Intraocular pressure after small incision cataract surgery with Healon5 and Viscoat

Purpose: To evaluate the effect of Healon(R)5 (sodium hyaluronate) and Visc oat(R) (sodium chondroitin sulfate-sodium hyaluronate) on intraocular press ure (IOP) after bilateral small incision cataract surgery. Setting: Department of Ophthalmology, University of Vienna, Vienna, Austria . Methods: This prospective randomized study comprised 70 eyes of 35 consecut ive patients with age-related cataract in both eyes scheduled for bilateral small incision cataract surgery. The patients were randomly assigned to re ceive Healon5 or Viscoat during cataract surgery in the first eye. The seco nd eye received the other viscoelastic substance. Cataract surgery was perf ormed in an identical fashion in both eyes, with a temporal 3.5 mm suturele ss posterior limbal incision, phacoemulsification, and implantation of a fo ldable silicone intraocular lens. The IOP was measured preoperatively and 6 hours, 20 to 24 hours, and 1 week postoperatively. Results: At 6 hours after surgery, the mean IOP increased by 5.2 mm Hg +/- 5.3 (SD) in the Healon5 group (P < .0001) and by 10.1 +/- 8.7 mm Hg in the Viscoat group (P < .0001). The increase was significantly higher in the Vis coat group than in the Healon5 group (P = .0016), Intraocular pressure spik es of 30 mm Hg or more occurred in 2 eyes in the Healon5 group and in 10 ey es in the Viscoat group (P = .0112). Twenty to 24 hours and 1 week postoper atively, the mean IOP in the 2 groups was not statistically different. Conclusions: Viscoat caused a significantly higher IOP increase and signifi cantly more IOP spikes than Healon5 in the early period after small incisio n cataract surgery. (C) 2000 ASCRS and ESCRS.