Skip to main content

Advertisement

Log in

Effects of phacoemulsification with versus without viscoelastic devices on surgical outcomes

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to report surgical outcomes in patients undergoing phacoemulsification surgery (PE) with versus without ophthalmic viscosurgical devices (OVDs).

Methods

This is a comparative case series study. In total, 145 patients who performed PE with OVDs in 68 eyes (Group 1) and without OVD in 77 eyes (Group 2) were enrolled. A comprehensive ophthalmological examination was performed including slit-lamp, fundus examination. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) specular endothelial microscopy (SM), and ultrasound pachymetry (UP) were also measured before surgery and at four-time points postoperatively. The differences in baseline characteristics as well as in outcomes were compared between the two groups.

Results

The mean BCVA was 0.41 ± 0.26 logMAR in Group 1 and 0.54 ± 0.34 in Group 2 at postoperative first day, with a significant difference (p < 0.01). The mean BCVA, IOP, and UP at 6 months did not differ between the groups. The mean baseline and postoperative SMs were 2063 and 1910 cells/mm2, respectively, and the endothelial cell loss (ECL) was 153.89 ± 189 in Group 1. The mean baseline and postoperative SMs were 2153 and 1948 cells/mm2, respectively, and the ECL was 205 ± 200 in Group 2. The difference between the groups was not statistically significant (p = 0.105).

Conclusions

The ECL seemed to be higher in the Group 2, but the difference was not significant. The final clinical outcomes were similar between the groups. In selected cases, PE without OVD may be preferable to reduce the cost of surgery in places with low economic status and to prevent side-effects of these devices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Dick HB, Gerste RD, Rivera RP, Schultz T (2013) Femtosecond laser-assisted cataract surgery without ophthalmic viscosurgical devices. J Refract Surg 29:784–787

    Article  PubMed  Google Scholar 

  2. Rosado-Adames N, Afshari NA (2012) The changing fate of the corneal endothelium in cataract surgery. Curr Opin Ophthalmol 23:3–6

    Article  PubMed  Google Scholar 

  3. Minkovitz JB, Stark WJ (1995) Corneal complications of intraocular surgery. Curr Opin Ophthalmol 6:79–85

    Article  CAS  PubMed  Google Scholar 

  4. Reepolmaha S, Limtrakarn W, Uthaisang-Tanechpongtamb W, Dechaumphai P (2010) Fluid temperature at the corneal endothelium during phacoemulsification: comparison of an ophthalmic viscosurgical device and balanced salt solution using the finite element method. Ophthalmic Res 43:173–178

    Article  PubMed  Google Scholar 

  5. Van den Bruel A, Gailly J, Devriese S, Welton NJ, Shortt AJ, Vrijens F (2011) The protective effect of ophthalmic viscoelastic devices on endothelial cell loss during cataract surgery: a meta-analysis using mixed treatment comparisons. Br J Ophthalmol 95:5–10

    Article  PubMed  Google Scholar 

  6. Hiratsuka Y, Yamada M, Murakami A et al (2011) Cost-effectiveness of cataract surgery in Japan. Jpn J Ophthalmol 55:333–342

    Article  Google Scholar 

  7. Dick HB, Augustin AJ, Pakula T, Pfeiffer N (2003) Endotoxins in ophthalmic viscosurgical devices. Eur J Ophthalmol 13:176–184

    Article  PubMed  Google Scholar 

  8. Jürgens I, Matheu A, Castilla M (1997) Ocular hypertension after cataract surgery: a comparison of three surgical techniques and two viscoelastics. Ophthalmic Surg Lasers 28:30–36

    PubMed  Google Scholar 

  9. Henry JC, Olander K (1996) Comparison of the effect of four viscoelastic agents on early postoperative intraocular pressure. J Cataract Refract Surg 22:960–966

    Article  CAS  PubMed  Google Scholar 

  10. Khanna R, Pujari S, Sangwan V (2011) Cataract surgery in developing countries. Curr Opin Ophthalmol 22:10–14

    Article  PubMed  Google Scholar 

  11. Kugu S, Erdogan G, Sahin Sevim M, Ozerturk Y (2015) A clinical comparison of safety and efficacy in phacoemulsification with versus without ophthalmic viscoelastic device. Semin Ophthalmol 30(2):96–100

    Article  PubMed  Google Scholar 

  12. Sim BW, Amjadi S, Singh R, Bhardwaj G, Dubey R, Francis IC (2013) Assessment of adequate removal of ophthalmic viscoelastic device with irrigation/aspiration by quantifying intraocular lens ‘Judders’. Clin Exp Ophthalmol 41:450–454

    Article  PubMed  Google Scholar 

  13. Modi SS, Davison JA, Walters T (2011) Safety, efficacy, and intraoperative characteristics of DisCoVisc and Healon ophthalmic viscosurgical devices for cataract surgery. Clin Ophthalmol 5:1381–1389

    Article  PubMed Central  PubMed  Google Scholar 

  14. Tak H (2010) Hydroimplantation: foldable intraocular lens implantation without an ophthalmic viscosurgical device. J Cataract Refract Surg 36:377–379

    Article  PubMed  Google Scholar 

  15. Queiros A, Peixoto-de-Matos SC, Ferrer-Blasco T, Gonzalez-Meijome JM (2010) Age-related changes of corneal endothelium in normal eyes with a non-contact specular microscope. J Emmetropia 1(2):132–139

    Google Scholar 

  16. Storr-Paulsen A, Jørgensen JS, Norregaard JC, Thulesen J (2014) Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α-1a antagonist medication (tamsulosin). Acta Ophthalmol 92:359–363

    Article  CAS  PubMed  Google Scholar 

  17. Schulze SD, Bertelmann T, Manojlovic I, Bodanowitz S, Irle S, Sekundo W (2015) Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation. Clin Ophthalmol (Auckland, NZ) 20159:2073–2080

    Article  Google Scholar 

  18. Unsal U, Baser G, Soyler M (2016) Intraocular lens implantation without the use of ophthalmic viscosurgical device. Int Ophthalmol Mar 14. [Epub ahead of print] PubMed PMID: 2697540

  19. Kiss B, Findl O, Menapace R et al (2003) Corneal endothelial cell protection with a dispersive viscoelastic material and an irrigating solution during phacoemulsification: low-cost versus expensive combination. J Cataract Refract Surg 29:733–740

    Article  PubMed  Google Scholar 

  20. Wessels IF, DeBarge R, Wessels DA (1998) Salvaged viscoelastic reduces irrigation frequency during cataract surgery. Ophthalmic Surg Lasers 29:688–691

    CAS  PubMed  Google Scholar 

  21. Jongsareejit A, Wiriyaluppa C, Kongsap P, Phumipan S (2012) Cost-effectiveness analysis of manual small incision cataract surgery (MSICS) and phacoemulsification (PE). J Med Assoc Thai 95:212–220

    PubMed  Google Scholar 

  22. Muralidhar R, Siddalinga Swamy GS, Vijayalakshmi P (2012) Completion rates of anterior and posterior continuous curvilinear capsulorhexis in pediatric cataract surgery for surgery performed by trainee surgeons with the use of a low-cost viscoelastic. Indian J Ophthalmol 60:144–146

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Fang J, Wang X, Lin Z, Yan J, Yang Y, Li J (2010) Variation of cataract surgery costs in four different graded providers of China. BMC Public Health. 10:543

    Article  PubMed Central  PubMed  Google Scholar 

  24. Gogate P (2010) Comparison of various techniques for cataract surgery, their efficacy, safety, and cost Oman. J Ophthalmol 3(3):105

    Google Scholar 

  25. Chandler HL, Haeussler DJ Jr, Gemensky-Metzler AJ, Wilkie DA, Lutz EA (2012) Induction of posterior capsule opacification by hyaluronic acid in an ex vivo model. Invest Ophthalmol Vis Sci 53:1835–1845

    Article  CAS  PubMed  Google Scholar 

  26. Arshinoff S (2000) New terminology: ophthalmic viscosurgical devices. J Cataract Refract Surg 26:627–628

    Article  CAS  PubMed  Google Scholar 

  27. Shingleton BJ, Mitrev PV (2001) Anterior chamber maintainer versus viscoelastic material for intraocular lens implantation: case-control study. J Cataract Refract Surg 27:711–714

    Article  CAS  PubMed  Google Scholar 

  28. Waseem M, Rustam N, ul Islam Q (2007) Intraocular pressure after phacoemulsification using hydroxypropyl methylcellulose and sodium hyaluronate as viscoelastics. J Ayub Med Coll Abbottabad. 19:42–45

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lokman Aslan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Taşkın, İ., Aslan, L. Effects of phacoemulsification with versus without viscoelastic devices on surgical outcomes. Int Ophthalmol 38, 5–10 (2018). https://doi.org/10.1007/s10792-017-0546-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-017-0546-y

Keywords

Navigation