Efficacy of collagen shields after extracapsular cataract extraction

The efficacy of presoaked porcine collagen shields was compared with subconjunctivally injected corticosteroids and antibiotics in reducing ocular inflammation after ECCE with IOL implantation, and signs of reduced oxygen delivery to the cornea were assessed. Fifty eyes of fifty patients were recruited. At the end of surgery 25 eyes (group 1) received a 24-h shield presoaked with 0.1% betamethasone disodium phosphate and 0.5% netilmycin. The other 25 eyes (group 2) received 1 mg betamethasone disodium phosphate and 250 mg piperacillin as a subconjunctival injection. The eyes were then taped closed. Inflammatory parameters (anterior chamber flare, fibrin, folds of Descemet's membrane, corneal edema) and tolerability of the delivery system (pain, itching) were evaluated 24 h after surgery. None of the patients lost the shield and the collagen devices were well tolerated. Groups 1 and 2 showed no significant differences in the parameters considered. There was, however, transient, slight diffuse superficial corneal edema in 24% of group 1 and 4% of group 2, raising the question of inadequate oxygen transmission through collagen shields under closed lids. The results suggest that collagen shields used with the right solution have no significant adverse effect and may be a less invasive alternative to subconjunctival injection.