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[Controlled clinical study of two viscoelastic substances].

J Kammann1, G Dornbach, C Vollenberg

  • 1Abteilung Augenheilkunde, St.-Johannes-Hospital, Dortmund 1, Bundesrepublik Deutschland.

Fortschritte Der Ophthalmologie : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|January 1, 1991
PubMed
Summary

In cataract surgery, both sodium hyaluronic acid and hydroxypropylmethyl cellulose (HPMC) showed similar safety profiles regarding intraocular pressure (IOP) and irritation. Hydroxypropylmethyl cellulose (HPMC) is more cost-effective for routine procedures.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Biomaterials Science

Background:

  • Viscoelastic substances are crucial for minimizing irritation in cataract surgery.
  • Sodium hyaluronate (glucosamine glykanes) and hydroxypropylmethyl cellulose (HPMC, cellulose ethers) are commonly used viscoelastic agents.
  • Understanding their comparative effects on intraocular pressure (IOP) and ocular irritation is essential for surgical practice.

Purpose of the Study:

  • To compare the clinical efficacy and safety of sodium hyaluronate versus hydroxypropylmethyl cellulose (HPMC) in cataract surgery.
  • To evaluate the impact of these viscoelastic agents on postoperative intraocular pressure (IOP) and anterior chamber inflammation.

Main Methods:

  • A controlled clinical study involving 200 cataract patients (excluding those with diabetes, glaucoma, or severe corneal damage).

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  • Patients received either sodium hyaluronate or hydroxypropylmethyl cellulose (HPMC) during surgery.
  • Intraocular pressure (IOP) and anterior chamber irritation were assessed on postoperative days 1, 2, and 5, and at 4 weeks.

    • Main Results:

    • No statistically significant differences were observed between the two groups regarding IOP.
    • Postoperative anterior chamber irritation levels were comparable for both sodium hyaluronate and hydroxypropylmethyl cellulose (HPMC).
    • Hydroxypropylmethyl cellulose (HPMC) demonstrated a significant cost advantage over sodium hyaluronate.

    Conclusions:

    • Both sodium hyaluronate and hydroxypropylmethyl cellulose (HPMC) are safe and effective viscoelastic agents for routine cataract surgery.
    • Hydroxypropylmethyl cellulose (HPMC) is recommended for routine cataract surgery due to its lower cost and comparable clinical outcomes.
    • Economic considerations favor the use of hydroxypropylmethyl cellulose (HPMC) in standard cataract procedures.