title: Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate whether the use of balanced salt solution (BSS) or an ophthalmic viscoelastic device (OVD) during hydrophilic acrylic intraocular lens (IOL) implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.
  
  
  METHODS
  Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus(®) or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy) were recorded.
  
  
  RESULTS
  Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD) and endothelium cell size were 2,506±310 cells/mm(2)/2,433±261 cells/mm(2) and 406±47 µm(2)/416±50 µm(2) (P=0.107/P=0.09). After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001) without significant differences between both groups (each P>0.05). Irrigation-aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds) and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes) were significantly longer in the OVD Z-Celcoat group (each P<0.001). No complications or serious side effects occurred.
  
  
  CONCLUSIONS
  Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.
authors.affiliation: Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Schulze
authors.affiliation: Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertelmann
authors.affiliation: Private Practice and Ambulatory Surgical Center, Bremen, Germany.
authors.forename: Irena
authors.initials: I
authors.lastname: Manojlovic
authors.affiliation: Private Practice and Ambulatory Surgical Center, Bremen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Bodanowitz
authors.affiliation: Freelance Statistician, Friedberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Irle
authors.affiliation: Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Sekundo
keywords: IOL; endothelial cell density; ophthalmic viscoelastic device; phacoemulsification