ON THE CORRELATION BETWEEN ACRYLIC HYDROPHILIC IOL OPACIFICATION AND THE TYPE OF VISCOELASTIC SOLUTION USED IN CATARACT SURGERY

Abstract

Abstract: : Purpose: To evaluate the role of viscoelastic solution used in cataract surgery with insertion of acrylic hydrophilic lens in IOL opacification. The results obtained from two groups of patients with cataract extraction and hydroview IOL implantation from 1996 to 2001 using 2 different types of viscoelastic are presented. Methods: Retrospective comparative study on two groups of eyes: Group A (453 eyes) and group B (269 eyes). All had cataract extraction using a standardized phacoemulsification technique and IOL hydroview H60M insertion in the bag from november1996 to February 2001. The viscoelastic material in group A was a solution of condroitin sodium sulphate–sodium hyaluronate (VISCOAT–Alcon Surgical) whereas a solution of sodium hyaluronate was used in group B (AMO VITRAX–Advanced Medical Optics. Inc.). All patients underwent medical history and complete ophthalmologic evaluation to check IOL opacification. All explanted lenses were tested to 1% red alizarin, reactive to calcium salts and to spectroscopic analysis with SEM. Statistic analysis of results was done using Student t–test. Results: Initial calcification signs started about six months after surgery, earlier in diabetic patients, concomitant ocular inflammation or vitrectomy. In Viscoat group 20% of eyes had some signs of IOL transparency loss, varying from a mild diffuse calcium deposition, to forceps marks on the optic plate, to total opacification and visual loss (BCVA < 0.1) in 23 eyes that underwent IOL substitution (p = 5.551% +/– 1.1%). In the AMO Vitrax group 1% had some calcium deposition on IOL without substantial visual loss; two eyes underwent IOL explantation (p = 0.743% +/– 0.5%). The risk difference of IOL opacification between Viscoat and AMO Vitrax groups is 4.77% (p=0.002). Conclusions: We did not observe any difference in sex, age, systemic disease or ocular disease distribution between groups. Our experience evidenced a temporal progression of calcium salts deposition, especially in patients with ocular or systemic diseases in group A. There is a statistically significant correlation between IOL opacification and viscoelastic solution used.

Keywords: cataract • clinical (human) or epidemiologic studies: outcomes/complications