Mp. Holzer et al., Effect of Healon5 and 4 other viscoelastic substances on intraocular pressure and endothelium after cataract surgery, J CAT REF S, 27(2), 2001, pp. 213-218
Purpose: To compare the ophthalmic viscoelastic device (OVD) Healon(R)5 (so
dium hyaluronate 2.3%) with 4 other commonly used OVDs during phacoemulsifi
cation and intraocular lens implantation in terms of influence on intraocul
ar pressure (IOP) postoperatively and endothelial cells preoperatively and
postoperatively.
Setting: Department of Ophthalmology, Ruprecht-Karls-University Heidelberg,
Germany.
Methods: This clinical randomized prospective study, in which patients and
observer were masked, comprised 81 eyes. Seventy-four eyes (man patient age
71.2 years +/- 7.8 [SD]) completed all preoperative and 5 postoperative ex
aminations. the OVDs used were OcuCoat(R) and Celoftal(R) (hydroxypropyl me
thylcellulose 2.0%), Viscoat(R) (sodium hyaluronate 3.0%-chondroitin sulfat
e 4.0%), Healon GV(R) (sodium hyaluronate 1.4%), and Healon5 (sodium hyalur
onate 2.3%). Intraocular pressure was measured by standard Goldmann applana
tion tonometry preoperatively and 4 to 6 and 24 hours and 7, 30, and 90 day
s postoperatively. Endothelial cell counts were done preoperatively and 90
days postoperatively using a Pro/Koester WFSCM contact endothelial microsco
pe. Exclusion criteria were IOP greater than 21 mm Hg at the preoperative e
xamination, age younger than 40 years, significant corneal pathology, and a
history or presence of uveitis or pseudoexfoliation syndrome.
Results: All groups had increased IOP 4 hours postoperatively. The Healon5
group had the highest mean pressure (24.9 mm Hg) followed by the Viscoat gr
oup (23.6 mm Hg). The mean IOP in the other OVD groups was less than 22.1 m
m Hg. These differences were not significant. Twenty-four hours postoperati
vely and at ail subsequent examinations, mean IOP was below 20 mm Hg. The H
ealon5 group had the lowest mean endothelial cell loss (6.2%), significantl
y lower than in the other groups (P < .02).
Conclusion: With all 5 OVDs, endothelial cell loss was found, with the lowe
st in the Healon5 group, and IOP was increased 4 to 6 hours postoperatively
. After 24 hours, no significant increases in IOP were noted. J Cataract Re
fract Surg 2001; 27: 213-218 (C) 2001 ASCRS and ESCRS.