The influence of viscoelastic substances on the corneal endothelium during cataract surgery by phacoemulsification

To compare the ability of different ophthalmic viscoelastic devices to protect the corneal endothelium following in-the-bag phacoemulsification with posterior chamber intraocular lens (IOL) implantation.

We studied 50 patients with soft to moderately dense (Grade 1-3) cataract and corneal endothelial cell density of >2000 cells/mm2. The corneal response to surgery was evaluated by measuring the endothelial cell loss, the variation in the mean cell area of the endothelial cells (CV), and the central corneal thickness, all that by using a TOPCON SP 2000P noncontact, specular microscope. Data were recorded preoperatively and postoperatively.

Preoperatively no statistical significant difference was observed in cell count, CV or pachymetry among groups. Postoperatively, all the groups had a statistically significant decrease (p < 0.001) in endothelial cell count. There was an equal and significant (p < 0.001) increase in visual acuity. Between groups there was no statistically significant difference (p > 0.17) in any of the parameters we studied.

Between the OVDs we used, either DisCoVisc or ProVisc & VisCoat, there was no statistical significant difference neither in surgical outcome nor in endothelial layer aspect and function. DisCoVisc protected better the endothelium cells even if it was not statistically significant, and is the one that can be used for the entire surgical procedure.