title: Corneal endothelial cell protection during phacoemulsification: low- versus high-molecular-weight sodium hyaluronate.
abstract: 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.
authors.affiliation: Meiwakai Medical Foundation, Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Miyata
authors.forename: Shinji
authors.initials: S
authors.lastname: Maruoka
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakahara
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Otani
authors.forename: Ryohei
authors.initials: R
authors.lastname: Nejima
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Samejima
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
mesh_terms: 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
chemical_list: D006820:Hyaluronic Acid