Comparison of the effect of sodium hyaluronate (Ophthalin) and hydroxypropylmethylcellulose (HPMC-Ophtal) on corneal endothelium, central corneal thickness, and intraocular pressure after phacoemulsification.
OBJECTIVE
To prospectively evaluate the effects of 2% hydroxypropyl-methylcellulose (HPMC-Ophtal) and sodium hyaluronate 1% (Ophthalin) on intraocular pressure, corneal thickness, and endothelial cell loss in small incision cataract surgery with implant.


METHODS
A total of 110 patients undergoing routine phacoemulsification with implant received either 2% hydroxypropyl methylcellulose or sodium hyaluronate 1% as ophthalmic viscosurgical device. Pre- and postoperative slitlamp examination, intraocular pressure measurement (preoperatively and at 1-4 hours, 1 day, and 7 days postoperatively), ultrasonic pachymetry (preoperatively and at 1 week, 4-6 weeks, and 12 weeks post operatively), and corneal endothelial cell count (preoperatively and 12 weeks postoperatively) were performed. Data were analyzed using two-way analysis of variance.


RESULTS
All measurements were comparable between the two groups preoperatively. Intraocular pressure was significantly lower in the Ophthalin group at 1 day post operatively, while no significant difference was found between the two groups on the 1-4 hours and 7 days examination. The central corneal thickness was not significantly different between the two groups at any postoperative visit . However, the mean cell density demonstrated a significant fall of 11.76% for Ophthalin and 4.27% for HPMC-Ophtal at 12 weeks post-operatively, the difference between the two being significant (p=0.009).


CONCLUSIONS
2% Hydroxypropyl methylcellulose, compared with sodium hyaluronate 1%, is superior in protecting the corneal endothelial cells, has the same effect on central corneal thickness, and is associated with slightly higher intraocular pressure 1 day post operatively. It compares favorably with sodium hyaluronate 1% and can be used as an effective and cheaper alternative in routine small incision cataract surgery with implant.
Ray-Chaudhuri
N
N
Department of Ophthalmology, Royal Victoria Infirmary, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom.
Voros
G M
GM
Sutherland
S
S
Figueiredo
F C
FC
D000867:Anterior Chamber / Q000187:drug effects; D002452:Cell Count; D003315:Cornea / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D065347:Hypromellose Derivatives; D007429:Intraocular Pressure / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D008747:Methylcellulose / Q000031:analogs & derivatives* / Q000494:pharmacology; D018918:Phacoemulsification / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D014463:Ultrasonography
D065347:Hypromellose Derivatives; D006820:Hyaluronic Acid; D008747:Methylcellulose