Study of the efficacy of the viscoelastic solutions in protection of the corneal endothelium during phacoemulsification

Abstract

Since the invention of phacoemulsification, several attempts and trials were made to achieve the best visual outcomes and corneal transparency. One of these factors are the OVDs used in phacoemulsification. There is a wide spectrum of OVDs used. In our study we compared the dispersive OVD (methyl cellulose) and cohesive OVD (sodium hyaluronate). The optimum OVD is that one which achieve corneal endothelial protection regarding endothelial cell density, Central corneal thickness, pleomorohism (HEX%) and polymegathism (CV%), and also achieve easy phacoemulsification in maintaining the AC depth, capsulorhexsis, phacoemulsification of the nucleus and implantation of the IOL. Both OVDs have a significant effect on the HEX% and the mean difference is significant in favour of dispersive OVD, while they had a significant effect on endothelial cell density and the mean difference is significant in favour of cohesive OVD. Both OVD have no significant effect on the CV % with no significant difference between them. Also the post operative increase in the CCT is very much comparable between the two OVDs. The pervious finding denotes that both OVD are protective on the corneal endothelium and the use of which is a surgeon preference. Further larger scale studies are needed to be performed and also in harder situations as harder nuclear cataract, a larger scale of CDE.