PURPOSE: To evaluate the effect of combined diclofenac sodium and nuclear rotation on the prevention of posterior capsule opacification (PCO). SETTING: Wuxi People's Hospital, Jiangsu, China. DESIGN: Comparative case series. METHODS: In a preclinical trial, porcine eyes were randomized to have hydrodissection with diclofenac sodium (Group A), diclofenac sodium and nuclear rotation (Group B), or a control (balanced salt solution/lidocaine). Primary cells of porcine lens epithelium from the posterior lens capsule were obtained in each group. Proliferation and coverage time for lens epithelial cells (LECs) were noted. In the clinical study, patients with age-related cataract were divided into 4 groups. Hydrodissection was performed with a balanced salt solution in Group 1, with lidocaine in Group 2, with 0.25 mg/mL diclofenac sodium in Group 3, and with 0.25 mg/mL combined diclofenac sodium and nuclear rotation in Group 4. Visual acuity and corneal endothelial cell density (ECD) were measured. RESULTS: In the preclinical trial (n = 30), the LEC coverage time in Group A and Group B was significantly longer than in the control group (P<.001). In the clinical study (n = 72), there were no significant differences between the 4 groups in corrected distance visual acuity or corneal ECD during the 2-year follow-up (P>.05). The PCO scores in Groups 3 and 4 were significantly lower than in Groups 1 and 2 (chi(2) = 23.109, P<.001). The lowest PCO score was in Group 4. CONCLUSION: Hydrodissection using combined diclofenac sodium and nuclear rotation prevented PCO up to 2 years postoperatively. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
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