Corneal endothelial cell protection during phacoemulsification: low- versus high-molecular-weight sodium hyaluronate.
OBJECTIVE
To compare the efficacy of low- and high-molecular-weight sodium hyaluronate in protecting corneal endothelial cells during phacoemulsification.


METHODS
Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan.


METHODS
One hundred forty-nine eyes of 136 cataract patients were randomly assigned to have cataract surgery using sodium hyaluronate 1% with a low molecular weight (0.6 to 1.2 million d, Opegan) or sodium hyaluronate 1% with a high molecular weight (4 million d, Healon) during phacoemulsification. Each group was divided into 2 subgroups depending on the amount of ultrasound (% min) used during phacoemulsification, which was defined as the mean phacoemulsification energy (%) multiplied by phacoemulsification time (minutes). Corneal endothelial cell density was examined preoperatively and 3 months after surgery. The rate of cell loss was compared between the subgroups in the Opegan group and the Healon group.


RESULTS
In the subgroups with ultrasound of 50% min or less, the mean rate of endothelial cell loss 3 months after surgery was 3.2% +/- 4.1% (SD) in the Opegan group and 5.9% +/- 5.3% in the Healon group (P =.0214). In the subgroups with ultrasound over 50% min, the mean rate of endothelial cell loss 3 months after surgery was 7.5% +/- 10.6% in the Opegan group and 14.8 +/- 9.0% in the Healon group (P =.0029).


CONCLUSIONS
The results suggest that Opegan is more effective than Healon in protecting corneal endothelial cells during phacoemulsification regardless of the amount of ultrasound energy used.
Miyata
Kazunori
K
Meiwakai Medical Foundation, Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan.
Maruoka
Shinji
S
Nakahara
Masaaki
M
Otani
Shinichiro
S
Nejima
Ryohei
R
Samejima
Tomokazu
T
Amano
Shiro
S
D000368:Aged; D000369:Aged, 80 and over; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000737:chemistry* / Q000627:therapeutic use*; D007429:Intraocular Pressure / Q000187:drug effects; D008875:Middle Aged; D008970:Molecular Weight; D018918:Phacoemulsification / Q000379:methods; D014464:Ultrasonic Therapy
D006820:Hyaluronic Acid