Clinical evaluation of endothelial cell decrease with VisThesia in phacoemulsification surgery.

Area of Science:

• Ophthalmology
• Corneal Science
• Surgical Innovation

Background:

• Ophthalmic viscosurgical devices (OVDs) are crucial in ophthalmic surgery, particularly phacoemulsification.
• Patient comfort during surgery under topical anesthesia is a significant consideration.
• Sodium hyaluronate-based OVDs are commonly used, but the addition of anesthetics warrants safety evaluation.

Purpose of the Study:

• To evaluate endothelial cell decrease following the use of sodium hyaluronate 0.3% and lidocaine hydrochloride 2% (VisThesia).
• To determine if lidocaine 1% added to sodium hyaluronate 1.5% increases corneal toxicity.
• To compare the safety profile of VisThesia with other OVDs.

Main Methods:

• A prospective study involving 50 eyes of 50 patients undergoing phacoemulsification.
• Application of VisThesia Topical followed by intracameral use as the routine OVD.
• Noncontact specular microscopy to assess central corneal endothelium preoperatively and at 3 months post-surgery.

Main Results:

• Mean best corrected visual acuity was 0.88 +/- 0.18, and mean manifest spherical equivalent was -0.36 +/- 1.78 D at 3 months.
• Mean endothelial cell density decreased from 2363.57 +/- 435.4 cells/mm² preoperatively to 2222.6 +/- 537.69 cells/mm² at 3 months.
• Observed endothelial cell loss is comparable to that reported for other OVDs in the literature.

Conclusions:

• The addition of lidocaine to sodium hyaluronate in VisThesia does not induce additional toxicity.
• VisThesia does not result in increased endothelial cell loss compared to similar ophthalmic viscosurgical devices.
• The findings support the safety of VisThesia for use in cataract surgery.