Abstract
Abstract: :
Purpose: To evaluate the effect of viscoelastic agents on protection of corneal endothelial cells during cataract surgery, we compared corneal endothelial cell density after use of 2 viscoelastic agents (Viscoat® versus Healon 5®) in each nuclear sclerosis grade. Methods: All 372 cases were performed by one surgeon, professional career. The surgeon performed all cases using the same phacoemulsification unit (Legacy Advantec, Neo sonic handpiece, 30° Kelman Flared ABS microtip, Alcon). Viscoat® was used in 152 eyes of 99 patients (Viscoat group), and Healon 5® in 220 eyes of 153 patients (Healon 5 group). We measured corneal endothelial cell density preoperatively and postoperatively (one month after surgery). The average loss of endothelial cell density was evaluated in each nuclear grade (Emery–Little grading). The 372 cases consisted of 43 eyes of grade 1, 201 of grade 2, 94 of grade 3 and 34 of grade 4. Results: No intraoperative and postoperative complications occurred in any of the cases. The average loss of endothelial cell density was 1.7% in the Viscoat group and 1.9% in the Healon 5 group (P=0.82). In nuclear grade 1, the average loss in the Viscoat group was lower than that in the Healon 5 group (p=0.04). There was no significant difference between the groups in grade 2 and 3. In grade 4, the average loss in the Viscoat group was higher compared to that in the Healon 5 group (p=0.03). The harder the nuclear sclerosis was, the more the postoperative corneal endothelial cell in the Viscoat group was damaged. However, the loss of endothelial cell density in the Healon 5 group was stable in each grade. It was not influenced by nuclear sclerosis. Conclusion: Our study indicated that Healon 5® is more effective on protection of endothelial cells in harder nuclear sclerosis cases than Viscoat®.
Keywords: treatment outcomes of cataract surgery • cataract • cornea: endothelium