Efficacy of the soft-shell technique using Viscoat and Hyal-2000.

摘要

PURPOSE: To evaluate whether the soft-shell technique using Viscoat (sodium hyaluronate 3%-chondroitin sulfate 4%) and Hyal-2000 (sodium hyaluronate 1%) reduces corneal endothelial cell damage during cataract surgery. SETTING: Department of Ophthalmology, Kangnam St. Mary's Hospital, Seoul, Korea. METHODS: The nuclear opacity in 252 eyes of 230 cataract patients was classified as grade 1, 2, 3, or > or =4 using the Lens Opacities Classification System III. In each classification, the patients were divided into 4 groups before phacoemulsification based on the type of ophthalmic viscosurgical device (OVD) used during surgery: Viscoat and Hyal-2000 (soft-shell technique), Viscoat alone, Hyal-2000 alone, or Provisc (sodium hyaluronate 1%) alone. All patients were operated on using the same technique except for the OVD. The visual acuity, corneal endothelial cell density, corneal thickness, and intraocular pressure (IOP) were evaluated postoperatively. RESULTS: The rate of endothelial cell loss 2 months after surgery in eyes with a nuclear opacity grade of > or =4 was significantly different between the 4 OVD groups. The rate in eyes with a nuclear opacity grade of < or =3 was not significantly different between the groups. There were no statistically significant differences between the 4 groups in visual acuity, corneal thickness, or IOP throughout the follow-up period. CONCLUSION: The soft-shell technique using Viscoat and Hyal-2000 protected corneal endothelial cells during cataract surgery in patients with a nuclear opacity grade of > or =4.