, grades 3 and 4, with no other ocular pathology. Central corneal thickness (CCT) was examined preoperatively and at 1 and 7 days, as well as 1 month postoperatively. Corneal endothelial cell density (ECD) was examined preoperatively and 3 months postoperatively. The CCT and ECD were compared between the two groups.
Results: There was no statistically significant difference in the mean preoperative and the mean postoperative central corneal thickness between the two groups during any of the follow-up visits at 1 day, 7 days and 1 month postoperative. At 1 day postoperative, the mean increase in CCT in Group A was 64±6mm while the mean increase in CCT in group B was 59±8mm (p=0.076). At 7 days postoperative, the mean increase in CCT in Group A was 23±7mm while in Group B it was 20±8mm (p=0.302). After 1 month postoperative, the mean increase in CCT was 2±4 and 3±1 for Groups A and B respectively (p=0.452). Such differences in the mean increase in CCT between both groups were statistically insignificant in any of the follow-up visits. Comparing endothelial cell loss after 3 postoperative months in the two groups, Group A had a 6.2±0.4% cell loss while Group B showed 6.4±0.3% cell loss. Such difference between the two groups was statistically insignificant (p=0.072).
Conclusion: The viscoadaptive agent Healon5 when utilized on its own is as effective as the dispersive cohesive soft-shell technique in protecting corneal endothelial cells during phacoemulsification of hard cataract.