title: Effectiveness of the soft-shell technique in patients with Fuchs' endothelial dystrophy.
abstract: OBJECTIVE
  To evaluate the protective ability of the soft-shell technique in patients with senile cataract and Fuchs' dystrophy having phacoemulsification with intraocular lens (IOL) implantation.
  
  
  METHODS
  Department of Ophthalmology, Railway Hospital, Katowice, Poland.
  
  
  METHODS
  Sixty-one eyes of 54 patients (37 women, 17 men) with clinically confirmed Fuchs' dystrophy and cataract had clear corneal phacoemulsification and implantation of an intracapsular posterior chamber IOL with sodium hyaluronate 1% (Healon) or chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) in combination with sodium hyaluronate 1% (Provisc) in 1 package (DuoVisc). The central corneal thickness (CCT), measured with a Pocket Precision ultrasonic pachymeter (Quantel Medical, Inc.), was compared preoperatively and 1 day, 1 week, and 1 and 6 months postoperatively.
  
  
  RESULTS
  The mean preoperative CCT was 549.5 microm +/- 29.3 (SD). The postoperative increase in CCT over preoperative pachymetry measurements remained statistically significant in both ophthalmic viscosurgical device groups throughout the entire follow-up, from the first day to the sixth month after surgery (P<.0001). The maximum increase in CCT in both groups was on the first postoperative day, and it was significantly higher in the Healon group. Six months postoperatively, patients in the Healon group had a significantly greater CCT increase (P = .008).
  
  
  CONCLUSIONS
  The soft-shell technique effectively protected the compromised endothelium in patients with Fuchs' dystrophy, proving its advantages in eyes with moderately damaged endothelium.
authors.affiliation: Department of Ophthalmology, District Railway Hospital, Katowice, Poland. dorota.tarnawska@gmail.com
authors.forename: Dorota
authors.initials: D
authors.lastname: Tarnawska
authors.forename: Edward
authors.initials: E
authors.lastname: Wylegała
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications; D002452:Cell Count; D002809:Chondroitin Sulfates / Q000008:administration & dosage*; D003316:Corneal Diseases / Q000517:prevention & control; D004359:Drug Therapy, Combination; D004728:Endothelium, Corneal / Q000187:drug effects*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies
chemical_list: D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates