methylcellulose and Corneal-Edema

To evaluate the protective effect on corneal endothelial cells of a low-cost and an expensive combination of a dispersive viscoelastic material and an irrigating solution during phacoemulsification.. Department of Ophthalmology, University of Vienna, Vienna, Austria.. This prospective randomized examiner- and patient-masked study comprised 90 eyes of 45 consecutive patients with age-related cataract in both eyes. For each patient, the first eye was randomly assigned to receive hydroxypropyl methylcellulose 2% (Ocucoat) and Ringer's solution (low-cost combination) or sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) and an enriched balanced salt solution (BSS Plus) (expensive combination) during phacoemulsification. The contralateral eye received the other treatment. Endothelial cell function was evaluated by measuring corneal thickness (CT) using partial coherence interferometry, morphology assessment, and endothelial cell counts.. The acute postoperative increase in CT was +9.8 microm in the low-cost group and +10.9 microm in the expensive group; the difference between groups was not significant. After 1 month, the CT still differed significantly from baseline in the low-cost group. Three months after surgery, the CT had returned to baseline values in both groups. There was no significant between-group difference in endothelial cell counts or morphology.. During phacoemulsification in a nonselected patient population, there was no difference in acute postoperative corneal edema and endothelial cell morphology after 3 months between a Viscoat and BSS Plus combination and an Ocucoat and Ringer's solution combination. Eyes receiving the expensive combination had marginally faster recovery of corneal swelling by 3 months. However, the cost of Viscoat and 500 mL BSS Plus is 5 times that of Ocucoat and Ringer's solution.

Topics: Aged; Aged, 80 and over; Bicarbonates; Cell Count; Chondroitin; Chondroitin Sulfates; Corneal Edema; Cytoprotection; Double-Blind Method; Drug Combinations; Drug Costs; Drug Therapy, Combination; Endothelium, Corneal; Glutathione; Humans; Hyaluronic Acid; Hypromellose Derivatives; Isotonic Solutions; Methylcellulose; Middle Aged; Ophthalmic Solutions; Phacoemulsification; Prospective Studies; Ringer's Solution

The protective effects of two viscoelastic substances (hydroxypropyl methylcellulose and sodium hyaluronate) on the cornea during phacoemulsification of senile cataracts were investigated in a prospective, randomized, clinical study. The viscoelastic substances were placed in the anterior chamber before and during phacoemulsification. The mean increase in central corneal thickness (measured by ultrasonic pachymetry) on the first postoperative day was statistically significantly higher (P less than .05) in the methylcellulose group (35 eyes) than in the sodium hyaluronate group (35 eyes). Five weeks postoperatively the difference in mean central corneal thickness between the two groups was not statistically significant. However, one eye in the methylcellulose group developed bullous keratopathy. The present study indicates that methylcellulose does not protect the corneal endothelium as effectively as sodium hyaluronate during phacoemulsification procedures.

Topics: Aged; Anterior Chamber; Cataract Extraction; Cornea; Corneal Edema; Humans; Hyaluronic Acid; Lenses, Intraocular; Methylcellulose; Middle Aged; Random Allocation