Performance and safety of two ophthalmic viscosurgical devices in cataract surgery

The aim of this study was to compare the clinical performance and safety of a highly dispersive and a highly cohesive ophthalmic viscosurgical device (OVD).

Vienna Institute for Research in Ocular Surgery (VIROS) at the Hanusch Hospital, Vienna.

This was a prospective, single-center study including 120 eyes of 80 patients using either a dispersive hydroxypropylmethylcellulose (HPMC, etacoat)- or a cohesive hyaluronic acid (HA, etafill)-based OVD (both Croma-Pharma GmbH, Leobendorf, Austria) for standard cataract surgery in a nonrandomized fashion. Endothelial cell count (ECC) was measured preoperatively and 90 days after surgery. Central corneal thickness (CCT) and intraocular pressure (IOP) were measured preoperatively as well as 1 h, 1 day, and 90 days after surgery. Furthermore, the surgeons’ satisfaction with the application of the device was assessed via a questionnaire after surgery.

The dispersive and the cohesive OVD groups comprised 51 eyes (34 patients) and 56 eyes (41 patients), respectively. The ECC loss was 36 cells/mm² or 1.2% (p = 0.09) and 125 cells/mm² or 4.6% (p < 0.01), respectively (p = 0.42). The CCT increased 1 h postoperatively by 49.4 µm or 9.1%, (p = 0.44) and by 62.6 µm or 11.2% (p < 0.01), while at 1 day postoperatively it increased by 22.4 µm or 4.1% (p = 0.279) and by 50.0 µm or 9.0% (p < 0.01); the CCT decreased 90 days after surgery from baseline by −2.4 µm or −0.5% (p = 0.16) and 0.0 µm or 0.1% (p = 1.00), respectively (p < 0.01, p < 0.01, p < 0.01).

The IOP increased 1 h after surgery (0.7 mm Hg and 0.4 mm Hg) and 1 day postoperatively (0.6 mm Hg and 0.1 mmHg), and it decreased 90 days after surgery (−1.4 mm Hg and −1.7 mmHg), respectively (p = 0.14, p = 0.04, p = 0.43). Appropriate working space in the anterior chamber was maintained during cataract surgery in all eyes with both OVDs.

Both OVDs successfully protected the cornea and achieved appropriate working space during anterior cataract surgery in all of the eyes that were treated.