Abstract
Abstract: :
Purpose: To compare the efficacy of 2.5% Sodium Hyaluronate (BD MultiviscTM) with the soft shell technique in reducing corneal endothelial cell damage during cataract phacoemulsification in patients with hard lens nucleus (3+) and cornea guttata. Methods: Thirty eyes (randomly divided in group A and B) with hard lens nucleus (grade 3 or higher) and cornea guttata had phacoemulsification using the soft shell technique (group A) with Amvisc–Plus® (Sodium hyaluronate 1.6%) and Viscoat® (Sodium hyaluronate 3%–chondroitin sulfate 4%) or with BD MultiviscTM alone (group B). Patients were evaluated preoperatively and after 1, 15, 90 days, checking for best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness, corneal endothelial density. Stop and chop phacoemulsification technique, with burst mode (Alcon Legacy 20000– Advantec), was performed. Results: There were no statistical significant differences between the two groups at 3 months in best corrected visual acuity, IOP, corneal thickness, endothelial count. The increase of central corneal thickness (preoperative: Group A 530.6±46.5 µm, Group B 563.4±38.8 µm; postoperative: Group A 540.2±30.9 µm, Group B 571.3±44.2 µm) was not statistically significant. The endothelial cell loss was greater in group B (preoperative: Group A 1017.5±809.5 cell/mm2, Group B 989.3±835.1 cell/mm2; postoperative: Group A 974.4 ±815.4 cell/mm2, Group B 915.1±713.2 cell/mm2), but not statistically significant. Discussion: The results suggest that the soft shell technique (Amvisc–Plus®, Viscoat®) and the 2.5% Sodium Hyaluronate (BD MultiviscTM) are both effective in protecting the corneal endothelium in Fuchs Dystrophy during phacoemulsification in patients with hard lens nucleus.
Keywords: cornea: endothelium • cataract • clinical (human) or epidemiologic studies: systems/equipment/techniques