Comparison of two ophthalmic viscosurgical devices used in phaecoemulsification

Abstract EN

Objective : To compare the effect of two ophthalmic viscosurgical devices OVDs (DisCoVisc, Alcon, Fort Worth, Taxes), and (Appavisc, Appassamy ocular devices PVT.

LTD.), that currently used in Phaecoemulsification cataract surgery and assess the outcome of these substances on the intraocular pressure (IOP), corneal thickness, endothelial cell counts, corneal clarity and initial visual acuity.

Patients and methods : This is a prospective, randomized case series study to compare between two kinds of OVDs used currently in Phaecoemulsification cataract surgery on 40 patients with age range from 55-65 years in the period from June 2009-June 2010, at Al-Jumhory Teaching Hospital, Mosul.

Standard procedure was implemented with intraocular lens implantation (IOL).

Patients were followed up for three months with particular attention to the first six hours to one day to assess the outcome of surgery in terms of intraocular pressure (IOP), corneal thickness, endothelial cell counts, corneal clarity and visual acuity.

Results : The study enrolled 46 patients, and 40 patients completed the study.

There was improvement of visual acuity in all patients.

No significant difference in the IOP between the two groups in the first 6 hours to 1 day post operatively (17.90 ± 2.53) (18.60 ± 2.21), (P = 0.26) and (17.90 ± 2.36) (18.55 ± 2.06), (P = 0.941) for Appavisc and DisCoVisc related groups respectively.

Also there was no difference with regard to both corneal thickness per-operatively and on day one post-operatively and endothelial cell counts (576.5 ± 44.04) (576.0 ± 50.2) (P = 0.974), (665.5 ± 141.9) (670.6 ± 117.1) (P = 0.902) and (2311.73 ± 288) (2359.78 ± 383.2) (P = 0.657), (2021.2 ± 201) (2035.05 ± 377) (P = 0.886) for Appavisc and DisCoVisc related groups respectively.

In Appavisc related group ; four patients had posterior capsular rupture (PCR) and two patients develop grade III corneal edema.

In DisCoVisc related group ; two patients had PCR and no significant corneal edema.

A formal dry vitrectomy done for those developing PCR with successful IOL implantation, and for those developing corneal edema; a frequent instillation of topical corticosteroid was prescribed with improvement of their vision after two weeks post operatively.

Initial visual acuity was better for DisCoVisc related group (0.74 ± 0.21) than for Appavisc related group (0.52 ± 0.29), (P = 0.01).

Conclusion : Both viscoelastics used had no significant effect on the IOP in the first six hours and first postoperative day, as well as pachymetry and endothelial cell counts both preoperatively and on day one postoperatively, however DisCoVisc was superior to Appavisc regarding corneal clarity and hence visual acuity.