Comparison of BD Multivisc with the soft shell technique in cases with hard lens nucleus and Fuchs endothelial dystrophy.

Abstract

PURPOSE:

To compare the efficacy of 2.5% sodium hyaluronate (BD Multivisc) with the soft shell technique in reducing corneal endothelial cell damage during cataract phacoemulsification in patients with hard lens nucleus (3+) and cornea guttata.

METHODS:

Thirty patients (37 eyes) scheduled for cataract surgery at Department of Ophthalmology and Visual Sciences, University Hospital San Raffaele, Milano, Italy. Thirty-seven eyes (randomly divided into Groups A and B) with hard lens nucleus (grade 3 or higher) and cornea guttata had phacoemulsification using the soft shell technique (Group A) with Biolon (sodium hyaluronate 1%) and Viscoat (sodium hyaluronate 3%-chondroitin sulfate 4%) or with BD Multivisc alone (Group B). Patients were evaluated preoperatively and after 1, 15, 90, and 180 days, checked for best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness, and corneal endothelial density. Stop and chop phacoemulsification technique, with burst mode (Alcon Legacy 20000, Advantec), was performed.

RESULTS:

There were no significant differences between the two groups at 3 and 6 months in BCVA, IOP, corneal thickness, or endothelial cell density. The increase of central corneal thickness (preoperative: Group A 584+/-30 microm, Group B 573+/-30 microm; postoperative at 90 days: Group A 593+/-38 microm, Group B 577+/-25 microm) was not significant. Endothelial cell loss was similar in both groups.

CONCLUSIONS:

The results suggest that the soft shell technique (Biolon, Viscoat) and 2.5% sodium hyaluronate (BD Multivisc) are both effective in protecting the corneal endothelium in Fuchs dystrophy during phacoemulsification in patients with hard lens nucleus.

• Authors: F Fasce, A Spinelli, G Bolognesi, M Rossi, M Gemma
• Journal: European journal of ophthalmology (Eur J Ophthalmol) 2007 Sep-Oct Vol. 17 Issue 5 Pg. 709-13 ISSN: 1120-6721 [Print] United States
• PMID: 17932844 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Hyaluronic Acid

Topics

• Aged
• Anterior Chamber
• Cataract (complications, pathology)
• Corneal Diseases (prevention & control)
• Endothelium, Corneal (drug effects)
• Follow-Up Studies
• Fuchs' Endothelial Dystrophy (complications, pathology)
• Humans
• Hyaluronic Acid (administration & dosage)
• Lens Nucleus, Crystalline (pathology)
• Lenses, Intraocular
• Phacoemulsification (methods)
• Treatment Outcome
• Visual Acuity