Corneal endothelial protection by different viscoelastics during phacoemulsification.

PURPOSE: To evaluate corneal endothelium morphology and function after phacoemulsification using different viscoelastics.

SETTING

Eye Clinic, University of Trieste, Italy.

METHODS

This prospective, randomized study included results of preoperative and postoperative (7, 30, and 90 days) examinations of 66 patients scheduled for phacoemulsification without ocular pathology; 8 patients were excluded. Patients were randomly assigned to one of four groups based on type of viscoelastic used: 1% sodium hyaluronate (Healon); 1.4% sodium hyaluronate (Healon GV); 4% sodium chondroitin sulfate-3% sodium hyaluronate (Viscoat); 2% hydroxypropyl methylcellulose (Hymecel). Mean cell density and cell size variation coefficient were determined by specular microscopy; central corneal thickness, by ultrasonic pachymetry; and endothelial permeability coefficient and active pump function, by anterior segment fluorophotometry.

RESULTS

There were no significant differences in postoperative mean cell loss among the groups. The cell size variation coefficient was altered in all groups 7 days after surgery and was still impaired at 30 days in the Hymecel group. A significant increase in mean corneal thickness, endothelial permeability, and active pump function occurred in the Healon and Hymecel groups 7 days after surgery. These parameters were still altered 30 days after surgery in the Hymecel group. Endothelial functional alterations did not occur in the Healon GV or Viscoat group.

CONCLUSION

Viscoat and Healon GV are effective in minimizing functional damage of endothelial structure in the early medium-term postoperative period.