97th DOG Annual Meeting 1999



A. Vogel, S. Christmann, O. Schwenn, B. Dick, F. Krummenauer*, N. Pfeiffer

Purpose: To compare Healon 5, a high molecular weight formulation of hyaluronate with new physicochemical properties that combines the advantages of cohesive and dispersive viscoelastics, with Viscoat, a combination of chondroitinsulfate (viscoelastic substance with high coatability) and hyaluronate (viscosity).

Patients and Methods: In a prospective, randomized and masked study we evaluated the postoperative effect of both viscoelastic agents on intraocular pressure (IOP) and laser flare (Kowa FM500) after 4, 8, 24, 48 and 72 hours. A pachymetry was performed after 24, 48 and 72 hours. 48 eyes of 48 patients undergoing routine planned phacoemulsification followed by foldable IOL (SI-40NB or SA-40N, Allergan) implantation were enrolled. 28 eyes received Viscoat and 20 eyes Healon 5. All surgeries were performed by one surgeon in a standardized manner. Irrigation and aspiration were performed bimanually by the I/A-device (diameter of aspiration hole: 0.3 mm) behind the IOL and in the anterior chamber (flow: 25 ml/min, vacuum: 500 mmHg, aspiration time: 60 sec).

Results: IOP was statistically significant higher after 4 hours (median Healon 5: absolute value: 17 mmHg, relative intraindividual difference to the preoperative value: 33%; median Viscoat: 27.5 mmHg, 82%; p=0.0020) as well as after 8 hours (median Healon 5: 17,5 mmHg, 22%; median Viscoat: 22.5 mmHg, 57%; p=0.0239) using Viscoat. 8 hours postoperatively, intraocular flare was statistically significant lower in the Healon 5 group (median Healon 5: 14.3 photon counts/ms, 5%; median Viscoat: 17.7 photon counts/ms, 51%; p=0.0196). There was no statistically significant difference of flare measured 4 hours after implantation (median Healon 5: 18,5 photon counts/ms, 81%; median Viscoat: 26,6 photon counts/ms, 114%; p=0.0912). Corneal thickness was the same in both groups.

Conclusion: Patients receiving Viscoat demonstrated higher intraocular pressure and flare in the early postoperative period.

Department of Ophthalmology, University of Mainz, Langenbeckstr. 1, D-55131 Mainz, Germany
*Department of Medical Statistics and Documentation, Obere Zahlbacher Stra├če 69, D-55131 Mainz, Germany