Comparison of Two Techniques in Phacoemulsification: Hydroimplantation and Viscoimplantation

The aim of this study was to compare hydroimplantation and viscoimplantation techniques in phacoemulsification surgery by analyzing corneal tomography parameters and changes in intraocular pressure (IOP).

This retrospective study included 74 eyes of 74 consecutive patients who underwent phacoemulsification surgery and implantation of a foldable intraocular lens (IOL). Each eye was assigned to either the viscoelastic material (VEM) group (VEM(+); (n=39) or the VEM (-) group (n=35). Accordingly, IOL implantation was performed with VEM (1.4% sodium hyaluronate; Protectalon, VSY, Turkey) in the VEM(+) group, whereas hydroimplantation without VEM was used in the VEM (-) group. Post-operative examinations were performed on post-operative days 1, 3, and 7, and at 1 month.

There was no statistically significant difference in IOP between the VEM(+) and VEM(-) groups before surgery or at any post-operative time point except at 24 h. At 24 h postoperatively, the VEM(+) group had a significantly higher IOP compared to the VEM(-) group (p=0.010). In addition, the central corneal thickness at 1 month was significantly higher in the VEM(+) group than in the VEM(-) group (p=0.027). No statistically significant differences were found between the groups in best corrected visual acuity, anterior chamber depth, and axial length. There was no posterior capsule rupture or zonular dialysis in either group.

Phacoemulsification using the hydroimplantation technique appears to be a safe and feasible approach that may help mitigate early post-operative IOP elevation; however, assessing corneal endothelial cell function by specular microscopy would be important for a more comprehensive safety comparison between techniques.