Endothelial cell loss after cataract phacoemulsification with Healon5 vs. I-Visc Phaco

BACKGROUND: Healon5, the first viscoadaptive agent introduced in ophthalmic surgery, has been judged to be superior to Healon GV in protecting corneal endothelial cells. The purpose of this study was to compare the endothelial protective effects of I-Visc Phaco, a newer viscoadaptive agent, with those of Healon5 in cataract phacoemulsification. METHODS: A total of 96 unselected patients scheduled to undergo cataract surgery at a community-based hospital in St. Catharines, Ont., were assigned to receive I-Visc Phaco. This group was compared with 112 patients who had received Healon5 in a previous study by the author. The technique used to remove the cataract with phacoemulsification and insertion of an intraocular lens was the same in the two groups. Endothelial cell count and corneal thickness were measured preoperatively and 3 and 8 weeks postoperatively with a Konan noncontact specular microscope. One-way analysis of variance was used to analyse the data. RESULTS: Preoperatively there was no statistically significant difference between the Healon5 and I-Visc Phaco groups in age, eye operated, or endothelial cell count or corneal thickness. At 3 weeks there was no significant difference between the two groups in mean endothelial cell count (2110.2 [standard deviation (SD) 529.9] cells/mm2 vs. 2113.5 [SD 566.6] cells/mm2) or mean corneal thickness (586.2 microm [SD 46.73 microm] vs. 583.9 microm [SD 42.23 microm]). Similarly, there was no significant difference between the two groups in mean endothelial cell count (2113.3 [SD 496.6] cells/mm2 vs. 2145.5 [SD 573.1] cells/mm2) or mean corneal thickness (570.9 microm [SD 44.09 microm] vs. 574.4 microm [SD 40.73 microm]) at 8 weeks. INTERPRETATION: Results at 3 and 8 weeks postoperatively indicate that Healon5 and I-Visc Phaco protect the endothelium equally well during cataract phacoemulsification surgery.