Comparative study of a collagen corneal shield and a subconjunctival injection at the end of cataract surgery

To compare the effectiveness of subconjunctival injections and collagen shields in delivering anti-inflammatory agents and antibiotics after cataract surgery, we conducted a prospective study of 61 patients. They were randomly assigned to three groups: subconjunctival injection of gentamicin and dexamethasone; the same route plus a collagen shield without drug; collagen shield soaked in gentamicin and dexamethasone. All subjects had a manual extracapsular cataract extraction with posterior chamber intraocular lens implantation. Eyes were evaluated at the end of surgery and 24 hours later. The collagen shield achieved a progressive effect on pain and a decrease in conjunctival redness after 24 hours. The occurrence of folds in Descemet's membrane was less frequent and aqueous flare less severe than when subconjunctival injections were used. No adverse effect was reported. We conclude that the collagen shield could be a safe, better, noninvasive technique because of its double action of bandage and enhancement of drug penetration.