title: Clinical evaluation of endothelial cell decrease with VisThesia in phacoemulsification surgery.
abstract: OBJECTIVE
  To assess the endothelial cell decrease after the use of sodium hyaluronate 0.3% and lidocaine hydrochloride 2% (VisThesia) to determine whether the addition of lidocaine 1% to sodium hyaluronate 1.5% makes the solution more toxic to the cornea.
  
  
  METHODS
  Instituto de Oftalmologia Avanzada, Madrid, Spain, and Unita Operative Oculistica, Cesena, Italy.
  
  
  METHODS
  VisThesia is an ophthalmic viscosurgical device (OVD) that incorporates lidocaine 1% to provide better comfort to patients under topical anesthesia. Fifty eyes 50 patients were operated on following the same patient selection and surgical technique. After the povidone-iodine (Betadine) ocular asepsis, 1 full ampoule of VisThesia Topical was applied over the corneal surface. The intracameral product was used as a routine OVD during the phacoemulsification procedure. The endothelium of the central cornea was examined preoperatively and 3 months after surgery using a noncontact endothelium microscope.
  
  
  RESULTS
  At the last follow-up visit, the mean best corrected visual acuity was 0.88 +/- 0.18 and the mean manifest SE was -0.36 +/- 1.78 D. The mean endothelial cell density had decreased from 2363.57 +/- 435.4 cells/mm2 preoperatively to 2222.6 +/- 537.69 cells/mm2 at 3 months. These values are comparable with results obtained in other investigations published in the literature using other, similar OVD.
  
  
  CONCLUSIONS
  The results observed in this investigation indicate that the addition of lidocaine to the sodium hyaluronate in VisThesia does not induce additional toxicity nor does it result in increased endothelial cell loss when compared with other, similar OVDs.
authors.affiliation: Instituto de Oftalmologia Avanzada, Madrid, Spain. fpoyales@oftalmologia-avanzada.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Poyales-Galan
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pirazzoli
mesh_terms: D000287:Administration, Topical; D000368:Aged; D017209:Apoptosis; D002452:Cell Count; D004359:Drug Therapy, Combination; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D008012:Lidocaine / Q000009:adverse effects* / Q000627:therapeutic use; D018918:Phacoemulsification / Q000379:methods*
chemical_list: D006820:Hyaluronic Acid; D008012:Lidocaine