Soft-shell technique using Viscoat® and Healon ®5: A prospective, randomized comparison between a dispersive-viscoadaptive and a dispersive-cohesive soft-shell technique

Abstract

Purpose: To compare the efficacy of the dispersive-viscoadaptive soft-shell technique using Viscoat® and Healon ®5 to the dispersive-cohesive soft-shell technique in reducing corneal endothelial cell damage during cataract surgery. Methods: In this prospective randomized study, 207 eyes of 171 cataract patients underwent phacoemulsification using the dispersive-viscoadaptive soft-shell technique (V-group, 102 eyes) with Viscoat and Healon5 or the dispersive-cohesive soft-shell technique (C-group, 105 eyes) with Viscoat and a cohesive agent (Opegan-Hi®). Each group was divided into two subgroups depending on the amount of ultrasound (%Min) used during phacoemulsification. Corneal endothelial cell density was examined preoperatively and 3months postoperatively. The endothelial cell loss was compared between the two groups, and also between the subgroups. Results: The mean endothelial cell loss 3 months after surgery was 8.4 ± 5.6% standard deviation (SD) in the V-group and 8.2 ± 6.2% in the C-group (P = 0.787). In the subgroups with ultrasound of 10 %Min or less, the mean endothelial cell loss 3months after surgery was 6.6 ± 4.6% in the V-group and 5.5 ± 5.0% in the C-group (P = 0.104). In the subgroups with ultrasound of over 10 %Min, this value was 10.6 ± 6.3% in the V-group and 11.9 ± 5.7% in the C-group (P = 0.413). The correlation coefficient of the endothelial cell loss rate and %Min was 0.245 (P = 0.0129) in the V-group and 0.501 (P < 0.0001) in the C-group. Conclusions: The dispersive-viscoadaptive soft-shell technique is as effective as the dispersive-cohesive soft-shell technique in protecting corneal endothelial cells during phacoemulsification regardless of the amount of ultrasound energy used. © 2007 The Authors Journal Compilation 2007 Acta Ophthalmol Scand.