Soft-shell technique using Viscoat and Healon 5: a prospective, randomized comparison between a dispersive-viscoadaptive and a dispersive-cohesive soft-shell technique.

Abstract

PURPOSE:

To compare the efficacy of the dispersive-viscoadaptive soft-shell technique using Viscoat and Healon 5 to the dispersive-cohesive soft-shell technique in reducing corneal endothelial cell damage during cataract surgery.

METHODS:

In this prospective randomized study, 207 eyes of 171 cataract patients underwent phacoemulsification using the dispersive-viscoadaptive soft-shell technique (V-group, 102 eyes) with Viscoat and Healon5 or the dispersive-cohesive soft-shell technique (C-group, 105 eyes) with Viscoat and a cohesive agent (Opegan-Hi). Each group was divided into two subgroups depending on the amount of ultrasound (%Min) used during phacoemulsification. Corneal endothelial cell density was examined preoperatively and 3 months postoperatively. The endothelial cell loss was compared between the two groups, and also between the subgroups.

RESULTS:

The mean endothelial cell loss 3 months after surgery was 8.4 +/- 5.6% standard deviation (SD) in the V-group and 8.2 +/- 6.2% in the C-group (P = 0.787). In the subgroups with ultrasound of 10 %Min or less, the mean endothelial cell loss 3 months after surgery was 6.6 +/- 4.6% in the V-group and 5.5 +/- 5.0% in the C-group (P = 0.104). In the subgroups with ultrasound of over 10 %Min, this value was 10.6 +/- 6.3% in the V-group and 11.9 +/- 5.7% in the C-group (P = 0.413). The correlation coefficient of the endothelial cell loss rate and %Min was 0.245 (P = 0.0129) in the V-group and 0.501 (P < 0.0001) in the C-group.

CONCLUSION:

The dispersive-viscoadaptive soft-shell technique is as effective as the dispersive-cohesive soft-shell technique in protecting corneal endothelial cells during phacoemulsification regardless of the amount of ultrasound energy used.

• Authors: Masaki Sato, Chiho Sakata, Mikako Yabe, Tetsuro Oshika
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 86 Issue 1 Pg. 65-70 (Feb 2008) ISSN: 1755-3768 [Electronic] England
• PMID: 17908256 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Drug Combinations
• chondroitin sulfate, sodium hyaluronate drug combination
• Hyaluronic Acid
• Chondroitin
• Chondroitin Sulfates

Topics

• Aged
• Aged, 80 and over
• Cataract Extraction (methods)
• Cell Count
• Chondroitin (therapeutic use)
• Chondroitin Sulfates
• Cytoprotection
• Drug Combinations
• Endothelium, Corneal (diagnostic imaging, drug effects, pathology)
• Female
• Humans
• Hyaluronic Acid (therapeutic use)
• Intraocular Pressure
• Intraoperative Care
• Male
• Middle Aged
• Phacoemulsification
• Postoperative Period
• Time Factors
• Ultrasonography