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K. Saito, M. Sato, C. Sakata, M. Yabe, T. Oshika; Efficacy of the Variant Soft-Shell Technique Using Viscoat and Healon5: A Comparison of the Dispersive-Viscoadaptive and the Dispersive-Cohesive Soft-Shell Technique. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1068.
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To evaluate the efficacy of the dispersive-viscoadaptive soft-shell technique using Viscoat and Healon5 in reducing corneal endothelial cell damage during cataract surgery.
In this 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 2 subgroups depending on the amount of ultrasound (%Min) used during phacoemulsification. Corneal endothelial cell density was examined preoperatively and 3 months postoperatively. The rate of endothelial cell loss was compared between two groups, and between the subgroups as well.
The mean rate of endothelial cell loss 3 months after surgery was 8.4 % ± 5.6 % (SD) in the V-group and 8.2 % ± 6.2 % in the C-group (p=0.787, Unpaired-t test). In the subgroups with ultrasound of 10 %min or less, the mean rate of 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, the above rate was 10.6 % ± 6.3 % in the V-group and 11.9 % ± 5.7 % in the C-group (p=0.413). A 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.
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.
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