Postoperative intraocular pressure changes with use of different viscoelastics.
Sixty eyes with age-related cataract underwent extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC-IOL) implantation under similar conditions using hydroxypropyl methylcellulose (HPMC) (Oculose) (n = 20), sodium hyaluronate (Healon) (n = 20), or hyaluronic acid (IAL) (n = 20) as the viscoelastic (VE). Postoperative evaluation was performed for intraocular pressure (IOP), corneal thickness, and anterior chamber reaction at 6, 24, 48, 72 hours, and 10 days. Statistically-significant rises in IOP with IAL and Healon were observed at 6 and 24 hours; no such rises were observed with Oculose (P < .05). Seven eyes in the IAL group and six in the Healon group had IOPs greater than 22 mm Hg at 6 hours (range: 22 to 38 mm Hg and 22 to 28 mm Hg, respectively). A significant increase in average corneal thickness was observed in all of the 60 patients at 6 hours (18.5%). The average thickness decreased to 6.8% by day 10, with no intergroup variations. There were significantly fewer anterior chamber cells at 6 hours in the Healon group. We conclude that all three viscoelastics are equally useful for routine ECCE with PC-IOL implantation. However, IAL and Healon do cause an early postoperative IOP increase, which, though transient, should be treated.
Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
V K
VK
Dada
N
N
Sindhu
M S
MS
Sachdev
D000867:Anterior Chamber / Q000473:pathology; D002387:Cataract Extraction / Q000009:adverse effects; D006801:Humans; D006820:Hyaluronic Acid; D065347:Hypromellose Derivatives; D007429:Intraocular Pressure; D007910:Lenses, Intraocular; D008747:Methylcellulose / Q000031:analogs & derivatives*; D009798:Ocular Hypertension / Q000209:etiology; D011183:Postoperative Complications; D016037:Single-Blind Method
D065347:Hypromellose Derivatives; D006820:Hyaluronic Acid; D008747:Methylcellulose