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R.C. J. Reinhardt, C.A. Lemley, T.T. Shen; Improved Corneal Clarity and Epithelial Protection During Routine Cataract Surgery: A Comparison of Corneal Protective Agents . Invest. Ophthalmol. Vis. Sci. 2005;46(13):785.
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Purpose: To evaluate various corneal protective agents as alternatives to balanced salt solution (BSS) during routine cataract surgery with intraocular lens implantation. Methods: This study is a retrospective review of medical charts and surgical videos of patients at the University of Washington medical center who underwent routine cataract surgery during 2003–2004. Various corneal protective agents (Refresh Liquigel, Ocucoat, Provisc, Goniosol, Celluvisc and Tearasol) were used on the corneal surface instead of BSS during routine cataract surgery with intraocular implantation. For each agent, the following characteristics were recorded and compared: corneal clarity, the frequency and duration of required applications, total volume of agent used, the requirement of an assistant during the surgical procedure and post operative corneal epithelium appearance. Results: The mean duration of application in the group studied ranged from 1 minute (for BSS) to 19 minutes (for Provisc). Mean frequency of application ranged from 20 (for BSS) per case to 1.1 (for Provisc). There was measurable difference in corneal clarity between the groups, majority of intraocular viscoelastics showed superior corneal clarity during the surgery. Conclusions: Various corneal protective agents can be used as alternatives to BSS during routine cataract surgery. These agents showed significant improvement in corneal clarity and reduction of frequency of application during surgery. The use of alternative corneal protective agents may provide an effective option in reducing the distraction to the patient as well as to the surgeon during surgery. The increased duration of application and improved clarity may obviate the need for a second assistant during a routine cataract surgery.
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