Skip to main content
Top
Published in: International Ophthalmology 1/2018

01-02-2018 | Original Paper

Effects of phacoemulsification with versus without viscoelastic devices on surgical outcomes

Authors: İbrahim Taşkın, Lokman Aslan

Published in: International Ophthalmology | Issue 1/2018

Login to get access

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.
Literature
1.
go back to reference Dick HB, Gerste RD, Rivera RP, Schultz T (2013) Femtosecond laser-assisted cataract surgery without ophthalmic viscosurgical devices. J Refract Surg 29:784–787CrossRefPubMed Dick HB, Gerste RD, Rivera RP, Schultz T (2013) Femtosecond laser-assisted cataract surgery without ophthalmic viscosurgical devices. J Refract Surg 29:784–787CrossRefPubMed
2.
go back to reference Rosado-Adames N, Afshari NA (2012) The changing fate of the corneal endothelium in cataract surgery. Curr Opin Ophthalmol 23:3–6CrossRefPubMed Rosado-Adames N, Afshari NA (2012) The changing fate of the corneal endothelium in cataract surgery. Curr Opin Ophthalmol 23:3–6CrossRefPubMed
3.
go back to reference Minkovitz JB, Stark WJ (1995) Corneal complications of intraocular surgery. Curr Opin Ophthalmol 6:79–85CrossRefPubMed Minkovitz JB, Stark WJ (1995) Corneal complications of intraocular surgery. Curr Opin Ophthalmol 6:79–85CrossRefPubMed
4.
go back to reference 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 43:173–178CrossRefPubMed 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 43:173–178CrossRefPubMed
5.
go back to reference 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 95:5–10CrossRefPubMed 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 95:5–10CrossRefPubMed
6.
go back to reference Hiratsuka Y, Yamada M, Murakami A et al (2011) Cost-effectiveness of cataract surgery in Japan. Jpn J Ophthalmol 55:333–342CrossRef Hiratsuka Y, Yamada M, Murakami A et al (2011) Cost-effectiveness of cataract surgery in Japan. Jpn J Ophthalmol 55:333–342CrossRef
7.
go back to reference Dick HB, Augustin AJ, Pakula T, Pfeiffer N (2003) Endotoxins in ophthalmic viscosurgical devices. Eur J Ophthalmol 13:176–184CrossRefPubMed Dick HB, Augustin AJ, Pakula T, Pfeiffer N (2003) Endotoxins in ophthalmic viscosurgical devices. Eur J Ophthalmol 13:176–184CrossRefPubMed
8.
go back to reference Jürgens I, Matheu A, Castilla M (1997) Ocular hypertension after cataract surgery: a comparison of three surgical techniques and two viscoelastics. Ophthalmic Surg Lasers 28:30–36PubMed Jürgens I, Matheu A, Castilla M (1997) Ocular hypertension after cataract surgery: a comparison of three surgical techniques and two viscoelastics. Ophthalmic Surg Lasers 28:30–36PubMed
9.
go back to reference Henry JC, Olander K (1996) Comparison of the effect of four viscoelastic agents on early postoperative intraocular pressure. J Cataract Refract Surg 22:960–966CrossRefPubMed Henry JC, Olander K (1996) Comparison of the effect of four viscoelastic agents on early postoperative intraocular pressure. J Cataract Refract Surg 22:960–966CrossRefPubMed
10.
go back to reference Khanna R, Pujari S, Sangwan V (2011) Cataract surgery in developing countries. Curr Opin Ophthalmol 22:10–14CrossRefPubMed Khanna R, Pujari S, Sangwan V (2011) Cataract surgery in developing countries. Curr Opin Ophthalmol 22:10–14CrossRefPubMed
11.
go back to reference 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):96–100CrossRefPubMed 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):96–100CrossRefPubMed
12.
go back to reference 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 41:450–454CrossRefPubMed 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 41:450–454CrossRefPubMed
13.
go back to reference Modi SS, Davison JA, Walters T (2011) Safety, efficacy, and intraoperative characteristics of DisCoVisc and Healon ophthalmic viscosurgical devices for cataract surgery. Clin Ophthalmol 5:1381–1389CrossRefPubMedCentralPubMed Modi SS, Davison JA, Walters T (2011) Safety, efficacy, and intraoperative characteristics of DisCoVisc and Healon ophthalmic viscosurgical devices for cataract surgery. Clin Ophthalmol 5:1381–1389CrossRefPubMedCentralPubMed
14.
go back to reference Tak H (2010) Hydroimplantation: foldable intraocular lens implantation without an ophthalmic viscosurgical device. J Cataract Refract Surg 36:377–379CrossRefPubMed Tak H (2010) Hydroimplantation: foldable intraocular lens implantation without an ophthalmic viscosurgical device. J Cataract Refract Surg 36:377–379CrossRefPubMed
15.
go back to reference 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 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
16.
go back to reference 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 92:359–363CrossRefPubMed 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 92:359–363CrossRefPubMed
17.
go back to reference 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) 20159:2073–2080CrossRef 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) 20159:2073–2080CrossRef
18.
go back to reference 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 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.
go back to reference 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 29:733–740CrossRefPubMed 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 29:733–740CrossRefPubMed
20.
go back to reference Wessels IF, DeBarge R, Wessels DA (1998) Salvaged viscoelastic reduces irrigation frequency during cataract surgery. Ophthalmic Surg Lasers 29:688–691PubMed Wessels IF, DeBarge R, Wessels DA (1998) Salvaged viscoelastic reduces irrigation frequency during cataract surgery. Ophthalmic Surg Lasers 29:688–691PubMed
21.
go back to reference 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 95:212–220PubMed 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 95:212–220PubMed
22.
go back to reference 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 60:144–146CrossRefPubMedCentralPubMed 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 60:144–146CrossRefPubMedCentralPubMed
23.
go back to reference 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. 10:543CrossRefPubMedCentralPubMed 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. 10:543CrossRefPubMedCentralPubMed
24.
go back to reference Gogate P (2010) Comparison of various techniques for cataract surgery, their efficacy, safety, and cost Oman. J Ophthalmol 3(3):105 Gogate P (2010) Comparison of various techniques for cataract surgery, their efficacy, safety, and cost Oman. J Ophthalmol 3(3):105
25.
go back to reference 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 53:1835–1845CrossRefPubMed 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 53:1835–1845CrossRefPubMed
26.
go back to reference Arshinoff S (2000) New terminology: ophthalmic viscosurgical devices. J Cataract Refract Surg 26:627–628CrossRefPubMed Arshinoff S (2000) New terminology: ophthalmic viscosurgical devices. J Cataract Refract Surg 26:627–628CrossRefPubMed
27.
go back to reference Shingleton BJ, Mitrev PV (2001) Anterior chamber maintainer versus viscoelastic material for intraocular lens implantation: case-control study. J Cataract Refract Surg 27:711–714CrossRefPubMed Shingleton BJ, Mitrev PV (2001) Anterior chamber maintainer versus viscoelastic material for intraocular lens implantation: case-control study. J Cataract Refract Surg 27:711–714CrossRefPubMed
28.
go back to reference 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. 19:42–45PubMed 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. 19:42–45PubMed
Metadata
Title
Effects of phacoemulsification with versus without viscoelastic devices on surgical outcomes
Authors
İbrahim Taşkın
Lokman Aslan
Publication date
01-02-2018
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2018
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-017-0546-y

Other articles of this Issue 1/2018

International Ophthalmology 1/2018 Go to the issue