Endothelial cell loss in different non-automated extracapsular nuclear evacuation techniques and the role of sodium...

In this study the effect of seven different non-automated nuclear evacuation techniques and the role of sodium hyaluronate (Healon) were evaluated. Thirty-five cats (seven groups) and 140 human patients (seven groups) were included in the study. Each experimental animal and human group was operated using one of the seven non-automated techniques. In each animal, one eye was operated with sodium hyaluronate and the other with Balanced Saline Solution (BSS). In each human group of 20 patients during cataract extraction and IOL implantation, sodium hyaluronate was used in half of the patients and BSS was used in the remaining ten. Eyes treated with sodium hyaluronate lost approximately 50% fewer endothelial cells and had approximately 50% less increase in corneal thickness than their counterparts treated with BSS. Based on the results of the endothelial cell loss and the corneal thickness, it is concluded that the most traumatic used technique was no. 2, followed by that of no. 5. The technique no. 7 may be considered as the most atraumatic of the tested procedures. Sodium hyaluronate effectively protected the endothelium, and its routine use in cataract surgery is recommended.