Methylcellulose instead of Healon in extracapsular surgery with intraocular lens implantation

Area of Science:

• Ophthalmology
• Surgical Techniques
• Corneal Science

Background:

• Cataract extraction requires methods to protect intraocular structures.
• Maintaining corneal endothelial cell count is crucial for visual outcomes.
• Previous methods for anterior chamber maintenance during surgery have varied.

Purpose of the Study:

• To compare the efficacy of methylcellulose 1% versus an air bubble in preserving corneal endothelial cells during extracapsular cataract extraction.
• To evaluate the impact of these agents on postoperative visual acuity, intraocular pressure, and inflammation.

Main Methods:

• A comparative study involving 133 eyes undergoing extracapsular cataract extraction.
• Eyes were implanted with posterior chamber lenses using either methylcellulose 1% or an air bubble in the anterior chamber.
• Preoperative and postoperative endothelial cell counts were measured at 8-12 weeks.

Main Results:

• Methylcellulose group showed significantly lower mean central endothelial cell loss (8% ± 5.3%) compared to the air bubble group (25.3% ± 14.6%) (P < 0.001).
• No significant differences were observed in postoperative visual acuity, intraocular pressure, or inflammation between the groups.
• Preoperative YAG laser anterior capsulotomy may have contributed to endothelial cell preservation in all cases.

Conclusions:

• Methylcellulose 1% is a superior agent for protecting corneal endothelial cells during cataract surgery compared to an air bubble.
• The use of methylcellulose facilitates lens implantation while minimizing endothelial cell loss.
• Further research may explore the combined effect of methylcellulose and YAG capsulotomy on long-term outcomes.